Binaural sensitivity to temporal fine structure and lateralization ability in children with suspected (central) auditory processing disorder.

OBJECTIVE: Previous studies have shown that a subgroup of children with suspected (central) auditory processing disorder (SusCAPD) have insufficient ability to use binaural cues to benefit from spatial processing. Thus, they experience considerable listening difficulties in challenging auditory environments, such as classrooms. Some researchers have also indicated the probable role of binaural temporal fine structure (TFS) in the perceptual segregation of target signal from noise and hence in speech perception in noise. Therefore, in the present study, in order to further investigate the underlying reason for listening problems against background noise in this group of children, their performance was measured using binaural TFS sensitivity test (TFS-LF) as well as behavioral auditory lateralization in noise test, both of which are based on binaural temporal cues processing.

METHODS: Participants in this analytical study included 91 children with normal hearing and no listening problems and 41 children (9-12 years old) with SusCAPD who found it challenging to understand speech in noise. Initially, the ability to use binaural TFS was measured at three frequencies (250, 500 and 750Hz) in both the groups, and the results of preliminary evaluations were compared between normal children and those with SusCAPD who participated in the study. Thereafter, the binaural performance of the 16 children with SusCAPD who had higher thresholds than the normal group at all three frequencies tested in TFS-LF test was examined using the lateralization test in 7 spatial locations.

RESULTS: Total 16 of the 41 children with SusCAPD who participated in this study (39%) showed poor performance on the TFS-LF test at all three frequencies, compared to both normal children and other children in the APD group (p<0.05). Furthermore, children in the APD group with binaural TFS coding deficits at all three frequencies revealed significant differences in the lateralization test results compared to normal children (p<0.05).

CONCLUSION: Findings of the current study demonstrated that one of the underlying causes for the difficulty understanding speech in noisy environments experienced by a subgroup of children with SusCAPD can be the reduced ability to benefit from binaural TFS information. This study also showed that a reduced ability to use binaural TFS cues in the group of children with SusCAPD was accompanied by reduced binaural processing abilities in the lateralization test which also admit the presence of binaural temporal processing deficits in this group of children.