Auditory Processing in Spanish-English Bilinguals: Is Performance Better When Tested in Spanish or English?
Condition: Auditory Processing Disorder
MeSH terms: Auditory Perceptual Disorders
Study type: Interventional

Summary: 
      The purpose of this study is to learn more about how bilingual individuals process sound in
      challenging listening environments and how testing language may impact results on auditory
      processing assessments. Auditory processing evaluations assess specific auditory skills
      necessary to hear and understand complex auditory signals, but many of these tests rely
      heavily on language. This poses an issue for individuals with native languages other than
      English because the test results may not clearly identify whether performance is due to an
      auditory processing problem or to the language used in the test materials. This study aims to
      identify whether auditory processing performance differs in Spanish-English bilinguals based
      on the language of the test materials used (English vs. Spanish). Ultimately, the results of
      this study may aid in more accurate diagnoses and treatment of auditory processing disorders
      in bilingual individuals.
    

Detailed description: 
      Auditory processing disorder (APD) is a disorder caused by a disruption within the central
      auditory pathway that impairs processing of complex or degraded auditory inputs. Patients
      with this condition often present with normal hearing but still report problems understanding
      speech. This commonly manifests as individuals having difficulty understanding speech in
      challenging listening environments (e.g., noisy backgrounds, reverberant environments, rapid
      speech), localizing sounds, and following complex auditory directions. An underlying auditory
      skill vital to these processes is binaural processing, or the ability to utilize auditory
      cues from both ears. Binaural processing aids in identifying a talker in the midst of
      background noise and allows us to better separate relevant from irrelevant inputs.

      While auditory processing evaluations assess specific auditory skills (like binaural
      processing) necessary for efficient processing and understanding of complex auditory signals,
      many of the tests rely heavily on language. This poses an issue for individuals for whom
      English is not their native language. Because the tests are linguistically loaded, the
      obtained results do not clearly identify whether an issue should be attributed to a central
      auditory problem or to the language used in the test materials. Thus, audiologists are often
      hesitant to test bilingual patients who demonstrate features of APD.

      It is possible that bilingual individuals would perform more favorably when tested in their
      native language (L1). Indeed, differences in complex auditory task performance have been seen
      in Spanish-English bilinguals when materials were presented in Spanish versus English. Recent
      studies have evaluated test-language effects in bilingual education and described significant
      improvements in performance when bilinguals were instructed and tested in their native
      language (L1) compared to performance in their later acquired language (L2). Numerous studies
      have also assessed monolingual vs. bilingual performance in complex auditory tasks including
      listening in noise, auditory memory, and competing speech. While much research in auditory
      processing of bilingual speakers compares performance between monolinguals and bilinguals,
      evidence to inform best clinical practice in the assessment of APD in bilinguals is lacking.
      To date, relatively few studies investigate performance within the same participant with
      testing language being the differential factor.

      Therefore, the purpose of this study is to compare binaural processing performance in
      Spanish-English bilingual participants when tested in Spanish (L1) versus in English (L2).
      Based on prior literature, we suspect that bilingual participants will perform better when
      they are instructed and presented with assessments in their native language versus when they
      are assessed in their later acquired language (L2). However, it is possible that our
      participants, who will be proficient in both L1 and L2, will show no difference in task
      performance. Regardless, by comparing binaural processing performance in bilingual
      participants, we will clarify whether testing bilingual individuals in a secondary language
      (when proficient in that language) results in valid and reliable measures of their auditory
      processing abilities. Thus, our results will provide evidence to establish best clinical
      practice when evaluating bilingual listeners for auditory processing deficits. This will
      enable clinicians to more confidently evaluate and diagnose auditory processing disorders in
      bilingual populations.
    

Intervention name(s): English APD assessment; Spanish APD assessment
Intervention type(s): Diagnostic Test; Diagnostic Test
Intervention description(s): Materials presented in English; Materials presented in Spanish
Intervention model: Single Group Assignment
Intervention model description: This study is a repeated measures experimental design in which participants will complete auditory processing tests in both English (L2) and Spanish (L1). The presentation of Spanish and English test materials will be counterbalanced across participants to minimize fatigue and practice effects.
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: bilingual; Spanish