Auditory processing disorder and speech perception problems in noise: finding the underlying origin

A hallmark listening problem of individuals presenting with auditory processing disorder (APD) is their poor recognition of speech in noise. The underlying perceptual problem of the listening difficulties in unfavorable listening conditions is unknown. The objective of this article was to demonstrate theoretically how to determine whether the speech recognition problems are related to an auditory dysfunction, a language-based dysfunction, or a combination of both.

Tests such as the Speech Perception in Noise (SPIN) test allow the exploration of the auditory and language-based functions involved in speech perception in noise, which is not possible with most other speech-in-noise tests. Psychometric functions illustrating results from hypothetical groups of individuals with APD on the SPIN test are presented. This approach makes it possible to postulate about the origin of the speech perception problems in noise.

APD is a complex and heterogeneous disorder for which the underlying deficit is currently unclear. Because of their design, SPIN-like tests can potentially be used to identify the nature of the deficits underlying problems with speech perception in noise for this population. A better understanding of the difficulties with speech perception in noise experienced by many listeners with APD should lead to more efficient intervention programs.