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