article · International Journal of Audiology
Central auditory tests are usually reserved for children aged six and older and are rarely incorporated into paediatric cognitive evaluations. A study assessed 486 children aged three to nine years in Dar es Salaam, Tanzania, including participants living with HIV, to establish whether younger children can reliably complete these evaluations. Participants undertook four auditory tests alongside a non-verbal cognitive assessment. More than 70 percent of the children completed at least one auditory test, and over 60 percent completed a three-test battery by age five, excluding the gap detection test. Successful completion of the auditory battery predicted higher IQ scores, and performance strongly correlated with core cognitive functions, including memory and processing speed. The findings demonstrate that central auditory testing is feasible in children under six and could serve as a complementary screening method for cognitive and auditory development.
Assessing cognitive health in young children often requires complex tools that can be difficult to administer. Demonstrating that auditory processing tests are feasible in children as young as five, and that their results mirror non-verbal cognitive abilities, suggests an accessible complementary method for spotting early cognitive and developmental challenges in young paediatric populations.
The findings indicate applied, clinical-stage potential for healthcare providers and diagnostic developers looking to expand paediatric screening protocols. The validated battery of three tests could be packaged or adapted by diagnostic software developers and clinics as a supplementary screening tool for cognitive and auditory function in early childhood. Real-world implementation would require clinical integration and validation alongside standard paediatric assessment programmes.
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OBJECTIVE: Central auditory tests (CATs) typically target children aged six and older and are not included in paediatric cognitive assessment. CATs have shown significant correlations with neurocognitive processing ability in adults. Whether children under six can reliably complete CATs or if CAT performance correlates with cognitive ability in children with normal hearing is unclear. This study aimed to determine the feasibility of conducting CATs in young children and investigate whether performance on CATs could predict neurocognitive function in a cohort of young Tanzanian children. If young children can complete CATs and their results correlate with neurocognitive function, CATs could supplement cognitive screening in young children. DESIGN: Data are from the first visit of an ongoing longitudinal study in Dar es Salaam, Tanzania. Each child was administered four CATs (the Hearing in Noise Test-HINT, Triple Digit Test-TDT, Staggered Spondaic Words test-SSW, and Gap Detection test-Gap) and one non-verbal cognitive test (Leiter-3). Performance on the CAT battery (HINT, TDT, SSW) was compared to performance on the Leiter-3, a non-verbal neurocognitive assessment. STUDY SAMPLE: Cross-sectional study in an infectious disease centre in Dar es Salaam, Tanzania. Participants included 486 Tanzanian children (50.6% female) aged 3-9 years with 46.7% living with HIV. RESULTS: Over 70% of children completed at least one CAT during their first visit (average age 6.29 years) with 61% able to complete three (HINT, TDT, and SSW), minus Gap. By age five, 62.5% of children could complete the CAT battery. Completing the CAT battery predicted higher IQ, and performance on the battery was associated with stronger cognitive abilities. CONCLUSIONS: The studied CAT battery, minus Gap detection, could be completed reliably by age five. CATs and cognitive domains (IQ, processing speed, memory) were significantly associated. Administering CATs is feasible in children younger than six, potentially providing a valuable supplementary tool to assess auditory and cognitive function.
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DOI: 10.1080/14992027.2025.2545441
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