What is the typical referral criteria for a child suspected of having an auditory processing disorder?
The referral criteria, as taken from senior audiologist, Dr. Susan Eichert (2010) from Cincinnati Children’s Hospital and Medical Center are as follows. The child should have normal peripheral hearing sensitivity. If a child has a sensorineural hearing loss, they will have auditory processing problems. That is not the same as a child with normal peripheral hearing that is then exhibiting those issues. For them to actually give a diagnosis of auditory processing disorder, and even for the referral criteria to be matched with an audiologist who specializes in this area, they must find that there is normal peripheral hearing sensitivity.
Secondly, the child must be at least seven to eight years of age. There are some hospitals in the country that might see children younger than this but our hospital requires the child to be at least seven years old.
In addition, the child must be able to understand language and be able to communicate orally. Therefore, a child who has a significant articulation disorder - meaning they are totally unintelligible - or has very, very severe apraxia will not be good a candidate to have an auditory processing test battery run by audiology. The child must have intelligible speech or there is no way for the audiologist to determine what the child has heard. They are relying on the child’s verbal expression, and if they cannot understand the child, they cannot appropriately determine if the child gave the right answer or not.
Additionally, the child must be able to tolerate wearing headphones for at least one hour. That can be difficult. At Cincinnati Children’s, the children’s primary language must be English. I am told that there are some different things going on from the evaluation standpoint in California. I think that is because they may have more Spanish native speakers there. But at Cincinnati Children’s, English must be the primary language. These are the main criteria for referring a child to audiology for a suspected auditory processing disorder.
Martha Coen-Cummings, PhD, CCC-S has worked at Cincinnati Children's Hospital for over 25 years. She is the Coordinator of the Mason location Speech-Language Pathology department, was nominated in 2010 for the hospital's Woman of the Year award, and in 2014 nominated for the Cincinnati Enquirer's Woman of the Year award. Her main clinical specialty areas of voice disorders and treatment of auditory processing disorders have led to numerous presentations at the local, state, national, and inter-national levels.