Opinion | April 2018 Hearing Review
As with any branch of auditory science, research on CAPD continues to be pursued in many different areas. However, there is robust scientific evidence pertaining to the clinical existence, diagnosis, and treatment of CAPD. This short article provides a literature review for what might be viewed as six key tenets related to CAPD.
There is widespread agreement among audiologists and our professional associations regarding the validity of the diagnosis of central auditory processing disorder (CAPD), the sensitivity of the diagnostic battery used to identify the disorder, and the efficacy of treatment for CAPD. This paper provides the evidence base for audiologists’ agreement supporting the clinical existence of CAPD, including the diagnosis and treatment of this disorder.
Musiek et al1 and Moncrieff2 provided substantial evidence that audiologists recognize the importance of assessment of the central auditory system to fully evaluate auditory or hearing function. The American Medical Association (AMA) has recognized the validity and clinical utility of CAPD by including it as a diagnosis code in the ICD-10. This ICD-10 code (H93.25) is recognized by Medicare, and the US Department of Veterans Affairs recognizes this code for testing and treatment. The Ninth Circuit Court of Appeals recently designated CAPD as an “Other Health Impairment” (OHI) under The Individuals with Disabilities Education Act (IDEA) and audiologists were named as qualified providers to diagnose CAPD.3,4 The Canadian Supreme Court in Pitcher v. Brown (2015)5 recognized CAPD as a valid clinical entity, despite arguments to the contrary.
Diagnosis and treatment of CAPD falls in the audiology scope of practice.6 While the scientific process within our profession continues to improve the evaluation and treatment of CAPD, most audiologists concur on the following points based on extensive, peer-reviewed published evidence, our collective practice-based clinical experience, and the positions of our major professional organizations:
1) The auditory sensori-perceptual system is comprised of the peripheral and central systems. These systems are interdependent, influencing each other.
2) Auditory signals are transformed into neural impulses. Auditory processing refers to the mechanisms which establish the neural code. These mechanisms preserve, refine, analyze, modify, organize, and interpret or process the input from the auditory periphery along intensity, frequency, and time domains.
3) Central auditory processing is fundamental to listening, which is a key process underlying communication and learning.
4) Treatment for deficit-specific weaknesses of central auditory processing has been shown to be effective.
5) Patients seek funding for CAPD evaluation and treatment. There is ample evidence to demonstrate that diagnosis of CAPD is sensitive and specific using available tests and procedures and that intervention for CAPD is efficacious.
6) Audiologists support serving patients with CAPD.
1) The auditory sensori-perceptual system is comprised of a peripheral and a central system. These systems are interdependent, influencing each other. Central auditory processing disorder has also been known as auditory processing disorder (APD), a term that acknowledges the interaction between the periphery and the central auditory systems.7-9 We use the term “CAPD” because CAPD reflects the origins of the disorder in the central nervous system and this is the term listed in the ICD-10 diagnosis codes. Audiologists recognize that CAPD is a term that involves multiple subprocesses and that deficit-specific identification and treatment is optimal to effectively and efficiently provide intervention for CAPD.
The peripheral and central auditory systems have been described with regards to anatomic site and function.10-13 The processing deficits of the central auditory system have been validated in animals and humans with confirmed neurological lesions.14-19 For example, damage to both auditory cortices can render a person totally deaf even when the cochleae are intact.20
CAPD is seen in persons with listening and learning difficulties with neurological lesions beyond the cochlea.10,14 These patients have specific difficulties with some mechanism of the auditory system used to analyze sound. Central auditory processing deficits have been identified in persons who have experienced, for example, traumatic brain injury (TBI) via blast exposure, motor vehicle accidents, strokes, sports- or accident-related concussions, and neurodegenerative diseases.21-29
CAPD also is identified in children who have listening, reading, learning, and language difficulties with no specific site of central pathology identified.30-55 These children are inferred to have more diffuse neuroanatomic abnormalities.56 Children with listening difficulties also frequently present comorbid learning difficulties, as well as ADHD, language, and reading problems.46,51,53,57-59 These comorbidities are not unexpected given the extensive organization of the auditory system which shares neural substrate and processing with other domains.60 This organization underlies both comorbid presentations, as well as interactions between sensory and cognitive systems.61-68 For example, reading is known to be auditory based, and many persons with CAPD have reading difficulties.31,32,34,36,37,40,41,43,45,54,55,69-71
As is true for any medical science, considerable audiologic efforts are continually invested in refining and expanding the evaluation and treatment of CAPD. Challenges to aspects of CAPD72,73 have been countered with extensive evidence.3,4 Accumulated clinical and basic evidence supports the validity and utility of the CAPD diagnosis. Audiologists are uniquely qualified to identify and treat CAPD, and we are the appropriate professionals to help patients with CAPD. As a profession, we recognize the remarkable complexity and interaction among audition, language, attention, and cognition.
2) Auditory signals are transformed into neural impulses. There are central mechanisms that process the input from the auditory periphery along intensity, frequency, and time domains. Central auditory processing refers to the brain’s essential function to decode patterns of electrical impulses critical to our ability to communicate effectively in our everyday environment. Noted auditory neuroscientist Nina Kraus, PhD, explained that the currency of the central auditory system is electrical impulses.74 The brain is the banker of this currency. Neural impulses give rise to a host of auditory processes: detection, localization, discrimination, temporal ordering, temporal resolution, temporal sequencing, binaural integration, binaural separation, spatial stream segregation, and auditory closure. These processes can be assessed and deficits identified using sensitive and specific tests and procedures.75 Perhaps the most well-known example is dichotic listening, which has been well-substantiated in the literature to identify hemispheric and inter-hemispheric processing deficits. The evidence that dichotic listening procedures can identify deficits in the central auditory pathways has been demonstrated by researchers across the world using a variety of languages.14,49,55,76-78
3) Central auditory processing is fundamental to listening. Listening is a key process by which we learn. Children need to hear and interpret sound in order to develop spoken language and succeed academically.33,35-37,79 Barker et al34 demonstrated electrophysiologically and behaviorally that intact central auditory function is fundamental for reading development. Auditory training has been an effective tool for people with deficits in detection (hearing loss) for over 100 years. Auditory training for persons with CAPD is also effective.39,42,46,51-53,58,70,71,80-86 A minimal level of intelligence, attention, and motivation underlies the success of any behavioral training program, including auditory training.32,36,42,87-89
Central auditory processing is fundamental to effective listening. CAPD and listening difficulties are frequently linked to learning deficits. Therefore, it is essential that audiologists identify and develop treatment plans for CAPD. Early diagnosis and treatment for CAPD may prevent, or at least minimize, its detrimental effects on listening, learning, language processing, and reading.
4) Treatment for central auditory processing deficits is shown to be effective. CAPD can be evaluated behaviorally, with treatment outcomes measured both behaviorally and electrophysiologically. In the United States, behavioral assessments follow the American Academy of Audiology (2010) guidelines75 which note that treatment for CAPD should be deficit-specific. There is an established body of evidence that CAPD can be ameliorated by remote microphone technology and/or auditory training, including some research with blinded, randomized controlled trials.12,24,28,39,79,81-83,90-101 Treatment can improve processing efficiency and listening. Improved listening can lead to better learning. Behavioral and electrophysiologic evidence demonstrates the effectiveness of both auditory training and/or remote microphone technology.79,80,84-86,97,102-113
5) Patients seek evaluation and treatment for CAPD. There is ample evidence to demonstrate that diagnosis of CAPD is sensitive and specific using available tests and procedures and that intervention for CAPD is efficacious. CAPD limits the ability to listen, read,32,98,106 communicate, and learn, and it adversely impacts the lives of special-needs children, veterans, seniors, and other patients who have TBI, cerebral vascular accidents, and other neuro-auditory disorders (eg, degenerative diseases) that underlie CAPD.
6) Audiologists support serving patients with CAPD. The advancement of science and debate among audiologists should not be misconstrued as justification to ignore our patients, or as a basis to label CAPD as “investigative.” While research will continue to improve diagnostic procedures and treatment approaches—as is true in all clinical fields—the current evidence base provides ample foundation to support audiologists who are dedicated to helping those with CAPD. CAPD is a valid clinical disorder, and providers such as insurers and schools should recognize the preponderance of evidence, as shown in this article, for supplying appropriate services to our patients.
As the experts in the diagnosis and treatment of CAPD, audiologists are bound to follow their code of ethical practice by serving the patient population with CAPD. To deny patients appropriate evidence-based intervention for CAPD harms them. As a profession, we strive to obtain the highest level of evidence for CAPD identification and remediation. The references found in the online version of this article delineate a rich body of evidence supporting the validity and clinical utility of CAPD and current best practices that provide effective treatments which mitigate the impact of CAPD.
Correspondence can be addressed to Dr Abramson at: [email protected]
Biography: Maria Abramson, AuD, has 30 years of experience in clinical practice with both adults and children and is the owner of Hear Now in Laguna Niguel, Calif; Deborah Moncrieff, PhD, is an Assistant Professor and Director of the Auditory Neurophysiology Laboratory at the University of Pittsburgh; Gail Chermak, PhD, is Professor of Audiology and Chair of the Department of Speech and Hearing Sciences, Elson S. Floyd College of Medicine, at Washington State University Health Sciences in Spokane, Wash; Frank Musiek, PhD, is a Professor in the Department of Speech, Language, Hearing Sciences at the University of Arizona; Donna Geffner, PhD, is dually certified and licensed as an audiologist and speech-language pathologist and maintains a private practice in Long Island, NY, and Lisa Guillory, AuD, is an audiologist at the Harry S. Truman Memorial Veterans’ Hospital in Columbia, Mo.
Original citation for this article: Abramson M, Moncrieff D, Chermak G, Musiek F, Geffner D, Guillory L. Six points of audiological consensus on central auditory processing disorders (CAPD). Hearing Review. 2018;25(4):38-40.
Musiek FE, Shinn J, Chermak GD, Bamiou D-E. Perspectives on the pure-tone audiogram. J Am Acad Audiol. 2017;28(7)[July/Aug]:655-671.
Moncrieff D. Response to de Wit, et al., 2016, “Characteristics of Auditory Processing Disorders: A Systematic Review.” J Sp Lang Hear Res. 2017;60[May]:1448-1450.
McCarty J, Lynch G, Richburg C. A new era in CAPD service delivery: Changes in IDEA eligiblity, ICD-10, coverage, and payment. Talk presented at: 2014 American Speech-Language-Hearing Association (ASHA) Convention; November 2014; Orlando, FL.
McCarty, J. A Boost for Central Auditory Processing Disorder Services. ASHA Leader. 2014;19. Available at: https://leader.pubs.asha.org/article.aspx?articleid=1901961
Pitcher v. Brown, 2015 BCSC 1019 (Supreme Court of British Columbia April 21, 2015).
American Speech-Language-Hearing Association (ASHA). Speech-Language Pathology Medical Review Guidelines. http://www.asha.org/uploadedfiles/slp-medical-review-guidelines.pdf. Published 2015.
Working Group on Auditory Processing Disorders, American Speech-Language-Hearing Association (ASHA). (Central) Auditory Processing Disorders (Technical Report). http://www.ak-aw.de/sites/default/files/2016-12/ASHA_CAPD_2005.pdf. Published 2005.
Jerger J, Musiek, F. Report of the consensus conference on the diagnosis of auditory processing disorders in school-aged children. J Am Acad Audiol. 2000;11: 467-474.
Johnson M, Bellis T, Billet C. Audiologic assessment of (C)APD. In: Geffner D, Ross-Swain, D. Auditory Processing Disorders: Assessment, Management, and Treatment. 2nd ed. San Diego, CA: Plural Publishing; 2012.
Boscariol M, Garcia, VL II, Guimarães III CA, et al. Auditory processing disorders in twins with perisylvian polymicrogyria. Arq. Neuro-Psiquiatr. 2009;67(2-B)[June]:499-501.
Musiek FE, Baran JA. The Auditory System: Anatomy, Physiology, and Clinical Correlates. 1st ed. San Diego, CA: Plural Publishing;2016.
Musiek F, Chermak G, Weihing, J. Auditory Training. In: Chermak GD, Musiek FE, eds. Handbook of Central Auditory Processing Disorder Comprehensive Intervention Volume 2. 2nd ed. San Diego, CA: Plural Publishing;2013.
International Association of Logopedics and Phoniatrics website. http://www.ialp.info. Accessed July 10, 2016.
Boscariol M, Garcia VL, Guimarães C, et al. Auditory processing disorder in perisylvian syndrome. Brain & Development. 2010;32(4):299-304.
Knight RT, Hillyard SA, Woods DL, Neville HJ. The effects of frontal and temporal-parietal lesions on the auditory evoked potential in man. Electroencephalography and Clinical Neurophysiology. 1980;50(1-2)[October]:112-124.
Musiek FE, Chermak GD, Weihing J, Zappulla M, Nagle S. Diagnostic accuracy of established central auditory processing test batteries in patients with documented brain lesions. Journal of the American Academy of Audiology. 2011;22(6)[June]:342-358.
Shinn JB, Musiek FE. The auditory steady state response in individuals with neurological insult of the central auditory nervous system. Journal of the American Academy of Audiology. 2007;18(10):826-845.
Woods DL, Knight RT, Neville HJ. Bitemporal lesions dissociate auditory evoked potentials and perception. Electroencephalography and Clinical Neurophysiology. 1984;57(3)[March]:208-220.
Woods DL, Clayworth CC, Knight RT, Simpson GV, Naeser MA. Generators of middle- and long-latency auditory evoked potentials: implications from studies of patients with bitemporal lesions. Electroencephalograhpy and Clinical Neurophysiology/Evoked Potentials Section.1987;68(2)[March]:132-148.
Hood LJ, Berlin CI, Allen P. Cortical deafness: a longitudinal study. J Am Acad Audiolo. 1994;5(5)[September]:330-342.
Bamiou D-E, Werring D, Cox K, et al. Patient-reported auditory functions after stroke of the central auditory pathway. Stroke. 2012;43[May]:1285-1289.
Fausti SA, Wilmington DJ, Gallun FJ, Myers PJ, Henry JA. Auditory and vestibular dysfunction associated with blast-related traumatic brain injury. The Journal of Rehabilitation Research and Development.2009;46(6):797-810.
Flood GM, Dumas HM, Haley SM. Central auditory processing and social functioning following brain injury in children. Brain Injury. 2005;19(12):1019-1026.
Gallun FJ, Diedesch, AC, Kubli, LR, et al. Performance on tests of central auditory processing by individuals exposed to high-intensity blasts. Journal of Rehabilitation Research and Development. 2012;49(7)[November]:1005-1024.
Gallun FJ, Lewis MS, Folmer RL, et al. Implications of blast exposure for central auditory function: A review. Journal of Rehabilitation Research and Development. 2012;49(7)[November]:1059-1074.
Lew HL, Lee EH, Pan SS, Date ES. Electrophysiologic abnormalities of auditory and visual information processing in patients with traumatic brain injury. American Journal of Physical Medicine & Rehabilitation. 2004;83(6)[June]:428-433.
Sarno S, Erasmus L-P, Frey M, Lippert G, Lipp B. Electrophysiological correlates of active and passive attentional states after severe traumatic brain injury. Functional Neurology. 2006;21(1):21-29.
Saunders GH, Echt, KV. Blast exposure and dual sensory impairment: An evidence review and integrated rehabilitation approach. Journal of Rehabilitation and Research and Development. 2012;49(7)[November]:1043-1058.
Tate DF, York GE, Reid MW, et al. Preliminary findings of cortical thickness abnormalities in blast injured service members and their relationship to clinical findings. Brain Imaging and Behavior. 2014;8(1)[March]:102-109.
Ahissar M, Protopapas A, Reid M, Merzenich MM. Auditory processing parallels reading abilities in adults. Proc Natl Acad Sci USA. 2000;97(12)[June]:6832-6837.
Amitay S, Ben-Yehudah G, Banai K, Ahissar M. Disabled readers suffer from visual and auditory impairments but not from a specific magnocellular deficit. Brain. 2002;125(Pt 10):2272-2285.
Barker MD, Kuruvilla-Mathew A, Purdy SC. Cortical auditory-evoked potential and behavioral evidence for differences in auditory processing between good and poor readers. J Am Acad Audiol. 2017;28(6)[June]:534-545.
Bailey PJ, Snowling MJ. Auditory processing and the development of language and literacy. Br Med Bull. 2002;63(1):135-146.
Banai K, Ahissar M. On the importance of anchoring and the consequences of its impairment in dyslexia. Dyslexia. 2010;16(3)[August]:240-257.
Benasich AA, Tallal P. Infant discrimination of rapid auditory cues predicts later language impairment. Behav Brain Res. 2002;136:31-49.
Boets B, Vandermosten M, Poelmans H, Luts H, Wouters J, Ghesquière P. Preschool impairments in auditory processing and speech perception uniquely predict future reading problems. Res Dev Disabil. 2011;32:560-570.
Boets B, Wouters J, van Wieringen A, De Smedt BG, Ghesquière P. Modelling relations between sensory processing, speech perception, orthographic and phonological ability, and literacy achievement. Brain Lang. 2008;106:29-40.
Cameron S, Dillon H. The Listening in Spatialized Noise-Sentences Test(LISN-S): Comparison to the prototype LISN and results from children with either a suspected (central) auditory processing disorder or a confirmed language disorder. J Am Acad Audiol. 2008;19:377-391.
Carcagno S, Plack CJ. Subcortical plasticity following perceptual learning in a pitch discrimination task. J Assoc Res Otolaryngol. 2011;12(1)[February]:89-100.
Corriveau K, Goswami U, Thomson JM. Auditory processing and early literacy skills in a preschool and kindergarten population. J Learn Disabil. 2010;43(4):369-382.
Foxton JM, Talcott JB, Witton C, Brace H, McIntyre F, Griffiths TD. Reading skills are related to global, but not local, acoustic pattern perception. Nat Neurosci. 2003; 6(4)[April]:343-344.
Kleindienst L, Musiek F. Do frequency discrimination deficits lead to specific language impairments? The Hearing Journal. 2011;4(64):10-11.
Kraus N, Anderson, S. For reading development, auditory processing is fundamental. The Hearing Journal. 2013;66(9)[September]:40.
Kujala T, Kuuluvainen S, Saalasti S, Jansson-Verkasalo E, von Wendt L, Lepistö T. Speech-feature discrimination in children with Asperger syndrome as determined with the multi-feature mismatch negativity paradigm. Clin Neurophysiol. 2010;121(9)[September]:1410-1419.
Maclean M, Bryant P, Bradley L. Rhymes, nursery rhymes, and reading in early childhood. Merrill Palmer Q. 1987;33(3)[July]:255-281.
McArthur GM, Bishop DVM. Frequency discrimination deficits in people with specific language impairment: Reliability, validity, and linguistic correlates. J Speech Lang Hear Res. 2004;47[June]:527-541.
Moncrieff DW, Black JR. Dichotic listening deficits in children with dyslexia. Dyslexia. 2007;14(1):54-75.
Moncrieff DW, Musiek FE. Interaural asymmetries revealed by dichotic listening tests in normal and dyslexic children. J Am Acad Audiol. 2002;13(8)[September]:428-437.
Moncrieff D, Keith W, Abramson M, Swann A. Diagnosis of amblyaudia, in children referred for auditory processing assessment. Int J Audiol. 2016;55(6):333-345.
Neijenhuis K, Snik A, van den Broek P, Neijenhuis K. Auditory processing disorders in adults and children: Evaluation of a test battery. Int J Audiol. 2003;42(7): 391-400.
Nickisch A, Massinger C. Auditory processing in children with specific language impairments: Are there deficits in frequency discrimination, temporal auditory processing or general auditory processing? Folia Phoniatrica et Logopaedica. 2009; 61:323-328.
Rinker T, Kohls G, Richter C, Maas V, Schulz E, Schecker M. Abnormal frequency discrimination in children with SLI as indexed by mismatch negativity (MMN). Neuroscience Letters. 2007;413(2)[February]:99-104.
Sharma M, Purdy SC, Kelly AS. Comorbidity of auditory processing, language, and reading disorders. Journal Speech, Lang, Hear Res. 2009;52[June]:706-722.
Tallal P. Improving language and literacy is a matter of time. Nat Reviews Neurosci. 2004; 5:721–728.
Tallal P, Fitch RH. Central auditory processing and language learning impairments: Implications for neuroplasticity research. In: Syka J, Merzenich MM, eds. Plasticity and Signal Representation in the Auditory System. Boston, MA:Springer Science and Business Media; 2005.
Chermak GD, Musiek FE. Neurological substrate of central auditory processing deficits in children. Current Pediatric Reviews. 2011;7(3):241-251.
Glydenkaerne P, Dillon H, Sharma M, Purdy SC. Attend to this: The relationship between auditory processing disorders and attention deficits. J Am Acad Audiol. 2014;25(7):676-687.
Sutcliffe PA, Bishop DVM, Houghton S, Taylor M. Effect of attentional state on frequency discrimination: A comparison of children with ADHD on and off medication. J Speech, Lang, Hear Res. 2006;49[October]:1072-1084.
Tomlin D, Dillon H, Sharma M, Rance G. The impact of auditory processing and cognitive abilities in children. Ear and Hearing. 2015;36(5):527-542.
60.Musiek FE, Bellis TJ, Chermak GD. Nonmodularity of the central auditory nervous system: implications for (central) auditory processing disorder. Am J Audiol. 2005;14[December]:128-138.
61. Bayazit O, Öniz A, Hahn C, Güntürkün O, Özgören M. Dichotic listening revisited: Trial-by-trial ERP analyses reveal intra- and interhemispheric differences. Neuropsychologia. 2009;47(2)[January]:536-545.
62. Buschman TJ, Miller EK. Top-down versus bottom-up control of attention in the prefrontal and posterior parietal cortices. Science. 2007;315(5820)[March]:1860-1862.
63. Petacchi A, Kaernbach C, Ratnam R, Bower JM. Increased activation of the human cerebellum during pitch discrimination: A positron emission tomography (PET) study. Hearing Research. 2011;282(1-2)[December]:35–48.
64. Plakke B, Ng C-W, Poremba A. Neural correlates of auditory recognition memory in primate lateral prefrontal cortex. Neuroscience. 2013; 244(6)[August]:62-76.
65. Poldrack RA, Clark J, Paré-Blagoev EJ, et al. Interactive memory systems in the human brain. Nature. 2001;414[November]:546-550.
66. Poremba A, Saunders RC, Crane AM, Cook M, Sokoloff L, Mishkin M. Functional mapping of the primate auditory system. Science. 2003;299(5606)[January]:568–572.
67. Price C, Thierry G, Griffiths T. Speech-specific auditory processing: Where is it? Trends Cogn Sci. 2005;9(6)[June]:271-276.
68. Wong PCM, Jin JX, Gunasekera GM, Abel R, Lee ER, Dhar S. Aging and cortical mechanisms of speech perception in noise. Neuropsychologia. 2009;47(3)[February]:693–703.
69. Ahissar M, Protopapas A, Reid M, Merzenich MM. Auditory processing parallels reading abilities in adults. Proc Natl Acad Sci USA. 2000 Jun 6;97(12):6832-6837.
70. McAnally KI, Stein JF. Auditory temporal coding in dyslexia. Proc Biol Sci. 1996;263(1373)[August]:961-965.
71. Tallal P, Piercy M. Defects of non-verbal auditory perception in children with developmental aphasia. Nature. 1973;16(241)[February]468-469.
72. Beck DL, Clarke JL, Moore DR. Contemporary issues in auditory processing disorders:2016. Hearing Review. 2016;23(4)[April]:22-27.
73. Vermiglio AJ. On the clinical entity in audiology: (Central) auditory processing and speech recognition in noise disorders. JAAA. 2014;25(9)[October]:904-917.
74. Kraus N. 20Q: Noise, aging and the brain—How experience and training can improve communication. July 8, 2013. Available at: https://www.audiologyonline.com/articles/20q-noise-aging-and-brain-11990
75. American Academy of Audiology (AAA). Clinical Practice Guidelines:Diagnosis, Treatment, and Management of Children and Adults with Central Processing Disorder. https://audiologyweb.s3.amazonaws.com/migrated/CAPD Guidelines 8-2010.pdf_539952af956c79.73897613.pdf. Published August 2010.
76. Hugdahl K, Westerhausen R, Alho K, Medvedev S, Laine M, Hämäläinen H. Attention and cognitive control: Unfolding the dichotic listening story. Scandinavian Journal of Psychology. 2009; 50(1):11-22.
77. Kimura D. Functional asymmetry of the brain in dichotic listening. Cortex. 1967;3(2)[June]:163-178.
78. Bamiou D-E, Musiek FE, Luxon LM. Aetiology and clinical presentations of auditory processing disorders—A review. Arch Dis Child. 2001;85(5):361-365.
79. Moncrieff DW, Wertz D. Auditory rehabilitation for interaural asymmetry: Preliminary evidence of improved dichotic listening performance following intensive training. Int J Audiol. 2008;47(2):84-97.
80. Moncrieff D, Keith W, Abramson M, Swann A. Evidence of binaural integration benefits following ARIA training for children and adolescents diagnosed with amblyaudia. Int J Audiol. 2017;56(8):580-588.
81. Murphy CFB, Schochat E. Effect of nonlinguistic auditory training on phonological and reading skills. Folia Phoniatrica et Logopaedica. 2011;63:147–153.
82. Schäffler T, Sonntag J, Hartnegg K, Fischer B. The effect of practice on low-level auditory discrimination, phonological skills, and spelling in dyslexia. Dyslexia. 2004; 10(2):119–130.
83. Tremblay K, Kraus N, Carrell TD, McGee T. Central auditory system plasticity: Generalization to novel stimuli following listening training. J Acoust Soc Am. 1997; 102(6)[December]:3762-3773.
84. Tremblay KL, Kraus N. Auditory training induces asymmetrical changes in cortical neural activity. Journal of Speech, Language, and Hearing Research. 2002;45[June]:564-572.
85. Tremblay K, Kraus N, McGee T, Ponton C, Otis B. Central auditory plasticity: Changes in the N1-P2 complex after speech-sound training. Ear and Hearing. 2001; 22:79-90.
86. Weihing J, Guenette L, Chermak G, et al. Characteristics of pediatric performance on a test battery commonly used in the diagnosis of central auditory processing disorder. JAAA. 2015;26(7)[July/August]:652-669.
87. Ferguson MA, Moore DR. Auditory processing performance and nonsensory factors in children with specific language impairment or auditory processing disorder. Semin Hear. 2014;35(1):1-14.
88. Spearman C. “General Intelligence,” objectively determined and measured. American Journal of Psychology. 1904;2(15)[April]:201-292.
89. Watson BU. Some relationships between intelligence and auditory discrimination. J Speech, Hear, Res. 1991;34[June]:621-627.
90. Cameron S, Glyde H, Dillon H. Listening in spatialized noise- sentences test (LiSN-S): Normative and retest reliability data for adolescents and adults up to 60 years of age. JAAA. 2011;22(10)[November/December]:697-709.
91. Delhommeau K, Micheyl C, Jouvent R, Collet L. Transfer of learning across durations and ears in auditory frequency discrimination. Percept Psychophys. 2002; 64(3)[April]:426–436.
92. Delhommeau K, Micheyl C, Jouvent R. Generalization of frequency discrimination learning across frequencies and ears: Implications for underlying neural mechanisms in humans. J Assoc Res Otolaryngol. 2005;6(2)[June]:171–179.
93. Dockrell J, Shield B. The impact of sound-field systems on learning and attention in elementary school classrooms. Journal of Speech, Language, and Hearing Research. 2012;55[August]:1163-1176.
94. Foxton JM, Brown ACB, Chambers S, Griffiths TD. Training improves acoustic pattern perception. Current Biology. 2004;14(4)[February]:322-325.
95. Geffner D. Management strategies and sound enhancement. In: Geffner D, Ross-Swain, D. Auditory Processing Disorders: Assessment, Management, and Treatment. 2nd ed. San Diego, CA: Plural Publishing; 2012.
96. Halliday LF, Taylor JL, Edmondson-Jones M, Moore DR. Frequency discrimination learning in children. Journal of the Acoustical Society of America. 2008;123(6):4393-4402.
97. Hornickel J, Zecker SG, Bradlow AR, Kraus N. Assistive listening devices drive neuroplasticity in children with dyslexia. PNAS. 2012;109(41)[October]:16731-16736.
98. Kraus N, Anderson S. For reading development, auditory processing is fundamental. The Hearing Journal. 2013;66(9)[September]:40.
99. Lewis MS, Crandell CC, Valente M, Horn JE. Speech perception in noise: Directional microphones versus frequency modulation (FM) systems. JAAA. 2004;15(6)[June]:426-439.
100. Soderquist DR, Moore MJ. Effect of training on frequency in primary school children. J Aud Res. 1970;10(3):185-192.
101. Weihing J, Chermak GD, Musiek FE. Auditory training for central auditory processing disorder. Seminars in Hearing. 2015;36(4):199-215.
102. Anderson S, Kraus N. Auditory training: Evidence for neural plasticity in older adults. Perspectives on Hearing and Hearing Disorders: Research and Diagnostics. 2013;17[May]:37-57.
103. Cunningham J, Nicol T, King C, Zecker SG, Kraus N. Effects of noise and cue enhancement on neural responses to speech in auditory midbrain, thalamus and cortex. Hearing Research. 2002;169:97-111.
104. Friederichs E, Friederichs P. Electrophysiologic and psycho-acoustic findings following one-ear application of a personal ear-level FM device in children with attention deficit and suspected central auditory processing disorder. Journal of Educational Audiology. 2005;12:31-36.
105. Kraus N. Auditory pathway encoding and neural plasticity in children with learning problems. Audiology & Neurotology. 2001;6:221-227.
106. Kraus N, Hornickel J. Meaningful engagement with sound for strengthening communication skills. In: Geffner D, Ross-Swain D, eds. Auditory Processing Disorders: Assessment, Management and Treatment. 2nd ed. San Diego, CA: Plural Publishing; 2012.
107. Kraus N, White-Schwoch T. Embracing the enigma of auditory processing disorder. The Hearing Journal. 2016;69(8)[August]:40,46.
108. Moncrieff D, Schmithorst V. fMRI outcomes following treatment of amblyaudia. Paper presented at: American Academy of Audiology (AAA) Annual Convention; April 2016; Phoenix, AZ.
109. Russo NM, Nicol TG, Zecker SG, Hayes EA, Kraus N. Auditory training improves neural timing in the human brainstem. Behavioural Brain Research. 2005;156:95-103.
110.Russo NM, Hornickel J, Nicol T, Zecker S, Kraus N. Biological changes in auditory function following training in children with autism spectrum disorders. Behavioral and Brain Functions. 2010;6(60).
111. Song JH, Skoe E, Wong PCM, Kraus N. Plasticity in the adult human auditory brainstem following short-term linguistic training. Journal of Cognitive Neuroscience. 2008;20(10)[October]:1892-1902.
112. Song JH, Skoe E, Banai K, Kraus N. Training to improve hearing speech in noise: Biological mechanisms. Cerebral Cortex. 2012;22(5)[May]:1180-1190.
113. Warrier CM, Johnson KL, Hayes EA, Nicol T, Kraus N. Learning impaired children exhibit timing deficits and training-related improvements in auditory cortical responses to speech in noise. Experimental Brain Research. 2004;157(4):431-441.