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Auditory Processing in Spanish-English Bilinguals: Is Performance Better When Tested in Spanish or English?

Comparing Central Auditory Processing Performance in Bilinguals Using L1 vs. L2 Materials

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05452486
Enrollment
29
Registered
2022-07-11
Start date
2022-07-25
Completion date
2022-11-16
Last updated
2024-09-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Auditory Processing Disorder

Keywords

bilingual, Spanish

Brief 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.

Interventions

DIAGNOSTIC_TESTEnglish APD assessment

Materials presented in English

DIAGNOSTIC_TESTSpanish APD assessment

Materials presented in Spanish

Sponsors

University of Arkansas
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
DIAGNOSTIC
Masking
NONE

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.

Eligibility

Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
Yes

Inclusion criteria

* Bilingual Spanish-English speakers * Must have learned Spanish first followed by English * Proficiency in both languages * Normal hearing

Exclusion criteria

* Hearing loss * History of traumatic brain injuries (TBI) * Neurological issues * Auditory processing concerns

Design outcomes

Primary

MeasureTime frameDescription
Mean Difference in Scores for APD Assessment Using English vs. Spanish Materials90 minutesThe APD assessment will include sub-tests (dichotic digits, dichotic word listening test, synthetic sentence identification test). Participants' performance will be scored as percent correct for each sub-test.

Countries

United States

Participant flow

Pre-assignment details

Of the 29 enrolled participants, 25 met the inclusion criteria and completed the auditory processing assessments.

Participants by arm

ArmCount
Auditory Processing Disorder (APD) Assessment
All participants received both experimental conditions (i.e., test materials in English, test materials in Spanish) in a counterbalanced order. English APD assessment: Materials presented in English Spanish APD assessment: Materials presented in Spanish
25
Total25

Baseline characteristics

CharacteristicAuditory Processing Disorder (APD) Assessment
Age, Continuous33.48 years
STANDARD_DEVIATION 11.17
Ethnicity (NIH/OMB)
Hispanic or Latino
25 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
0 Participants
Race (NIH/OMB)
More than one race
4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
9 Participants
Race (NIH/OMB)
White
11 Participants
Sex: Female, Male
Female
16 Participants
Sex: Female, Male
Male
9 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 25
other
Total, other adverse events
0 / 25
serious
Total, serious adverse events
0 / 25

Outcome results

Primary

Mean Difference in Scores for APD Assessment Using English vs. Spanish Materials

The APD assessment will include sub-tests (dichotic digits, dichotic word listening test, synthetic sentence identification test). Participants' performance will be scored as percent correct for each sub-test.

Time frame: 90 minutes

ArmMeasureGroupValue (MEAN)Dispersion
APD AssessmentsMean Difference in Scores for APD Assessment Using English vs. Spanish MaterialsDichotic Digits - Spanish97.40 percentage of correctly identified stimStandard Error 0.58
APD AssessmentsMean Difference in Scores for APD Assessment Using English vs. Spanish MaterialsDichotic Digits - English94.87 percentage of correctly identified stimStandard Error 0.58
APD AssessmentsMean Difference in Scores for APD Assessment Using English vs. Spanish MaterialsDichotic Words - Spanish97.14 percentage of correctly identified stimStandard Error 0.9
APD AssessmentsMean Difference in Scores for APD Assessment Using English vs. Spanish MaterialsDichotic Words - English85.48 percentage of correctly identified stimStandard Error 0.9
APD AssessmentsMean Difference in Scores for APD Assessment Using English vs. Spanish MaterialsSynthetic Sentences - Spanish100 percentage of correctly identified stimStandard Error 0
APD AssessmentsMean Difference in Scores for APD Assessment Using English vs. Spanish MaterialsSynthetic Sentences - English100 percentage of correctly identified stimStandard Error 0
Comparison: Dichotic digits comparisonp-value: <0.01Mixed Models Analysis
Comparison: Dichotic words comparisonp-value: 0.69Mixed Models Analysis

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026