Questionnaires and checklists for central auditory processing screening used in Brazil: a systematic review

Volpatto, Francielli Loss; Rechia, Inaê Costa; Lessa, Alexandre Hundertmarck; Soldera, Cristina Loureiro Chaves; Ferreira, Maria Inês Dornelles da Costa; Machado, Márcia Salgado

doi:10.1016/j.bjorl.2018.05.003

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Brazilian Journal of Otorhinolaryngology

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Review articles • Braz. j. otorhinolaryngol. 85 (1) • Jan-Feb 2019 • https://doi.org/10.1016/j.bjorl.2018.05.003 copy

Questionnaires and checklists for central auditory processing screening used in Brazil: a systematic review^☆ ☆ Please cite this article as: Volpatto FL, Rechia IC, Lessa AH, Soldera CL, Ferreira MI, Machado MS. Questionnaires and checklists for central auditory processing screening used in Brazil: a systematic review. Braz J Otorhinolaryngol. 2019;85:99-110.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction:

The action of listening involves a complex interaction between the peripheral and central auditory systems. Central auditory processing disorder can be described as any problem in one or more auditory abilities. Literature reports that behavioral questionnaires and checklists can be applied to screen individuals at risk for central auditory processing disorder.

Objective:

To identify and analyze in the national literature questionnaires and checklists for the screening of central auditory processing available in Brazil for the Portuguese language.

Methods:

The research was carried out in electronic databases and "gray literature". The search strategy was: "questionnaires OR surveys and questionnaires AND auditory OR hearing tests OR auditory perception AND Brazil". The research was carried out between June and August of 2017. Study selection followed inclusion and exclusion criteria. The criteria adopted included Brazilian studies, without date and design restriction, that were carried out, translated, adapted and/or validated to Brazilian Portuguese or European Portuguese, as tools for central auditory processing screening. International studies that were not adapted to the Portuguese language were excluded, as well as the ones that were not available in full.

Results:

A total of 3664 publications were found and seven articles were selected for this systematic review, according to the established criteria.

Conclusions:

There is scarce national literature for central auditory processing screening and the only tool validated to Brazilian Portuguese, published as a monograph, is the auditory processing domains questionnaire. It is suggested that new studies with greater methodological stringency related to the processes of tool adaptation and validation be developed and published in the usual scientific databases, aiming at greater diffusion and clinical applicability.

KEYWORDS
Surveys and questionnaires; Auditory; Hearing tests; Auditory perception; Brazil

Title/author/year	Type of study	Objective of the study	Main findings
1. Otitis media and sound localization ability in preschool children. Lima-Gregio et al. (2010) ³⁶36 Lima-Gregio AM, Calais LL, Feniman MR. Otitis media and sound localization ability in preschool children. Rev CEFAC. 2010;12:1033-40.	Scientific article	To compare the performance of children in the SL test, with the parents' answers to a questionnaire.	Except for the question that investigated inattention, there was no significant difference between the two tested groups - with the questionnaire and the SL test being insufficient tools to differentiate them. The authors believe this fact is justified by the socioeconomic factors of the assessed sample.
2. Identification of risk factors for the (central) auditory processing disorder in preschool children Luz and Costa-Ferreira (2011) ³⁷37 Luz DM, Costa-Ferreira MID. Identification of risk factors for (central) auditory processing disorder in preschool children. Rev CEFAC. 2011;13:657-67.	Scientific article	To identify the risk factors for CAPD in preschool children attending the public school system.	The tool was effective in identifying statistically significant risk factors for CAPD in the studied population regarding the variables: greater number of siblings, greater request for repetition of instructions and comprehension difficulties in a competitive environment. Another important finding was the large number of children who never underwent any type of audiological examination, and some of them requested repetition of instructions frequently.
3. Perception of parents about the auditory attention skills of his kid with cleft lip and palate: retrospective study. Feniman et al. (2012) ³⁸38 Feniman MR, Souza TC, Teixeira TS, Mondelli MFCG. Perception of parents about the auditory attention skills of his kid with cleft lip and palate: retrospective study. Int Arch Otorhinolaryngol. 2012;16:115-20.	Scientific article	To verify the perception of the parents of children with CLP on their children's auditory attention.	The findings showed that most interviewed parents pointed out at least one of the attention-related behaviors included in the questionnaire, suggesting that the presence of CLP may be related to difficulties in auditory attention.
4. Scale of Auditory Behaviors and auditory behavior tests for auditory processing assessment in Portuguese children Nunes et al. (2013) ¹1 Nunes CL, Pereira LD, Carvalho de GS. Scale of auditory behaviors and auditory behavior tests for auditory processing assessment in Portuguese children. CoDAS. 2013;25:209-15.^,²²22 Schow RL, Seikel JA, Brockett JE, Whitaker MM. Multiple Auditory Processing Assessment (MAPA) test manual 1.0 version. St. Louis, MO: Auditec; 2007.	Scientific article	To investigate the hearing abilities of Portuguese children and to verify if there is correlation between them and the Scale of Auditory Behaviors (SAB) score.	A significant correlation was observed between the questionnaire score and that of the behavioral tests, the highest of which was observed in the tests related to temporal processing. The higher the SAB score, the better the responses obtained at the behavioral evaluation of the CAP. The study also confirmed that most children with a score <46 points in the SAB had an alteration in one or more of the CAP tests.
5. The auditory processing domains questionnaire (APDQ): Portuguese version. Yokoyama, et al. (2015) ¹⁹19 O'Hara B. The Auditory Processing Domains Questionnaire APDQ rev. 1. For parents and teachers of students ages 7 through 17 years; 2006.^,³³33 Martins KVC, Pereira LD, Ziliotto K. Investigation of the set of auditory behaviors by means of a questionnaire [Monograph]. São Paulo, SP: Escola Paulista de Medicina, Departamento de Fonoaudiologia, Curso de Especialização em Audiologia, Universidade Federal de São Paulo - UNIFESP; 2015.^,⁴⁴44 Yokoyama CH, Dias KZ, Pereira LD. The auditory processing domains questionnaire (APDQ): Portuguese version [Monograph]. São Paulo, SP: Departamento de Fonoaudiologia, Curso de Especialização em Audiologia, Universidade Federal de São Paulo - UNIFESP; 2015.	Monograph	To adapt the APDQ into Portuguese and apply the Portuguese version of the questionnaire to a group of school-aged children without CAP alterations.	A Portuguese version of the APDQ questionnaire was obtained through the translation and validation processes. The total score of the original tool is 208 points and the Brazilian version has a total of 199.2 - very close to the maximum score of the original version. The tool was validated with 100% of sensitivity and specificity.
6. Questionnaire children's auditory performance scale: translation and adaptation into Brazilian Portuguese Donadon et al. (2015)¹²12 Smoski WJ, Brunt MA, Tannahill JC. Children's auditory performance scale. Tampa, FL: Educational Audiology Association; 1998.^,⁴³43 Donadon C, Pinto SNFR, Couto CM, Colella-Santos MF. Questionnaire children's auditory performance scale: translation and adaptation into Brazilian Portuguese [Monograph]. Campinas, SP: Programa de Pós-Graduação Latu Sensu da Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP; 2015.	Monograph	To translate and culturally adapt the CHAPS questionnaire into Brazilian Portuguese and apply it to verify its effectiveness.	The tool went through all stages of the cultural adaptation process, obtaining substantial support for its content validity according to semantic-idiomatic and cultural equivalence criteria. The members of the committee agreed on 84% with the cultural adaptation of the questionnaire. There was a correlation between the questions of the "Auditory Memory" module and the performance in the DD test - binaural integration step.
7. Use of questionnaires in the monitoring of auditory training results. Cibian and Pereira (2015)¹⁸18 Fisher LI. Fisher's Auditory Problems Checklist. Tampa, FL: Educational Audiology Association; 1976.^,³⁵35 Cibian AP, Pereira LD. Use of questionnaires in the monitoring of auditory training results. Distúrbios Comun. 2015;27:466-78.	Scientific article	Monitor auditory behavior through Fisher's Auditory Problems Checklist in 19 individuals diagnosed with CAPD who underwent auditory training.	The sample, who showed alterations in selective attention and/or temporal processing skills, were submitted to auditory training and demonstrated, midway and at the end of the training, an improvement in the score of the questionnaire answered by the parents.

PG	Mean age range	Questionnaire Lima-Gregio et al. ³⁶36 Lima-Gregio AM, Calais LL, Feniman MR. Otitis media and sound localization ability in preschool children. Rev CEFAC. 2010;12:1033-40.	Audiological and cognitive aspects in pre-schoolers ³⁷37 Luz DM, Costa-Ferreira MID. Identification of risk factors for (central) auditory processing disorder in preschool children. Rev CEFAC. 2011;13:657-67.	Auditory/Attention Questionnaire ³⁸38 Feniman MR, Souza TC, Teixeira TS, Mondelli MFCG. Perception of parents about the auditory attention skills of his kid with cleft lip and palate: retrospective study. Int Arch Otorhinolaryngol. 2012;16:115-20.	SAB¹1 Nunes CL, Pereira LD, Carvalho de GS. Scale of auditory behaviors and auditory behavior tests for auditory processing assessment in Portuguese children. CoDAS. 2013;25:209-15.^,²²22 Schow RL, Seikel JA, Brockett JE, Whitaker MM. Multiple Auditory Processing Assessment (MAPA) test manual 1.0 version. St. Louis, MO: Auditec; 2007.	APDQ¹⁹19 O'Hara B. The Auditory Processing Domains Questionnaire APDQ rev. 1. For parents and teachers of students ages 7 through 17 years; 2006.^,³³33 Martins KVC, Pereira LD, Ziliotto K. Investigation of the set of auditory behaviors by means of a questionnaire [Monograph]. São Paulo, SP: Escola Paulista de Medicina, Departamento de Fonoaudiologia, Curso de Especialização em Audiologia, Universidade Federal de São Paulo - UNIFESP; 2015.^,⁴⁴44 Yokoyama CH, Dias KZ, Pereira LD. The auditory processing domains questionnaire (APDQ): Portuguese version [Monograph]. São Paulo, SP: Departamento de Fonoaudiologia, Curso de Especialização em Audiologia, Universidade Federal de São Paulo - UNIFESP; 2015.	CHAPS¹²12 Smoski WJ, Brunt MA, Tannahill JC. Children's auditory performance scale. Tampa, FL: Educational Audiology Association; 1998.^,⁴³43 Donadon C, Pinto SNFR, Couto CM, Colella-Santos MF. Questionnaire children's auditory performance scale: translation and adaptation into Brazilian Portuguese [Monograph]. Campinas, SP: Programa de Pós-Graduação Latu Sensu da Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP; 2015.	QFISHER¹⁸18 Fisher LI. Fisher's Auditory Problems Checklist. Tampa, FL: Educational Audiology Association; 1976.^,³⁵35 Cibian AP, Pereira LD. Use of questionnaires in the monitoring of auditory training results. Distúrbios Comun. 2015;27:466-78.
Individuals with morbidities and/or CAPD	6-17 years	X	X		X	X	X	X
Individuals with CLP	6-11 years			X			X
Individuals with OSAS	6-12 years				X

Instrumentos	Auditory skills
	Figure-ground and auditory closure	Auditory attention	Binaural interaction	Temporal resolution	Temporal ordering	Binaural integration and separation
Questionnaire by Lima-Gregio et al. ³⁶36 Lima-Gregio AM, Calais LL, Feniman MR. Otitis media and sound localization ability in preschool children. Rev CEFAC. 2010;12:1033-40.	X	X	X			X
Audiological and Cognitive Aspects in Pre-Schoolers ³⁷37 Luz DM, Costa-Ferreira MID. Identification of risk factors for (central) auditory processing disorder in preschool children. Rev CEFAC. 2011;13:657-67.	X	X		X		X
Auditory/Attention Questionnaire ³⁸38 Feniman MR, Souza TC, Teixeira TS, Mondelli MFCG. Perception of parents about the auditory attention skills of his kid with cleft lip and palate: retrospective study. Int Arch Otorhinolaryngol. 2012;16:115-20.	X	X		X	X
SAB¹1 Nunes CL, Pereira LD, Carvalho de GS. Scale of auditory behaviors and auditory behavior tests for auditory processing assessment in Portuguese children. CoDAS. 2013;25:209-15.^,²²22 Schow RL, Seikel JA, Brockett JE, Whitaker MM. Multiple Auditory Processing Assessment (MAPA) test manual 1.0 version. St. Louis, MO: Auditec; 2007.	X	X		X	X	X
APDQ¹⁹19 O'Hara B. The Auditory Processing Domains Questionnaire APDQ rev. 1. For parents and teachers of students ages 7 through 17 years; 2006.^,³³33 Martins KVC, Pereira LD, Ziliotto K. Investigation of the set of auditory behaviors by means of a questionnaire [Monograph]. São Paulo, SP: Escola Paulista de Medicina, Departamento de Fonoaudiologia, Curso de Especialização em Audiologia, Universidade Federal de São Paulo - UNIFESP; 2015.^,⁴⁴44 Yokoyama CH, Dias KZ, Pereira LD. The auditory processing domains questionnaire (APDQ): Portuguese version [Monograph]. São Paulo, SP: Departamento de Fonoaudiologia, Curso de Especialização em Audiologia, Universidade Federal de São Paulo - UNIFESP; 2015.	X	X	X	X	X	X
CHAPS¹²12 Smoski WJ, Brunt MA, Tannahill JC. Children's auditory performance scale. Tampa, FL: Educational Audiology Association; 1998.^,⁴³43 Donadon C, Pinto SNFR, Couto CM, Colella-Santos MF. Questionnaire children's auditory performance scale: translation and adaptation into Brazilian Portuguese [Monograph]. Campinas, SP: Programa de Pós-Graduação Latu Sensu da Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP; 2015.	X	X	X	X	X	X
QFISHER¹⁸18 Fisher LI. Fisher's Auditory Problems Checklist. Tampa, FL: Educational Audiology Association; 1976.^,³⁵35 Cibian AP, Pereira LD. Use of questionnaires in the monitoring of auditory training results. Distúrbios Comun. 2015;27:466-78.	X	X		X	X	X

Version available in Brazil	Current situation	Tool characteristics	Target audience and application range	Type and number of questions	Correlations with CAP tests	Other studies that used the tool
Lima-Gregio et al. (2010) Questionnaire ³⁶36 Lima-Gregio AM, Calais LL, Feniman MR. Otitis media and sound localization ability in preschool children. Rev CEFAC. 2010;12:1033-40.	National; non-validated.	Covers basic audiological complaints such as hearing, otitis and ME alterations, as well as risk factors and classic signs and symptoms of CAPD; Does not generate a score.	Target audience: Parents; Range of application: Preschoolers.	14 mixed questions (open and closed)	No correlation was found with the SL test. ³⁶36 Lima-Gregio AM, Calais LL, Feniman MR. Otitis media and sound localization ability in preschool children. Rev CEFAC. 2010;12:1033-40.	Not found
Audiological and Cognitive Aspects in Pre-Schoolers (Luz and Costa-Ferreira, 2011) ³⁷37 Luz DM, Costa-Ferreira MID. Identification of risk factors for (central) auditory processing disorder in preschool children. Rev CEFAC. 2011;13:657-67.	National; non-validated.	Covers several aspects of child development: gestation, birth, development, family history, routine, language, school learning and auditory behaviors suggestive of CAPD. Does not generate a score.	Target audience: Parents; Range of application: Preschoolers and 1st-Grade students.	39 mixed questions (open and closed)	No such correlations were carried out.	Not found
Auditory/Attention Questionnaire (Feniman et al., 2012) ³⁸38 Feniman MR, Souza TC, Teixeira TS, Mondelli MFCG. Perception of parents about the auditory attention skills of his kid with cleft lip and palate: retrospective study. Int Arch Otorhinolaryngol. 2012;16:115-20.	National; non-validated.	It is divided into three parts: Part I (Child Identification), Part II (Hearing Health) and Part III (Child's attention); It covers the following aspects of hearing health: history of hearing loss and ME infections. Contains a checklist with aspects related to hearing health. Does not generate a score.	Target audience: Parents; Range of application: 6-11 years of age.	Part I: 8 open questions; Part II: 2 mixed questions (open and closed); Part III: 32 closed questions. Total: 42 questions	No such correlations were carried out.	Not found
Scale of Auditory Behaviors - SAB (Nunes et al., 2013) ¹1 Nunes CL, Pereira LD, Carvalho de GS. Scale of auditory behaviors and auditory behavior tests for auditory processing assessment in Portuguese children. CoDAS. 2013;25:209-15.	Translated and adapted to European Portuguese.	Likert scale style; It covers items of auditory behavior most frequently related to CAP; Generates score: The sum of the items generates a final score and, according to the performance, it indicates: typical auditory behavior for the age group; need to evaluate CAP; or probable alteration in CAP.	Target audience: Parents and/or teachers Range of application: 10-13 years of age	12 closed questions.	There was correlation with all eight tests applied; statistical significance for the following testes: MSV, MSNV; FR in LE; DD in RE; TDDH in the RE and LE; DP; GIN in the RE and LE. The highest correlation occurred in the PD test. ¹1 Nunes CL, Pereira LD, Carvalho de GS. Scale of auditory behaviors and auditory behavior tests for auditory processing assessment in Portuguese children. CoDAS. 2013;25:209-15.	Kemp AAT, Cardoso ACV (2016) ²⁹29 Kemp AAT, Cardoso ACV [Dissertation] Auditory processing (central) in educational series initial literacy. Marília, SP: Programa de Pós-Graduação em Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista - UNESP; 2016.; Leite Filho CA, et al. (2017) ²⁸28 Leite Filho CA, Silva FF, Pradella-Hallinan M, Xavier SD, Miranda MC, Pereira LD. Auditory behavior and auditory temporal resolution in children with sleep-disordered breathing. Sleep Med. 2017;34:90-5.
Children's Auditory Performance Scale - CHAPS (Donadon et al., 2015)⁴³43 Donadon C, Pinto SNFR, Couto CM, Colella-Santos MF. Questionnaire children's auditory performance scale: translation and adaptation into Brazilian Portuguese [Monograph]. Campinas, SP: Programa de Pós-Graduação Latu Sensu da Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP; 2015.	Translated and adapted to Brazilian Portuguese.	Likert scale style; Divided into six Auditory Task modules: In Noise, In Silence, In ideal Condition, Multiple Information, Auditory Memory/Sequencing and Extended Auditory Attention. Generates score: Gross and average, being possible to analyze them by module or by the total sum. According to the performance, it indicates normal individuals or those at risk for the CAPD. Analysis of results and reference values are not described in the translation and adaptation study.	Target audience: Parents and/or teachers Range of application: 7-14 years of age.	36 closed questions.	There was correlation with the DD Test (binaural integration step).⁴³43 Donadon C, Pinto SNFR, Couto CM, Colella-Santos MF. Questionnaire children's auditory performance scale: translation and adaptation into Brazilian Portuguese [Monograph]. Campinas, SP: Programa de Pós-Graduação Latu Sensu da Faculdade de Ciências Médicas, Universidade Estadual de Campinas - UNICAMP; 2015.	Manoel and Freitas (2006) ³¹31 Manoel RR, Freitas JAS [Thesis] Hearing behavior of the student with a cleft lip and palate: the assessment of the teacher. Bauru, SP: Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo - USP; 2006. Barufi et al. (2004)³⁹39 Barufi L, Netto MP, Ulhôa FM, Rego CF, Feniman MR, Cruz MS, et al. Hearing behavior in individuals with lip and palate cleft: preliminary findings. J Bras Fonoaudiol. 2004;5:1-4. Manoel et al. (2010)³⁰30 Manoel RR, Feniman MR, Buffa MJMB, Maximino LP, Lauris JRP, Freitas JAS. Children's listening with cleft lip and palate in the school. Int Arch Otorhinolaryngol. 2010;14:280-7.
Fisher's Auditory Problems Checklist for Auditory Processing Evaluation - QFISHER (Cibian e Pereira, 2015) ³⁵35 Cibian AP, Pereira LD. Use of questionnaires in the monitoring of auditory training results. Distúrbios Comun. 2015;27:466-78.	Informally translated into Brazilian Portuguese.	Likert scale style; The questions cover hearing, attention, memory, language and school performance aspects. Generates a score: The sum of the items generates a score by category (Hearing, Attention, Memory, Language and School Performance) and a total score. The individual is considered to be at risk for the CAPD if 7 or more items are scored.	Target audience: Parents and/or teachers Range of application: 12-15 years of age.	24 closed questions.	There was improvement of the scores after auditory training of dichotic approach with the following tests: DD, NVD, PSI, SSI, DCVT and LSPMC³⁵35 Cibian AP, Pereira LD. Use of questionnaires in the monitoring of auditory training results. Distúrbios Comun. 2015;27:466-78.	Geribola and Lewis (2008) ³²32 Geribola FC, Lewis DR [Thesis] Analysis of the performance of children aged 7 to 11 years in the tests of location of the sound source acoustic-motor organization and auditory discrimination. São Paulo, SP: Pontifícia Universidade de São Paulo - PUCSP; 2008.
Auditory Processing Domains Questionnaire - APDQ (Yokoyama et al., 2015)⁴⁴44 Yokoyama CH, Dias KZ, Pereira LD. The auditory processing domains questionnaire (APDQ): Portuguese version [Monograph]. São Paulo, SP: Departamento de Fonoaudiologia, Curso de Especialização em Audiologia, Universidade Federal de São Paulo - UNIFESP; 2015.	Translated and validated to Brazilian Portuguese with 100% sensitivity and specificity.	Likert scale style; It has a directed anamnesis; It covers the everyday life auditory skills of a student: decoding, prosody, auditory separation and binaural integration, taking into consideration the quiet and noisy environment. It also includes attention, language and school aspects. Generates score: Analysis performed according to three subscales: "Auditory Processing", "Attention Control" and "Linguistic and Cognitive Skills"; Analysis of the results and parameters of normality were not described in the translation, adaptation and validation study.	Target audience: Parents and/or teachers Range of application: 7-17 years.	52 closed questions.	The following CAP tests were carried out: LS, MSV, MSNV, DP, RGDT, SSI, IPRF, FR, DD, DNV (free and targeted attention). There was correlation with the SL test. ³³33 Martins KVC, Pereira LD, Ziliotto K. Investigation of the set of auditory behaviors by means of a questionnaire [Monograph]. São Paulo, SP: Escola Paulista de Medicina, Departamento de Fonoaudiologia, Curso de Especialização em Audiologia, Universidade Federal de São Paulo - UNIFESP; 2015.	Martins KVC et al. (2015) ³³33 Martins KVC, Pereira LD, Ziliotto K. Investigation of the set of auditory behaviors by means of a questionnaire [Monograph]. São Paulo, SP: Escola Paulista de Medicina, Departamento de Fonoaudiologia, Curso de Especialização em Audiologia, Universidade Federal de São Paulo - UNIFESP; 2015.

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[1] * Corresponding author. E-mail:marciasm@ufcspa.edu.br (M.S. Machado).