The diagnosis and management of auditory processing disorder.

PURPOSE: To provide a personal perspective on auditory processing disorder (APD), with reference to the recent clinical forum on APD and the needs of clinical speech-language pathologists and audiologists.
METHOD: The Medical Research Council-Institute of Hearing Research (MRC-IHR) has been engaged in research into APD and auditory learning for 8 years. This commentary is informed by and describes that and other research.
RESULTS: Currently, APD is ill defined, and training-based interventions appear to have limited effectiveness. However, there remains a huge clinical and caregiver appetite for evidence-based information about children's listening difficulties and how they might be managed. MRC-IHR research suggests that both the problem and the solution revolve around auditory cognition and, in particular, working memory and attention. Children who are poor listeners tend to have a range of cognitive difficulties. But, results of training studies within and beyond auditory science indicate that training primarily influences sustained attention (focus) rather than more basic sensory detection or discrimination.
CONCLUSION: Providing logical and rigorous scientific information on the nature and alleviation of listening difficulties in children should remain a high priority for speech, language, and hearing research. We should be optimistic that collaboration between clinicians and researchers will result in much greater understanding and improved management of listening disorders in the near future.