JCPSLP
Volume 16, Number 2 2014
73
KEYWORDS
TREATMENT
SPEECH
PATHOLOGY
(C)APD
SURVEY
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
Wendy L. Arnott
(top), Caroline A.
Henning (centre),
and Wayne J.
Wilson
Policy and practice
training, prosody training, and commercially available
auditorylinguistic training software packages.
Fey et al. (2011) went on to review auditory interventions
for (C)APD and concluded that while these interventions
can lead to gains in discrete auditory processing skills,
they do not lead to functional gains in language, literacy,
or academic function. This suggests the role played by
the SLP in the management of (C)APD should be limited
to the direct management of speech/language disorders
that might coexist with (C)APD rather than the direct
management of the (C)APD itself. Such a suggestion is
more consistent with Speech Pathology Australia’s Scope
of Practice (2003), which includes speech and language
intervention/rehabilitation secondary to hearing loss or
(C)APD in its services to be provided by SLPs.
Despite their conclusions, Fey et al. (2011) still
encouraged clinicians and researchers to work together
towards better outcomes for children with (C)APD and
Kamhi (2011) has suggested that SLPs treat children
with (C)APD in the same way that they treat children with
language and learning disabilities – by assessing and
treating any coexisting language, literacy, and metalinguistic
difficulties. Currently, however, there is limited information
regarding the specific treatments used by SLPs to treat
children with (C)APD. Hind (2006) and Logue-Kennedy et
al. (2011) surveyed SLPs and other professionals in the
United Kingdom and the Republic of Ireland, respectively,
to explore all aspects of service provision for clients with
(C)APD. Treatment-related questions were limited, with
respondents being asked whether they provided verbal
advice or programs of treatment to clients with (C)APD.
Specific details regarding the nature of the advice or
programs provided were not gathered. To our knowledge,
there have been no surveys of how SLPs are treating
children with (C)APD in practice.
In light of the potential for confusion as to the role of
the SLP in treating (C)APD, the major objective of the
present study was to determine how SLPs currently
manage (C)APD and to compare the results with published
recommendations (ASHA, 2005; Fey et al., 2011; McArthur,
Ellis, Atkinson & Coltheart, 2008; Wilson & Arnott, 2012).
This study is the second of two articles, the first of which
(Arnott, Henning & Wilson, 2014) considered how these
SLPs screen and assess for (C)APD.
Methods
Participants
Speech-language pathologists (SLPs, n = 1,536) registered
with the Speech Pathologists’ Board of Queensland were sent
Methods of treating (central) auditory processing
disorder ([C]APD) continue to attract consider
able controversy. This study (the second in a
two-part series) surveyed 60 Queensland
speech-language pathologists (SLPs) on how
they treat children suspected of having
(C)APD. The treatments used by these SLPs
were found to be generally consistent with
those recommended in the literature, with most
clinicians treating the language and literacy
deficits associated with the disorder rather
than focusing on specific auditory deficits.
(Central) auditory processing disorder or (C)APD refers to
difficulties in the perceptual processing of auditory
information in the central nervous system (CNS), as
demonstrated by poor performance in one or more of a
range of skills such as sound localisation and lateralisation,
auditory discrimination, auditory pattern recognition,
temporal aspects of audition, auditory performance in
competing acoustic signals, and auditory performance with
degraded acoustic signals (ASHA, 2005). (C)APD may
coexist with other disorders (such as language disorders)
but is not the result of those disorders, although the rate of
coexistence of (C)APD with other disorders appears to be
high (Sharma, Purdy & Kelly, 2009).
As is the case with diagnosis, treatment of (C)APD is a
topic that continues to attract considerable controversy.
While current best practice guidelines developed by ASHA
(2005) support a multidisciplinary approach to managing
(C)APD as a whole, treating (C)APD is often seen as the remit
of speech-language pathologists (SLPs; Emanuel, Ficca, &
Korczak, 2011). Deciding which treatments fall within the
SLP’s scope of practice is confounded by debates over what
separates auditory treatments from language and literacy
treatments. Fey et al. (2011) described auditory treatments
as being those that manipulate the acoustic features of
non-speech and/or speech stimuli. These include, but are
not limited to, nonspeech auditory training, nonlinguistic
simple speech auditory training, speech-in-noise training,
localisation training, and commercially available auditory
training software packages. They described language and
literacy treatments as those that manipulate language form,
content, and use. These include, but are not limited to,
individualised languagebased treatments, phonological
awareness training, visualisation and verbalisation,
individualised reading and spelling remediation, closure
Treating (C)APD and the
role of the speech language
pathologist
A survey of Queensland clinicians
Wendy L. Arnott, Caroline A. Henning, and Wayne J. Wilson
