Musiek • Chermak 15 An opportunity for readers to have technical questions researched and answered. Clinical Focus ■ Consult Frank E. Musiek Dartmouth-Hitchcock Medical Center, Lebanon, NH Gail D. Chermak Washington State University, Pullman Three Commonly Asked Questions About Central Auditory Processing Disorders: Management 1 A lthough the etiology and nature of central auditory processing disorders (CAPD) remain unresolved (ASHA, 1992; Musiek, Gollegly, & Ross, 1985), performance deficits associated with this complex group of disorders are well docu- mented. Children with CAPD present deficits in auditory perception and auditory-language processing (Katz, 1992; Keith, 1983; Willeford & Burleigh, 1985). In addition to deficits in dichotic listening, selective attention, and temporal processing, children with CAPD often demonstrate reduced auditory memory and sound-blending skills (Butler, 1983; Ferre & Wilber, 1986; Jerger, Johnson, & Loiselle, 1988; Jerger, Martin, & Jerger, 1987; Katz, 1983, 1992; Lasky & Tobin, 1973; Musiek, Geurkink, & Keitel, 1982; Pinheiro, 1977; Sloan, 1986; Wepman & Morency, 1973; Willeford & Burleigh, 1985). These functional deficits underlie the commonly cited difficulties observed among children with CAPD, includ- ing difficulty comprehending speech in backgrounds of noise or competing speech, distractibility, inattentiveness, difficulty understanding verbal directions, and associated reading difficulties due to auditory-phonetic confusion (ASHA, 1992; Chermak & Musiek, 1992; Musiek & Guerkink, 1980; Willeford, 1985; Willeford & Burleigh, 1985). Similarly, theoretical differences exist about whether auditory processing deficits either underlie or reflect language disorders (Bannatyne, 1971; Keith, 1981a, 1981b; Rees, 1973, 1981; Sloan, 1980, 1986). New assess- ment strategies, however, may clarify the relationships among auditory processing, cognitive, and linguistic deficits, and may offer greater direction for management (Chermak, Vonhof, & Bendel, 1989; Jerger, Johnson, & Loiselle, 1988; Jerger et al., 1991; Jerger, Martin, & Jerger, 1987). Although further research is needed to establish the efficacy of both assessment and treatment approaches, aggressive rehabilitative efforts must incorporate strategies and tech- niques most likely to reduce the communication and learning disabilities associated with CAPD (Chermak & Musiek, 1992). In this paper, we address three questions about the management of CAPD in children that are frequently posed at national meetings and in our practices. By publishing these questions and answers in this forum, we hope to reach a large number of clinicians who struggle with the issues raised in these questions. Question 1: What type of rehabilitation approach is indicated when a child does poorly on the frequency (pitch) pattern test? The objectives of central auditory assess- ment with children are to ascertain the neuromaturational status and integrity of the central auditory nervous system and to quantify functional deficits requiring treatment, particu- larly as they relate to the child’s communica- tion, academic, and social skills (ASHA, 1992; Baran & Musiek, 1991; Keith, 1981a, 1983; Musiek, Gollegly, & Baran, 1984). Because they reveal deficits underlying functional behaviors, some central auditory tests provide data particularly relevant to intervention. For example, outcomes of tests involving compet- ing message tasks may not only imply a site or level of dysfunction, they may also suggest American Journal of Audiology • Vol. 4 • 1059-0889/95/0401-0015 © American Speech-Language-Hearing Association 1 This article is the second of two. The first, “Three Commonly Asked Questions About Central Auditory Processing Disorders: Assessment,” appeared in the November 1994 issue of the American Journal of Audiology, Vol. 3, No. 3, pp. 23–27.