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Characteristics of children with listening difficulties: APD or not?
Introduction: It is not clear for speech-language pathologists and audiologists, which characteristics are typically for children with listening difficulties, and whether auditory processing disorders (APD) can be distinguished from other developmental disorders.While our other studies aim to explore the perspectives of Dutch health professionals and reach consensus regarding characteristics, definition, symptomatology, comorbidity and diagnostics, this study aims to examine the characteristics associated with APD and to determine which characteristics of children with APD overlap with the characteristics of children diagnosed with specific language impairment (SLI), dyslexia, and attention deficit hyperactivity disorder (ADHD).Methods: We conducted two separate systematic reviews to find peer-reviewed studies about the behaviours and performance of children with (suspected) APD. In the first systematic review we included studies reporting the performance of children with (suspected) APD in comparison with typically developing (TD) children. In the second systematic review we included studies reporting the performance of children with APD in comparison with children diagnosed with another developmental disorder, like SLI, dyslexia, and ADHD. In both systematic reviews, two researchers were, independently of each other, responsible for the identification, screening, inclusion, and assessment of the methodological quality of the studies. After each phase the selection and appraisal of the two reviewers was compared during a consensus meeting.Results: After assessing methodological quality, we included 48 studies from 1954 up to May 2015 for the first systematic review and 13 studies for the second systematic review. The overall results showed significant differences between children with (suspected) APD and TD children in auditory and visual functioning, on cognitive, language, and reading tests, and auditory brain measures such as auditory ERP and otoacoustic emissions. Furthermore, children with APD perform equal to children with SLI, dyslexia, ADHD on cognitive and language tests, and only small differences between groups, which are not consistent across studies, were found on auditory, visual and reading tasks.Conclusion: Our results showed that there is no evidence to conclude that APD can be seen as a distinctive clinical disorder. There is a difference between children with (suspected) APD and typically developing children. However, the characteristics of children with APD appear to be similar in many respects to the characteristics of children diagnosed with SLI, dyslexia, and ADHD. Children that are referred with listening difficulties may fail the auditory tests that are involved in the typical diagnosis of APD. However, it is important to realize that the evidence for a specific auditory condition is inadequate. Children with listening difficulties have poorer performance on multiple domains, and share the same characteristics for a part with children diagnosed with other developmental disorders. More research is needed to better understand the different profiles of children with various complaints or disorders.