The Use of Feather Squadron as a Remote Assessment of Auditory Processing in Australian Children With Listening Difficulties.

Purpose: Auditory processing (AP) disorder is underdiagnosed in Australian children due to reduced access to assessments. Mobile health technology (mHealth) tools such as the AP assessment application Feather Squadron (FS) may be a way to overcome barriers of clinical assessments. This study aimed to consider the validity of FS as a remote assessment tool when compared to current Australian clinical assessments of speech recognition in noise, dichotic listening, temporal processing, and auditory short-term memory.

Method: This study employed a within-subject, comparative design. Thirty-five normal-hearing children aged between 6.8 and 13.1 years (M = 9.1, SD = 1.8) were tested on the following AP skills: dichotic listening, temporal sequencing, speech recognition in noise, and auditory short-term memory. Participants were tested using traditional clinical tests administered by a qualified audiologist and then completed an mHealth delivered counterpart via the FS application. Results of both clinical and FS tests were converted into age-related z scores or scaled scores for comparison.

Results: Significant, positive interclass correlations were found on assessments of dichotic listening in the worse ear and temporal sequencing. However, poor agreement was noted between these assessments using Bland-Altman analysis, which found substantial bias and wide limits of agreement. A moderate significant Pearson correlation was noted when comparing performance on the clinical and FS auditory short-term memory task.

Conclusions: mHealth tools like FS may be useful for identifying children at risk of AP disorder and increasing referrals for assessment. The poor limits of agreement and bias recognize that FS assessments cannot directly replace clinical tests of AP skills and that despite significant relations between tasks, clinical assessments of AP skills delivered by specialists in a controlled environment remains preferable.