Auditory Processing and Speech Sound Disorders: Behavioral and Electrophysiological Findings

Background: Children diagnosed with Speech Sound Disorders (SSDs) encounter difficulties in speech perception, especially when listening in the presence of background noise. Recommended protocols for auditory processing evaluation include behavioral linguistic and speech processing tests, as well as objective electrophysiological measures. The present study compared the auditory processing profiles of children with SSD and typically developing (TD) children using a battery of behavioral language and auditory tests combined with auditory evoked responses. Methods: Forty (40) parents of 7-10 years old Greek Cypriot children completed parent questionnaires related to their children's listening; their children completed an assessment comprising language, phonology, auditory processing, and auditory evoked responses. The experimental group included 24 children with a history of SSDs; the control group consisted of 16 TD children. Results: Three factors significantly differentiated SSD from TD children: Factor 1 (auditory processing screening), Factor 5 (phonological awareness), and Factor 13 (Auditory Brainstem Response-ABR wave V latency). Among these, Factor 1 consistently predicted SSD classification both independently and in combined models, indicating strong ecological and diagnostic relevance. This predictive power suggests real-world listening behaviors are central to SSD differentiation. The significant correlation between Factor 5 and Factor 13 may suggest an interaction between auditory processing at the brainstem level and higher-order phonological manipulation. Conclusions: This research underscores the diagnostic significance of integrating behavioral and physiological metrics through dimensional and predictive methodologies. Factor 1, which focuses on authentic listening environments, was identified as the strongest predictor. These results advocate for the inclusion of ecologically valid listening items in the screening for APD. Poor discrimination of speech in noise imposes discrepancies between incoming auditory information and retained phonological representations, which disrupts the implicit processing mechanisms that align auditory input with phonological representations stored in memory. Speech and language pathologists can incorporate pertinent auditory processing assessment findings to identify potential language-processing challenges and formulate more effective therapeutic intervention strategies.