Auditory Processing Disorders: Navigating the Diagnostic Maze of Central Hearing Losses

Background: Auditory Processing Disorder (APD) manifests as impaired auditory information processing despite normal peripheral hearing. Current clinical protocols lack standardization, hampering evidence-based intervention development. Objective: This review analyzes APD research developments from 2011 to 2025, examining diagnostic criteria, assessment protocols, and treatment effectiveness. Methods: Medline, Embase, Scopus, and Cochrane Library databases were analyzed (January 2011-January 2025), following PRISMA guidelines. Two reviewers independently screened 413 articles, with 156 meeting inclusion criteria. Analysis included chi-square tests for intervention distribution and t-tests for diagnostic comparisons (α = 0.05). Results: Among 156 studies analyzed, medical interventions were markedly underrepresented (n = 4) compared to rehabilitative approaches (n = 52; χ² = 50.28, p < 0.001). The Random Gap Detection Test and Dichotic Digits Difference Test were most frequently used (12.86% and 10.48% of studies, respectively). Cognitive skill enhancement dominated intervention strategies (52.8%), followed by computer-based rehabilitation (26.4%). Publication frequency showed consistent annual growth, peaking at 57 studies in 2024. Sample sizes were comparable between APD and CAPD studies (mean difference = 4.2 cases, t = 0.416, p = 0.679). Environmental modifications appeared in 15.1% of interventions, while speech therapy was reported in only 3.8% of studies. Conclusions: The substantial imbalance between medical and rehabilitative interventions necessitates standardized diagnostic protocols and enhanced multidisciplinary collaboration. Implementation of a hierarchical processing framework is recommended for assessment and treatment. Future research should prioritize large-scale controlled trials and unified diagnostic criteria development.