Behavioral tests of auditory processing: a study on reference values for normal-hearing adults.
Sthella Zanchetta, Laura Caetano Meneghelli, Pamela Papile Lunardelo
PMID 42018793WHAT IT FOUND
Healthy adults' scores on gap detection, pitch and duration patterns, and dichotic digits all fall as they get older, while the masking level difference test stays steady from 18 to 59.
The authors propose separate cut-offs by age instead of one adult norm.
Key findings
01In 116 normal-hearing adults aged 18 to 59, performance on the Gaps-In-Noise, pitch pattern, duration pattern and dichotic digits tests declined with increasing age, while the masking level difference test did not change.
02The authors propose age-banded cut-offs for gap detection (6 ms or lower at 18-39 years, 8 ms or lower at 40-59 years), pitch patterns (at least 76.6% and at least 63.3%), and duration patterns (at least 90.3%, 80.0% and 70.0% across 18-29, 30-49 and 50-59 years).
03For the dichotic digits test the proposed cut-offs are at least 98.5% (right ear) and at least 97.5% (left ear) at 18-39 years, and at least 93.2% and at least 95.0% at 40-59 years.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The 116 participants were volunteers recruited by word of mouth and media. All had at least secondary education (11 to 23 years of schooling) and scored 29 or above on the Mini-Mental State Examination, so this is not a typical clinic population and the values may not fit the adults you see. Several tests were given to only 20 people per age group, which is a small number on which to base a cut-off. Not everyone had every test, and the results pool two cross-sectional cohorts with different research objectives. No single participant's full test profile is reported. The study is cross-sectional. It shows that older adults in this sample scored lower than younger ones. It does not show that any one person's scores fall as they age. The cut-offs come from percentiles, which the authors defend because the scores were not normally distributed. They also note that using the mean plus two standard deviations is the more commonly recommended approach, and that only the duration patterns test showed a clear gap between the two methods. The age band for the right-ear dichotic digits cut-off is inconsistent: the text splits it at age 40 (18-39 and 40-59), while the accompanying table presents it as 18-49 against 50-59. The paper states there is agreement that a battery of tests, not a single test, should be used to identify auditory processing disorder, so no single result here should be read on its own.
Declared interests
Funded by Brazilian public research agencies, FAPESP (grant 19/00598-0) and CAPES (grants 88887.79860/2022-00 and 88887.467938/2019-00). No commercial funding and no conflicts of interest are declared in the text supplied.
The easy way to misread this
Do not treat these proposed cut-offs as diagnostic criteria for auditory processing disorder. They come from 116 healthy volunteers recruited by convenience at a single centre, several of the tests were given to only 20 people per age group, and the paper proposes them rather than showing how well they separate people who have the disorder from people who do not.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →