Auditory Processing Intervention Program for school-aged children – development and content validation

Luís, Cátia; Abrantes, Ana; Oliveira, Catarina; Alves, Marisa; Martins, Jorge Humberto

doi:10.1590/2317-1782/20212021146en

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Original Article • CoDAS 35 (1) • 2023 • https://doi.org/10.1590/2317-1782/20212021146en copy

Auditory Processing Intervention Program for school-aged children – development and content validation

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

The study aimed at the development and content validation of an Auditory Processing Intervention Program for school-aged European Portuguese speaking children with Auditory Processing Disorder.

Methods

The first step was the program’s development and its instructions manual, which includes objectives, activities, procedures, materials, reinforcement, instructions, and verbal stimuli used, for the following auditory skills: auditory discrimination, auditory attention; auditory memory; auditory closure; figure-ground; auditory separation; auditory integration; binaural fusion; content validation was performed next, with two expert panels analyzing the program, through the use of a questionnaire. Content validity was calculated using the content validity index.

Results

Program evaluation shows an excellent content validity. Some items were modified after analyzing the experts’ comments and suggestions (e.g. instructions, intensity differences, main character).

Conclusion

This work allowed the development and content validation of an auditory processing intervention program, with verbal stimuli, selected according to strict linguistic criteria. In the future, the acceptability and efficacy of this program with the target population should be analyzed.

Keywords
Auditory Processing; Rehabilitation; Child; Portugal; Educational Status

Space	Targeted Skills	No. of Levels	Name of the Activity	Type of Stimuli
Dolphin Bay	Auditory discrimination	4	The Shark Scare	Consonant-Vowel Syllables
			The Dolphin's Jump	Words
			Soraia, the Ray	Words
			The Seahorse's Kiss	Pseudowords
Pelican Feeding	Auditory Attention	3	Tadpoles	History
			Birds	History
			Insects	Music
Enchanted Forest	Auditory Memory	5	The Rhino's Horn	Words of the semantic category related to colors
			The Lion's Mane	Words from the semantic category related to food
			The Zebra's Stripes	Words
			The Elephant's Trunk	Pseudowords
			The Giraffe's Neck	History
Prehistoric Park	Closure	4	Pterodactylus	Sets of three equal/one different words+ noise
			Diplodocus	Sets of three equal/one different words+ noise
			Triceratops	Simple sentences + noise
			T-Rex	Complex phrases + noise
Vibrant Sky	Binaural separation	5	Hunter Owl	Words
			Talking Parrot	Pairs of similar words
			How many babies can the stork carry?	Pairs of similar words
			The Pigeon Postman	Words (presented two at a time in each ear)
			The flight of the eagle	Simple sentences
Crawlers' Nest	Binaural integration	4	Snake Labyrinth	Words
			Iguana's log	Words
			How many colors does the chameleon have?	Simple sentences
			How many worms does the salamander eat?	Sentences with ungrammatical semantic elements.
Mr. Manel's farm	Binaural fusion	4	The laying hen	Phrases
			The glutton rabbit	Words
			The hungry pig	Pseudowords
			The jumping goat	History and questions
The Enchanted Forest	Figure-ground	3	The squirrel	History and words
			The wolf	Complex sentences
			The fox	Simple sentences

Subjects Identification		Gender	Educational Stage	Years of Profession Activity	Intervention*	Degree ^* * Regarding the AP scope	Instructor*
PE1	Subject 1	Female	Licentiate	5	Yes	Yes	No
	Subject 2	Female	Licentiate	27	Yes	Yes	No
	Subject 3	Female	Doctorate	17	No	Yes	No
	Subject 4	Female	Doctorate	17	Yes	Yes	Yes
	Subject 5	Female	Licentiate	20	Yes	Yes	No
PE2	Subject 1	Female	Licentiate	14	Yes	Yes	Yes
	Subject 2	Female	Licentiate	20	Yes	Yes	Yes
	Subject 3	Female	Licentiate	19	Yes	Yes	Yes
	Subject 4	Female	Master's Degree	8	Yes	Yes	No
	Subject 5	Female	Master's Degree	14	Yes	Yes	No
	Subject 6	Female	Doctorate	12	Yes	Yes	Yes

Items to validate/validated	CVI
1. These materials are useful for clinical practice.	1
2. The selected auditory skills are adequate.	1
3. The instructions are clear and have practical relevance	0.8
4. The program is suitable for school-aged children with Auditory Processing Disorder.	1
5. The program's framework (a girl visiting a zoo) is appropriate.	1
6. The division of spaces to visit in the zoo in connection to the selected skills is appropriate.	1
7. The feedback reward given in each activity is adequate.	1
8. The tasks included in the auditory discrimination section (dolphin bay) allow for the appropriate intervention with children with difficulties related to said skill	1
9. The tasks included in the auditory attention section (pelicans' feeding) allow for the appropriate intervention with children with difficulties related to said skill.	1
10. The tasks included in the auditory memory section (enchanted forest) allow for adequate intervention with children with difficulties related to said skill.	1
11. The tasks included in the closure section (prehistoric park) allow for adequate intervention with children with difficulties related to said skill.	0.6
12. The stimuli selected for each of the tasks are adequate.	0.8
13. The number of stimuli included in the tasks is adequate.	1
14. Within each skill, the organization of tasks at difficulty levels is adequate.	1
PE1 overall total	0.94

Items to validate/validated	CVI
15. These materials are useful for clinical practice.	1
16. The selected auditory skills are adequate.	1
17. The instructions are clear and have practical relevance.	0.83
18. The program is suitable for school-aged children with Auditory Processing Disorder.	1
19. The program's framework (a girl visiting a zoo) is appropriate.	0.83
20. The division of spaces to visit in the zoo in connection to the selected skills is appropriate.	1
21. The feedback reward given in each activity is adequate.	1
22. The tasks included in the binaural separation section (Vibrant Sky) allow for the appropriate intervention with children with difficulties related to said skill.	1
23. The tasks included in the binaural integration section (Crawlers' Nest) allow for the appropriate intervention with children with difficulties related to said skill.	0.83
24. The tasks included in the binaural fusion section (Mr. Manel's Farm) allow for the appropriate intervention with children with difficulties related to said skill.	1
25. The tasks included in the figure-ground section (Enchanted Forest) allow for the appropriate intervention with children with difficulties related to said skill.	1
26. The stimuli selected for each of the tasks are adequate.	1
27. The stimuli selected for each of the tasks are adequate.	1
28. Within each skill, the organization of tasks at difficulty levels is adequate.	1
PE2 overall total	0.96

Space	Alteration
Program framework	Gender choice (male/female) of PIPA's main character
Vibrant Sky	Alteration in instructions	Introduction of a higher intensity variation (20dB, 15dB, 10dB, 5dB and without variation) between the stimuli
Crawlers' Nest
Mr. Manel's Farm
The Enchanted Forest		Intensity variation manipulation (20dB, 15dB, 10dB, 5dB and no variation)
The Dolphin's Jump	Alteration of three pairs of stimuli
The Seahorse's Kiss	Increased number of stimuli
The flight of the Eagle	Alteration of some sentences
How many colors does the chameleon have?	Alteration of some sentences
How many worms does the salamander eat?	Conservation of sentences with only ungrammatical semantic elements. Review of the entire lexicon
The Rhino's Horn	Reformulation of the task to allow it to be performed by children with color blindness.
All Activities	Introducing training items

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[1] Conflict of interests: nothing to declare.