Comorbidity of auditory processing, language, and reading disorders

J Speech Lang Hear Res. 2009 Jun;52(3):706-22. doi: 10.1044/1092-4388(2008/07-0226). Epub 2008 Dec 8.


Purpose: The authors assessed comorbidity of auditory processing disorder (APD), language impairment (LI), and reading disorder (RD) in school-age children.

Method: Children (N = 68) with suspected APD and nonverbal IQ standard scores of 80 or more were assessed using auditory, language, reading, attention, and memory measures. Auditory processing tests included the Frequency Pattern Test (FPT; F. E. Musiek, 1994; D. Noffsinger, R. H. Wilson, & F. E. Musiek, 1994); the Dichotic Digit Test Version 2 (DDT; F. E. Musiek, 1983); the Random Gap Detection Test (R. W. Keith, 2000); the 500-Hz tone Masking Level Difference (V. Aithal, A. Yonovitz, & S. Aithal, 2006); and a monaural low-redundancy speech test (compressed and reverberant words; A. Boothroyd & S. Nittrouer, 1988). The Clinical Evaluation of Language Fundamentals, Fourth Edition (E. Semel, E. Wiig, & W. Secord, 2003) was used to assess language abilities (including auditory memory). Reading accuracy and fluency and phonological awareness abilities were assessed using the Wheldall Assessment of Reading Passages (A. Madelaine & K. Wheldall, 2002) and the Queensland University Inventory of Literacy (B. Dodd, A. Holm, M. Orelemans, & M. McCormick, 1996). Attention was measured using the Integrated Visual and Auditory Continuous Performance Test (J. A. Sandford & A. Turner, 1995).

Results: Of the children, 72% had APD on the basis of these test results. Most of these children (25%) had difficulty with the FPT bilaterally. A further 22% had difficulty with the FPT bilaterally and had right ear deficits for the DDT. About half of the children (47%) had problems in all 3 areas (APD, LI, and RD); these children had the poorest FPT scores. More had APD-RD, or APD-LI, than APD, RD, or LI alone. There were modest correlations between FPT scores and attention and memory, and between DDT scores and memory.

Conclusions: LI and RD commonly co-occur with APD. Attention and memory are linked to performance on some auditory processing tasks but only explain a small amount of the variance in scores. Comprehensive assessment across a range of areas is required to characterize the difficulties experienced by children with APD.

MeSH terms

  • Analysis of Variance
  • Attention
  • Auditory Perceptual Disorders / epidemiology*
  • Child
  • Comorbidity
  • Confidence Intervals
  • Dyslexia / epidemiology*
  • Female
  • Functional Laterality
  • Humans
  • Language Disorders / epidemiology*
  • Language Tests
  • Male
  • Memory
  • Neuropsychological Tests
  • Severity of Illness Index