الفهرس 
Auditory processing disordersOnly 14 pages are availabe for public view
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Abstract
APD is defined as a deficit in the perceptual (neural) processing of acoustic stimuli and neuro-biologic activity that underlies those processes (ASHA, 2005a & 2005b). Auditory training is classified into formal and informal programs. Coupling formal and informal auditory training should maximize treatment efficiency (Chermak and Musiek, 2007).
Many researchers evaluated the outcome of auditory training programs proving their efficacy in management of APD. Few of them explored the long term outcome, for periods not exceeding 6 months from the end of therapy. Accordingly, this study was designed to evaluate the long term outcome of auditory training programs in children with APD, and to explore factors affecting such outcome, if any.
Thirty children ranging in age from 7 to 16 1/2 years were included. They were diagnosed with APD and received the proper management at time of diagnosis. They were subjected to long term evaluation either subjective using questionnaire and school performance or objective using the psychophysical central test battery.
All children started AT before the age of 12 years with a mean 8 (±1.8) years. The duration of training in this study ranged from 2 to 18 months with a mean 5.45 (± 3.97) months in the form of 2-3 sessions /week each 30-45 minutes. A statistical significant improvement in the mean total scores of the Arabic questionnaire for CAPD was detected after training. The pre and post remediation psychophysical tests results for the study group showed marked improvement in almost all tests proving the efficacy of training.
The study group children were evaluated for long term outcome after mean duration of 24.5 (±17.5) months following AT with a range of 7-42 months. Comparing the post-remediation and outcome results, showed better or nearly same scores for Arabic questionnaire and the psychophysical tests as the immediate post training evaluation. Statistical significant improvement was obtained in the scores of questionnaire, PPS test, Memory for content and sequence tests. This proved the consistency of the treatment outcome.
There was non significant statistical difference between the subjective and objective measures proving that both are important in follow up. It was proved that the regularity of training has a critical role in the outcome results. The correlation between subjective measures and PPS, GIN tests highlighted the role of temporal processing abilities in monitoring AT programs and its progress.
To exclude the learning effect, the study group was divided according to age into two subgroups with a cut off age 12 years. A new battery was used and comprised Arabic DRT, DPT, and informal memory test. The results obtained when the new test battery pointed to the consistency of the outcome from AT program and excluding any learning effect in the younger age group.
The outcome of the AT program used for children with APD showed long term consistent improvement for periods more than 6 months up to 4 years. The outcome of auditory training was mainly affected by the regularity of therapy. The Arabic questionnaire for APD and the school performance proved to be effective subjective measures for long term follow up. The temporal processing tests “PPS and GIN” were sensitive tools in monitoring the progress of training. The new psychophysical test battery used was as effective as the diagnostic test battery in assessing the long term effects of AT program.
It is recommended to use the AT regularly in training children with CAPD. Serial monitoring for the efficacy of training until stabilization of results and/or reaching the age-based normative data. Finally, the use of auditory electrophysiology tests should be applied when possible during the remediation plan.