An innovative approach to the
remediation of Central Auditory
Processing Disorder (CAPD) in children at
Australian Hearing
Karin Gillies1, Sharon Cameron2, Helen Glyde2, Alison King3 and Harvey
Dillon3.
Australian Hearing, Melbourne, Victoria, Australia
National Acoustic Laboratories, Macquarie University, NSW, Australia
3 Australian Hearing, Box Hill, Victoria, Australia
1
2
Audiology Australia Conference, Melbourne, Australia - 2016
Background
Home-based auditory training programs offer a convenient and
cost-effective option for the remediation of specific listening
deficits that come under the Central Auditory Processing
Disorder (CAPD) umbrella.
Two such programs are:
• LiSN & Learn for children with spatial processing disorder
(Cameron & Dillon 2011, Cameron et al. 2012)
• Memory Booster for children with a verbal memory deficit
(St Clair-Thompson et al 2010)
Intake
questionnaire
Fail
Full
audiogram
Screening audiometry
Mild cond. HL
Pass
LiSN-S High Cue
Discontinue
CAPD testing
<-1 SD
≥-1 SD
Full LiSN-S
Goal setting (COSI-C),
strategies &
recommendations re
L&L / FM
Fail SPD
Fail LC or Pass
Number Memory Forward & Number Memory Reversed
Goal setting (COSI-C),
strategies & recommendations
re MB / FM
Fail
Pass
Goal setting (COSI-C),
strategies &
recommendations re FM
Dichotic Digits
Clinical population
Auditory
training
program
Number of
children
Age range
LiSN & Learn
69
6:0 to 13:0
Memory
Booster
52
6:1 to 13:3
Methods
Auditory
training
program
Home-based
training regime
Remote clinical
Post-training
support during
evaluation
training
Email progress
2 games a day, 5
Repeat LiSN S,
LiSN & Learn
report end of
days a week,
review COSI-C
st
th
th
1 , 5 and 10
over 10 weeks
and Teacher LIFE
weeks
20 minutes of
Email progress
Repeat NMF/
Memory
training a day, 5
report
NMR, review
Booster
days a week,
end of 1st, 4th
COSI-C and
over 8 weeks
and 8th weeks
Teacher LIFE
L&L
The child listens to the target sentence
with competing speech at ± 90O under
headphones and selects one of 4 pictures
on the screen
MB
The child is taught memory strategies and
listens to the target phrase and selects
from the pictures on the screen
The program adapts in difficulty
Rewards are incorporated into the software program
Results
Completion of the LiSN &Learn (N=69)
training completed
3
2
2 2
unknown
lost contact with family
7
training ongoing
family declined follow up appointment
12
41
training not completed due to health
problems
training not completed due to software
problems
Results
Completion of the Memory Booster (N=52)
3
training completed
2
5
lost contact with family
unknown
11
31
training not completed
due to family reasons
training ongoing
Results
Time to complete training program
Auditory
training
program
Expected time Actual time to complete
to complete
training
training
Average
Range
L&L (N=40)
10 weeks
20.2 weeks
10.7 – 43.6 weeks
MB (N=30)
8 weeks
16.3 weeks
7.8 – 36.1 weeks
Results
Post-training evaluation for LiSN S (N=33)
• Significant improvements on all spatially-separated conditions of
LiSN-S (high cue SRT, spatial, total advantage; each p < 0.00001)
and on low cue SRT (p < 0.0005).
• 27 (82%) children showed normal results on the LiSN-S test.
• 30 (91%) children showed an improvement on the LiSN S test.
• 30 (91%) children reported real-life improvement on the COSI-C.
• 15 LIFE questionnaires were returned. The mean score was 19
(range -1 to 35).
Results
Post-training evaluation for NMF/ NMR (N=30)
•
Significant improvement on both mean scaled score of NMF (n=17*, p=0.003)
and NMR (n=18*, p=0.002).
•
11 children (65%) were within the normal range and 14 children (82%) showed
improvement post-training on the NMF.
•
11 children (61%) were within the normal range and 14 children (78%) showed
improvement post-training on the NMR.
•
22 out of 26 children (85%) reported real life improvements on the COSI-C.
•
12 LIFE questionnaires were returned. The mean score was 15 (range -2 to 32).
* results incl. only for children who failed that test pre-training
Summary
•
Post-training evaluation showed significant
improvement on diagnostic assessment results and on
real life outcomes measures.
•
Of the children who undertook to complete a homebased auditory training program, 60% completed their
program.
•
A small number of children abandoned training
because of technical, family or health issues.
•
Outcomes could not be verified for all families.
Conclusions
•
Home-based auditory training programs can be an
effective option for the remediation of specific
listening deficits in a clinical CAPD service.
•
Factors for successful completion of training are:
o
identifying and addressing technical, family or
health issues that may delay or disrupt training
o
providing strategies to keep the child motivated to
continue the training
o
maintaining contact with families whose children
commence training
New developments
•
In March 2016, LiSN & Learn
was superseded by Sound
Storm
•
Sound Storm is an app for
iPads that uses the same
auditory training stimuli and
adaptive algorithms, set in a
more engaging space fantasy
game
References
Cameron, S., Glyde, H., Dillon, H., King, A., & Gillies, K. (2015). Results from a national
central auditory processing disorder service: A "real world" assessment of diagnostic
practices and remediation for CAPD. Seminars in Hearing, 36 (4), 216-236.
Cameron, S., Glyde, H. & Dillon, H. (2012). Efficacy of the LiSN & Learn auditory training
software: Randomized blinded controlled study. Audiology Research, 2:e15.
Cameron, S., & Dillon, H. (2011). Development and Evaluation of the LiSN & Learn
Auditory Training Software for Deficit-Specific Remediation of Binaural Processing
Deficits in Children: Preliminary Findings. Journal of the American Academy of
Audiology, 22(10), 678-696.
St Clair-Thompson, H., Stevens, R., Hunt, A., & Bolder, E. (2010) Improving children’s
working memory and classroom performance. Educational Psychology, 30, 203-219.
Thank you for listening
For more information:
http://www.hearing.com.au
http://capd.nal.gov.au