Assessing the agreement between auditory processing test results of children with listening difficulties obtained in a clinical setting and in a zoom-based remote environment.

Objective: To compare results of auditory processing (AP) tests delivered in clinic versus remotely via shared video conferencing (VC) software (Zoom) in children with listening difficulties.

Design: Cross-sectional study.

Study sample: 39 children aged 6.8-13.1 years with parent/teacher-reported listening difficulties and with normal cognition, hearing, and middle ear function.

Results: Good agreement was found between in-clinic and remote test results for single-channel AP tests assessing temporal patterning (intraclass correlation coefficient (ICC)=0.81) and diotic listening (ICC = 0.77). However, poor to fair agreement occurred for tests requiring two-channel audio delivery, including the Listening in Spatialised Noise-Sentences test of binaural interaction (ICC = 0.43) and the Dichotic Digits difference Test of binaural integration (ICC = 0.32-0.51), likely due to the technical limitations of current VC software. Overall, remote testing showed greater variability in scores compared to in-clinic.

Conclusions: While some AP skills could be reliably assessed remotely via VC software, tests requiring complex binaural audio integration were limited by technical factors. Tablet-based assessments or remote operation of clinical software may be more viable alternatives for comprehensive tele-audiology assessment of auditory processing disorder.