Preliminary Report on the Efficacy of the Dichotic Offset Training Program in Auditory Integration Processing Disorder: A single-subject study
Abstract
Background and aims: Auditory integration deficit is one of the subcategories and the most complex form of Auditory Processing Disorder (APD). This is due to its association with specific brain regions such as the corpus callosum and angular gyrus, which are key areas for multisensory integration. This study introduced the first Persian development of the dichotic offset training program. It presents preliminary findings on its efficacy when delivered in-person versus on-line.
Methods: In this single-subject study, two children, aged 13 years, diagnosed with auditory integration deficit, participated The main intervention consisted of 8-14 sessions of Persian-Dichotic Offset Training (DOT), followed by post-treatment follow-up assessments utilizing two methods of treatment delivery: in-person and on-line. Data collected via Persian Buffalo Model Questionnaire-Revised (PBMQ-R), Randomized Dichotic Digits Test (P-RDDT), Persian-Dichotic Offset Test (P-DOM), and Persian-Staggered Spondee Word (SSW) and analyzed employing a single-subject statistical formula.
Results: The results suggest that the treatment effectively reduced integration problems in both in-person and on-line methods, as indicated by competitive left ear stimulus, Type A pattern, and qualitative error IX, the left ear performance, and the questionnaire scores. Both delivery methods proved effective, but online administration showed slightly superior outcomes.
Conclusion: The P-DOT Program, especially in its on-line method, appears to be a promising intervention for children with APD (integration subcategory). By enhancing binaural hearing skills, this approach may considerably improve the brain regions responsible for dichotic processing. These preliminary single-subject findings, pending confirmation through larger-scale studies, particularly Randomized Controlled Trial(RCT) studies, may inform evidence-based clinical protocols for audiologists.
2. Katz J. Therapy for auditory processing disorders: simple effective procedures. Denver: Educational Audiology Association; 2009.
3. Katz J, Stecker NA, Henderson D. Central auditory processing: a transdisciplinary view. St. Louis: Mosby; 1992.
4. Palfery TD, Duff D. Central auditory processing disorders: review and case study. Axone. 2007;28(3):20-3.
5. Golding M, Carter N, Mitchell P, Hood LJ. Prevalence of central auditory processing (CAP) abnormality in an older Australian population: the Blue Mountains Hearing Study. J Am Acad Audiol. 2004;15(9):633-42. [DOI:10.3766/jaaa.15.9.4]
6. Katz J. The Buffalo CAPD Model: The importance of phonemes in evaluation and remediation. J Phonet and Audiol. 2016;2(1):111. [DOI:10.4172/2471-9455.1000111]
7. Brown WS, Paul LK. The Neuropsychological Syndrome of Agenesis of the Corpus Callosum. J Int Neuropsychol Soc. 2019;25(3):324-30. [DOI:10.1017/S135561771800111X]
8. Kinsbourne M. The cerebral basis of lateral asymmetries in attention. Acta Psychol (Amst). 1970;33:193-201. [DOI:10.1016/0001-6918(70)90132-0]
9. Kimura D. Functional asymmetry of the brain in dichotic listening. Cortex. 1967;3(2):163-78. DOI:10.1016/S0010-9452(67)80010-8G]
10. Moncrieff DW. Dichotic listening in children: age-related changes in direction and magnitude of ear advantage. Brain Cogn. 2011;76(2):316-22. [DOI:10.1016/j.bandc.2011.03.013]
11. Weihing J, Musiek FE. Dichotic interaural intensity difference (DIID) training. In: Chermak GD, Musiek FE, editors. Handbook of central auditory processing disorder. volume II. 2nd ed. San Diego: Plural Publishing; 2013. p. 225-42.
12. Musiek FE, Schochat E. Auditory training and central auditory processing disorders—a Case Study. Semin Hear. 1998;19(4):357-65. [DOI:10.1055/s-0028-1082983]
13. Katz J, Chertoff M, Sawusch JR. Dichotic training. J Aud Res. 1984;24(4):251-64.
14. Moncrieff DW, Wertz D. Auditory rehabilitation for interaural asymmetry: preliminary evidence of improved dichotic listening performance following intensive training. Int J Audiol. 2008;47(2):84-97. [DOI:10.1080/14992020701770835]
15. Kaul K, Lucker JR. Auditory Processing Training with Children Diagnosed with Auditory Processing Disorders: Therapy Based on the Buffalo Model. J Educ Pediatr Rehabil. audiol. 2016;22.
16. Delphi M, Zamiri Abdollahi F. Dichotic training in children with auditory processing disorder. Int J Pediatr Otorhinolaryngol. 2018;110:114-7. [DOI:10.1016/j.ijporl.2018.05.014]
17. Mahdavi ME, Rezaeian M, Zarrinkoob H, Rezaeian M, Akbarzadeh A. Effect of a Dichotic Interaural Time Difference Program on Dichotic Listening Deficit of Children with Learning Difficulty. J Am Acad Audiol. 2021;32(5):295-302. [DOI:10.1055/s-0041-1728753]
18. Price PC, Jhangiani R, Chiang I. Research Methods in Psychology. 2nd ed. Victoria BC: BCCampus; 2015.
19. Negin E, Farahani S, Babaei S, Faryadras R, Barootiyan SS. Cross-cultural adaptation and determining validity and reliability of the Persian revised Buffalo model questionnaire. Aud Vestib Res. 2020;29(3):178-85. [DOI:10.18502/avr.v29i3.3851]
20. Irani R, Fatahi F, Farahani S, Shomeil Shushtry S, Jalaie S, Katz J. Development of the Persian Version of Dichotic Offset Measure and Evaluation of Its Psychometric Properties in Normal-hearing Children: A Pilot Study. Aud Vestib Res. 2023;32(2):98-106. [DOI:10.18502/avr.v32i2.12168]
21. Mahdavi ME, Aghazadeh J, Tahaei SAA, Heiran F, Akbarzadeh Baghban A. [Persian randomized dichotic digits test: Development and dichotic listening performance in young adults]. Audiol. 2015;23(6):99-113. Persian.
22. Goll JC, Crutch SJ, Warren JD. Central auditory disorders: toward a neuropsychology of auditory objects. Curr Opin Neurol. 2010;23(6):617-27. DOI:10.1097/WCO.0b013e32834027f6]
23. Hayes EA, Warrier CM, Nicol TG, Zecker SG, Kraus N. Neural plasticity following auditory training in children with learning problems. Clin Neurophysiol. 2003;114(4):673-84. [DOI:10.1016/s1388-2457(02)00414-5]
24. Bartel-Friedrich S, Broecker Y, Knoergen M, Koesling S. Development of fMRI tests for children with central auditory processing disorders. In Vivo. 2010;24(2):201-9.
25. Loo JH, Rosen S, Bamiou DE. Auditory Training Effects on the Listening Skills of Children with Auditory Processing Disorder. Ear Hear. 2016;37(1):38-47. [DOI:10.1097/AUD.0000000000000225]
26. Hrastinski II, Bonetti AM, Hedjever MA. Relationship between auditory processing skills and academic achievement of elementary school children. Specijalna edukacija i rehabilitacija. 2023;22(2):95-116. [DOI:10.5937/specedreh22-37415]
27. Anderson S, Kraus N. Auditory Training: Evidence for Neural Plasticity in Older Adults. Perspect Hear Hear Disord Res Res Diagn. 2013;17:37-57. [DOI:10.1044/hhd17.1.37]
28. Bush ML, Thompson R, Irungu C, Ayugi J. The Role of Telemedicine in Auditory Rehabilitation: A Systematic Review. Otol Neurotol. 2016;37(10):1466-74. [DOI:10.1097/MAO.0000000000001236]
29. M R NN, Seethapathy J. Tele-Audiology in India: Current and Future Trends in Knowledge, Attitude, and Practice Among Audiologists. J Audiol Otol. 2022;26(3):130-41. [DOI:10.7874/jao.2021.00584]
30. Musiek FE, Baran JA, Bellis TJ, Chermak GD, Hall JW, Keith RW, et al. Guidelines for diagnosis, treatment, and management of children and adults with central auditory processing disorder. Reston, American Academy of Audiology. 2010:1-51.
Files | ||
Issue | Articles in Press | |
Section | Research Article(s) | |
Keywords | ||
Auditory processing disorder dichotic offset training Buffalo model auditory training integration telerehabilitation |
Rights and permissions | |
![]() |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |