Question
How do you report SSW results from children with higher order disorders (autism, low IQ, etc.) - do you still compare test scores to the age-based norms?Answer
I try to describe any aberrant test behavior that could lead to extraneous problems on the test. As clinicians we have to make the determination whether our results are mildly, moderately, etc. affected by outside influences or if they are good representations of the person's auditory processing abilities. If the headphones were removed during some items or the person was talking, for example, then either the items should be eliminated from the scoring or you can suggest that there were major problems which puts the specifics of the test or the entire test in question. No doubt having autism or a low IQ greatly increases the chances of an auditory processing disorder (APD). Using the SSW test, we have tested many individuals with these issues. The Intellectually Disabled (ID) adults, in one study, were tested because they were in a residential setting not because of concern for APD. Three out of 44 residents (with IQs of 40-86 and normal hearing) had normal SSW results. Those with cognitive disorders can obtain normal SSW and speech-in-noise test scores because these procedures require only an echoic response (something with which those with ID are often excellent). I use the regular norms but leave myself two options of safety if I feel that in this particular case the person should have some leeway. One can use the 2 standard deviation (SD) norm instead of the 1 SD;or, use the Traditional Analysis (that is for APD especially when there is a hearing loss), because the norms are not as demanding. We have had very good results in auditory training with those who have ID and those on the autism spectrum. This not only showed that they have a major capacity to improve their APD but that APD was a much greater problem before the therapy and much reduced after. In my new book on therapy (Therapy for APD: Simple, Effective Procedures by Jack Katz, Ph.D., available through the Educational Audiology Association, www.edaud.org) there is a more in-depth discussion of this issue.
This Ask the Expert was based on the recorded course series entitled "The Staggered Spondaic Word (SSW) Test - Virtual Conference" that was presented live on AudiologyOnline in Summer 2009. We invite you to view the recorded courses from this series that can be found in the AudiologyOnline library: Scoring Staggered Spondaic Word (SSW) Items - Plugging in the Best Information (course #14141);Scoring the Staggered Spondaic Word (SSW) Test: Using All the Elements (course #14166);and Auditory Processing Disorder (APD): Making a Diagnosis and Checking it Twice (course #14212).
Jack Katz has been involved in the study of central auditory disorders for over five decades. He has developed effective tests and therapy procedures to evaluate and remediate this prevalent problem. He has editied several books on this topic and has written many articles and chapters and has presented on this topic nationally and internationally. He has just completed a book focusing on therapy for APD that will be distributed by Educational Audiology Association. Dr. Katz has spent 50 years developing the SSW test as a measure of central auditory function.
