Relationships between hearing, auditory processing, and communication in children diagnosed with auditory neuropathy spectrum disorder

Objectives: The objectives of this study were to evaluate the relationships between auditory processing, speech discrimination, and listening and communication abilities in children diagnosed with auditory neuropathy spectrum disorder (ANSD) compared to those with normal hearing.

Methods: This was a case-control study involving seventeen participants with a diagnosis of ANSD who used spoken language as their primary mode of communication and wore hearing aids or were unaided and 21 normally hearing controls. All underwent a battery of behavioural measures of hearing, speech perception and auditory processing skills. Their parents filled in a series of questionnaires to evaluate listening and communication abilities. Group differences were evaluated, and hierarchical linear regression was carried out to assess the extent to which auditory measures predicted parent report scores.

Results: Slow-rate amplitude modulation detection (AMD) was an important predictor of listening and communication abilities over and above the pure-tone audiogram in children diagnosed with ANSD. There was a significant relationship between the pure-tone audiogram and the ability to discriminate speech in quiet but not in noise. Children in the ANSD group had more difficulty completing tests of auditory processing ability or performed significantly more poorly than the control group for most tasks.

Conclusions: This study confirms that outcomes for children diagnosed with ANSD are heterogeneous, and provides new information about real world listening and communication abilities. These findings will be useful for clinicians counselling families of newly diagnosed infants and providing management for children with a diagnosis of ANSD.