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Clinical Management of Auditory Processing Disorders: Mediating, Moderating, and Confounding Factors

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1.  Auditory processing assessment strategies should seek to minimize or avoid cognitive (attention, memory) load under which of the following conditions?
  1. A patient self-reports tinnitus
  2. A patient has signs/symptoms of sensorineural hearing loss
  3. A patient has a history of blast exposure and/or traumatic brain injury
  4. A patient has sound intolerance/hyperacusis
2.  Which of the following is NOT a reason to be cautious of possible peripheral hearing dysfunction when performing an auditory processing assessment?
  1. Patients with peripheral hearing dysfunction will be prescribed hearing aids anyway so there is no reason to assess their central auditory processing function
  2. Reduced audibility may affect the patient’s performance on the test, thus complicating test interpretation
  3. Many auditory processing tests do not have normative data for patients with peripheral hearing loss
  4. Patients with previous noise exposure as well as older adults may have cochlear dysfunction that affects the encoding of auditory information in the peripheral auditory system even when hearing thresholds remain normal
3.  What auditory processing test strategy can be used to reduce the possible influence of higher cognitive dysfunction?
  1. Use dichotic listening tests with consonant-vowels or dichotic rhyming
  2. Compare dichotic listening in the free recall condition with compressed speech
  3. Establish any two test scores at least two standard deviations above the mean
  4. Compare dichotic listening test performance between free recall and directed ear conditions
4.  Regarding testing strategies to rule out cognitive factors, which of the following statements is correct?
  1. Sentence-level stimuli are better than phoneme or word-level stimuli
  2. When two ears show different test findings, abnormalities are probably not due to cognitive dysfunction
  3. The Gaps-in-Noise test is especially useful because it does not require close or sustained attention
  4. Electrophysiological testing is necessary to confirm differences between ears on dichotic listening and frequency pattern tests
5.  What auditory processing tests or strategies can be used to minimize possible peripheral hearing loss confounds?
  1. Monaural administration of the frequency pattern test and comparing performance for the two ears
  2. Compare audiogram findings against findings on the masking level difference test for 500 Hz
  3. Use dichotic digits, frequency pattern, and/or gaps-in-noise tests
  4. Use compressed speech and staggered spondaic word tests

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