Assessment of childhood listening difficulties (Moore et al., 2025)

Purpose: Listening difficulty (LiD), often classified as auditory processing disorder (APD), has been studied in both research and clinic settings. The aim of this study was to examine the predictive relation between these two settings. In our SICLiD (Sensitive Indicators of Childhood Listening Difficulties) research study, children with normal audiometry, but caregiver-reported LiD, performed poorly on both listening and cognitive tests. Here, we examined results of clinical assessments and interventions for these children in relation to research performance.Method: Study setting was a tertiary pediatric hospital. Electronic medical records were reviewed for 64 children aged 6–13 years recruited into a SICLiD LiD group based on a caregiver report (Evaluation of Children’s Listening and Processing Skill [ECLiPS]). The review focused on clinical assessments and interventions provided by audiology, occupational therapy, psychology (developmental and behavioral pediatrics), and speech-language pathology services, prior to study participation. Descriptive statistics on clinical encounters, identified conditions, and interventions were compared with quantitative, standardized performance on research tests. z scores were compared for participants with and without each clinical condition using univariate and logistic prediction analyses.Results: Overall, 24 clinical categories related to LiD, including APD, were identified. Common conditions were Attention (32%), Language (28%), Hearing (18%), Anxiety (16%), and Autism Spectrum Disorder (6%). Performance on research tests varied significantly between providers, conditions, and interventions. Quantitative research data combined with caregiver reports provided reliable predictions of all clinical conditions except APD. Significant correlations in individual tests were scarce but included the SCAN Composite score, which predicted clinical language and attention difficulties, but not APD diagnoses.Conclusions: The variety of disciplines, assessments, conditions, and interventions revealed here supports previous studies showing that LiD is a multifaceted problem of neurodevelopment. Comparisons between clinical- and research-based assessments suggest a path that prioritizes caregiver reports and selected psychometric tests for screening and diagnostic purposes.Supplemental Material S1. Assessment codes allocated to electronic medical records (EMR; Epic) and the number of children receiving each code (Cases). All Hospital divisions.Supplemental Material S2. Summary assessments (from codes in Supplemental Material S1).Supplemental Material S3. Speech/Language Pathology Intervention codes. Here, and in Supplemental Materials S4–S6, the types of intervention in the EMR, either recommended or delivered, by each Hospital division, and the number of children receiving each code are listed.Supplemental Material S4. Audiology (see Supplemental Material S3 for further details).Supplemental Material S5. Psychology (see Supplemental Material S3 for further details).Supplemental Material S6. Occupational Therapy (see Supplemental Material S3 for further details).Supplemental Material S7. Summary of interventions and the four most common interventions for each Division.Moore, D. R., Lin, L., Bhalerao, R., Caldwell-Kurtzman, J., & Hunter, L. L. (2025). Multidisciplinary clinical assessment and interventions for childhood listening difficulty and auditory processing disorder: Relation between research findings and clinical practice. Journal of Speech, Language, and Hearing Research, 68(6), 2978–2991. https://doi.org/10.1044/2025_JSLHR-24-00306研究背景与目的：聆听困难（Listening difficulty, LiD），常被归类为听觉处理障碍（Auditory Processing Disorder, APD），已在科研与临床场景中得到广泛研究。本研究旨在探讨这两类场景间的预测关联。在我们的儿童聆听困难敏感指标（Sensitive Indicators of Childhood Listening Difficulties, SICLiD）研究中，听力筛查正常但照料者报告存在聆听困难的儿童，在聆听与认知测试中均表现不佳。本研究旨在分析此类儿童的临床评估与干预结果，及其与科研测试表现的关联。 研究方法：本研究依托一所三级儿童医院开展。我们回顾了64名6~13岁儿童的电子病历，这些儿童均基于照料者报告的儿童聆听与加工技能评估量表（Evaluation of Children’s Listening and Processing Skill, ECLiPS）结果，被纳入SICLiD聆听困难组。回顾内容聚焦于研究入组前，听力学、作业治疗、心理学（发育与行为儿科学方向）以及言语语言病理学服务所提供的临床评估与干预措施。我们将临床就诊记录、确诊病症与干预措施的描述性统计数据，与科研测试的标准化量化表现进行对比。通过单变量与逻辑回归预测分析，对比存在与不存在各临床病症的受试者的z分数差异。 研究结果：最终共识别出24种与聆听困难相关的临床病症类别，其中包含听觉处理障碍。常见病症依次为注意力障碍（32%）、语言障碍（28%）、听力障碍（18%）、焦虑障碍（16%）与孤独症谱系障碍（6%）。科研测试的表现在不同提供者、病症类型与干预措施间存在显著差异。结合照料者报告的量化科研数据，可对除听觉处理障碍外的所有临床病症进行可靠预测。单项测试间的显著相关性较为少见，其中SCAN综合得分（SCAN Composite score）可预测临床层面的语言与注意力困难，但无法预测听觉处理障碍的诊断。 研究结论：本研究揭示的多学科场景、评估手段、病症类型与干预措施多样性，佐证了此前研究的结论——聆听困难是一种多维度的神经发育问题。对比临床与科研导向的评估结果，本研究提出了一条优先采用照料者报告与选定的心理测量测试用于筛查与诊断的路径。 补充材料S1：分配至电子病历（Electronic Medical Records, EMR；Epic系统）的评估编码及接受各编码的儿童数量（病例数），涵盖医院所有科室。 补充材料S2：基于补充材料S1中编码的汇总评估结果。 补充材料S3：言语语言病理学干预编码。本材料与补充材料S4~S6均列出了各医院科室在电子病历中记录的、被推荐或实际实施的干预类型，以及接受各编码的儿童数量。 补充材料S4：听力学相关内容（详见补充材料S3）。 补充材料S5：心理学相关内容（详见补充材料S3）。 补充材料S6：作业治疗相关内容（详见补充材料S3）。 补充材料S7：干预措施汇总及各科室最常见的4项干预措施。 Moore, D. R., Lin, L., Bhalerao, R., Caldwell-Kurtzman, J., & Hunter, L. L. (2025). 儿童聆听困难与听觉处理障碍的多学科临床评估及干预：科研发现与临床实践的关联. 《言语、语言与听力研究期刊》, 68(6), 2978–2991. https://doi.org/10.1044/2025_JSLHR-24-00306