Listening difficulties in children:auditory processing and beyond

There are children who seem to have difficulty in hearing and understanding speech despite normal peripheral hearing. After hearing the sound, something seems to go wrong with the processing of the auditory information. Such problems in listening are known as (unexplained) listening difficulties or auditory processing disorder (APD). Children with such problems have difficulties with understanding speech in complex listening situations, such as in a busy classroom with a lot of background noise. The overall aim of this thesis was to investigate which behavioral characteristics are associated with listening difficulties and whether APD must be considered as distinct and unique construct. The aim was four-fold. Firstly, to investigate which behavioral characteristics are associated with (suspected) APD. Secondly, to investigate the relationship between APD and other neurological developmental disorders. Thirdly, to explore the role of cognitive processes in children with unexplained listening difficulties. Finally, to achieve, in collaboration with professionals from Dutch audiological centers, a practice-oriented definition and method for children with listening difficulties.Based on the results, it can be concluded that listening difficulties in children are multifactorial in nature and may be a consequence of cognitive (intelligence, attention, and working memory), language, and auditory capacities rather than being uniquely limited to the auditory system. APD cannot be considered as an isolated disorder that can be differentiated from other neurodevelopmental disorders, such as language development disorders, dyslexia and ADHD. The diagnostic label APD is therefore not suitable for classifying listening difficulties in children