Central auditory testing in young Tanzanian children: feasibility and relationship to cognition.

Objective: Central auditory tests (CATs) typically target children aged six and older and are not included in paediatric cognitive assessment. CATs have shown significant correlations with neurocognitive processing ability in adults. Whether children under six can reliably complete CATs or if CAT performance correlates with cognitive ability in children with normal hearing is unclear. This study aimed to determine the feasibility of conducting CATs in young children and investigate whether performance on CATs could predict neurocognitive function in a cohort of young Tanzanian children. If young children can complete CATs and their results correlate with neurocognitive function, CATs could supplement cognitive screening in young children.

Design: Data are from the first visit of an ongoing longitudinal study in Dar es Salaam, Tanzania. Each child was administered four CATs (the Hearing in Noise Test-HINT, Triple Digit Test-TDT, Staggered Spondaic Words test-SSW, and Gap Detection test-Gap) and one non-verbal cognitive test (Leiter-3). Performance on the CAT battery (HINT, TDT, SSW) was compared to performance on the Leiter-3, a non-verbal neurocognitive assessment.

Study sample: Cross-sectional study in an infectious disease centre in Dar es Salaam, Tanzania. Participants included 486 Tanzanian children (50.6% female) aged 3-9 years with 46.7% living with HIV.

Results: Over 70% of children completed at least one CAT during their first visit (average age 6.29 years) with 61% able to complete three (HINT, TDT, and SSW), minus Gap. By age five, 62.5% of children could complete the CAT battery. Completing the CAT battery predicted higher IQ, and performance on the battery was associated with stronger cognitive abilities.

Conclusions: The studied CAT battery, minus Gap detection, could be completed reliably by age five. CATs and cognitive domains (IQ, processing speed, memory) were significantly associated. Administering CATs is feasible in children younger than six, potentially providing a valuable supplementary tool to assess auditory and cognitive function.