Validation and standardization of the Scale of Self-Perception of Central Auditory Processing Skills (EAPAC) - expanded.
Luciana Cássia de Jesus, Luciana Mendonça Alves, Luciana Macedo de Resende
The EAPAC-Expanded questionnaire did not validate as a screening tool for central auditory processing disorder in Brazilian adults.
Its sensitivity and specificity fell below recommended thresholds. It did capture the self-reported hearing difficulties these adults experience in daily life.
Key findings
1The EAPAC-Expanded did not meet the 70% minimum the authors cite as the reference for a screening tool. For CAPD defined as one altered test, sensitivity was 65.2% and specificity 40.7% (cutoff 4.5). For two or more altered tests, sensitivity was 54% and specificity 48.5% (cutoff 5.5). The authors conclude the scale did not present adequate psychometric parameters for identifying CAPD risk.
2Sixty-three individuals completed the scale twice over a year and a half, and no domain or the total score showed a significant difference between the two time points.
3The most frequent self-reported complaints were academic difficulty with concentration (63.7%), planning (61.8%), and memory (60.3%), followed by difficulty understanding speech in noise (58.6%), perceiving sound over time (48.6%), and attention to sound (47.1%).
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What it does not show
Single site: all participants were members of one university, with a median age of 27 to 28 years, so the findings may not generalise to older adults or to populations outside academia. No control group of individuals confirmed to have normal auditory and cognitive performance was included; the authors note this is needed for future work. The gold-standard comparison sample (116) was smaller than the 146 the sample-size calculation called for. The high prevalence of CAPD in the sample (76.7% with one altered test) may reflect self-selection, since participants who chose to take part likely already had auditory complaints. The scale was self-administered online rather than administered by a speech-language pathologist, which the authors flag as a limitation for interpreting the results. No investigation of factors that might enhance auditory performance, such as musical training, was included.
Declared interests
Funded by CAPES (grant 88887.932223/2024-00), a Brazilian government agency for graduate education. No industry funding or conflicts of interest were declared.
The easy way to misread this
Do not use the EAPAC-Expanded score to diagnose or rule out central auditory processing disorder. The areas under the ROC curves were below the 70% reference and not statistically significant, and the best sensitivity across all auditory processes was 77.6% with a specificity of 70%. The authors state plainly that the scale did not present adequate psychometric parameters for identifying CAPD risk.
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 →