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This text is designed to provide comprehensive coverage of the anatomy and physiology of the central and peripheral auditory systems. Readers will benefit from the important link between science and clinical practice, with integrated clinical correlates found in each chapter. It is an essential text for graduate programs in audiology and a valuable reference for audiologists at any stage of their career.

There are still no valid, clinically feasible instruments to assess backward masking (BM), an auditory temporal processing (ATP) phenomenon. The aim of this study was to develop, standardize and present evidence of validity for a behavioral test for BM assessment. Young adults were submitted to a BM test (BMT), where they were asked to identify a 1000 Hz pure tone followed by a narrowband noise with interstimulus intervals of 0 to 400 ms and signal-to-noise ratio (SNR) between −20 and −30 dB. The correct response rate and target sound detection threshold were calculated, and the results compared with those of young adults with abnormal ATP tests and older adults. Diagnostic accuracy analyses were carried out. Young adults with normal ATP obtained an average correct response rate of 89 and 87% for SNR −20 and −30 dB, respectively, with average thresholds between 10 and 15 ms and no difference between the left and right ears. Results were more consistent at SNR −20 dB, and the best diagnostic accuracy was obtained for SNR −20 dB, with good specificity, but low sensitivity. Normative values were obtained for the BMT, which proved to be clinically feasible, with preliminary evidence of validity.

Diagnostic batteries to assess the integrity of the central auditory nervous system (CANS) include behavioral (i.e., psychophysical) tests, electrophysiologic procedures, and to some degree, electroacoustic procedures. In this chapter, we focus on behavioral tests used to identify lesions (including diffuse lesions), abnormalities, or dysfunction of the CANS, as well as identify associated functional deficits (e.g., listening in noise deficits). Following a brief review of several tests considered more peripheral in their application (e.g., pure-tone thresholds, otoacoustic emissions, acoustic reflex), we provide some historic context and a review of tests currently in use which are sensitized by design to measure central auditory function, as well as others which have not been adopted clinically and new tests and procedures which hold promise for clinical diagnosis. Tests reviewed include those of dichotic listening, temporal processing (e.g., temporal resolution and temporal patterning), binaural interaction (e.g., masking level differences), monaural low-redundancy measures (e.g., speech in noise or competition, filtered speech, time-compressed speech), and new paradigms which measure auditory evoked potentials in response to test stimuli typically used in behavioral tests.

To provide a commentary on \"Auditory Processing Disorder and Auditory/Language Interventions: An Evidence-Based Systematic Review\" by Fey et al. (2011). Examination of the conclusions drawn by Fey et al. (2011) in the context of the American Academy of Audiology (2010a, 2010b) and American Speech-Language-Hearing Association (2005a, 2005b, 2005c) guidelines for the diagnosis and treatment of auditory processing disorder, the evidence cited therein, and other pertinent published reports. The review provided by Fey et al. (2011) is limited due to the exclusion of pertinent efficacy studies from their analysis, inclusion of studies that did not employ strictly auditory-based therapies, and lack of well-defined experimental groups in many of the studies cited. Further, the questions posed by their literature review may not have addressed the efficacy of true auditory interventions in the remediation of auditory difficulties in children who have primary deficits in central auditory processing. A more comprehensive review than that done by Fey et al. (2011) would have better addressed the fundamental question of the efficacy of direct remediation activities for children with central auditory processing disorder.

This response to A. T. Cacace and D. J. McFarland (2005) identifies points of agreement and disagreement regarding the concept of modularity in the diagnosis of (central) auditory processing disorder [(C)APD]. We concur that the evaluation of (C)APD must take into consideration the influence of higher order global or pansensory issues on performance on tests of central auditory function. To accomplish this goal, multidisciplinary (e.g., multimodal) testing is an integral part of differential diagnosis of (C)APD. We also agree that the efficiency of diagnostic tests of (C)APD should not be evaluated by imprecise criteria [e.g., \"presumed\" or \"suspected\" (C)APD], which do not provide accurate measures of the true sensitivity and specificity of these tests. Our conceptualization and recommendations for clinical practice in this area diverge, however, from that of Cacace and McFarland in a number of pivotal ways. Based on the current limitations of multimodal assessment relative to issues related to scope of practice and test efficiency, as well as the accumulated basic science and clinical literature that demonstrates the nonmodularity and interactive organization of the brain, we recommend use of the sensitized test battery of the central auditory nervous system (CANS) in combination with multidisciplinary testing to differentially diagnose (C)APD and to guide treatment of the disorder. We assert that sensitivity and specificity measures derived from individuals with well-circumscribed lesions of the CANS provide an important guide to establishing the validity of central auditory diagnostic tests. We note that researchers in the area of auditory science and (C)APD must acknowledge the challenges of the clinical arena, and we encourage their continued help to develop diagnostic tools that are both efficient and practical for the differential diagnosis of (C)APD. We conclude that our approach, which combines multidisciplinary evaluation and specific tests of central auditory function that have demonstrated sensitivity and specificity for disorders of the CANS, allows us to identify (and thus rehabilitate) the auditory deficits present in individuals with (C)APD in its \"purest\" form. It also permits the identification and rehabilitation of auditory deficits in individuals who exhibit auditory perceptual problems that coexist with other processing problems, while ruling out those who perform poorly on auditory tests because of a global, supramodal problem involving cognition, attention, language, memory, or related skills.

Chermak and Musiek's two-volume, award-winning handbooks are back in newly revised editions.Extensively revised and expanded, Volume II provides expanded coverage of rehabilitative and professional issues, detailing intervention strategies for children and adults.