A range of deficits can cause children difficulty when understanding speech in challenging listening environments, such as noisy classrooms. Children with listening difficulties are at risk of having poor long-term academic outcomes and social skills, especially when clinicians cannot detect or remediate their specific deficits. Deficits in auditory, speech, language, or cognition abilities may present in a similar manner. Currently, it is difficult to determine the cause of these difficulties. A systematic approach to differentiate between these causes in individual children has been devised (Dillon & Cameron, 2021, doi:10.1097/AUD.0000000000001069).

Children aged 6-12 years, enrolled in mainstream primary schools, go through a tri-level test battery; a combination of top-level speech perception in noise and reverberation ability, mid-level phoneme identification ability, and low-level acoustic resolution ability is applied (Dillon & Cameron, 2021). In conjunction with language and cognitive test scores, the combined approach allows for differentiation of the cause of the observed listening deficit.

The present study aims to investigate the relationship between hearing, speech, language and cognition as a first step to diagnosing auditory processing disorder (APD). Speech-sound identification ability in noise and reverberation, non-speech auditory processing abilities, language abilities and cognitive abilities will be used to predict the understanding of sentences in noise and reverberation. A more comprehensive understanding of the underlying factors contributing to listening difficulties is critical for the development of customised efficacious interventions to avoid and alleviate long-term consequences.