Longitudinal Listening Difficulties in Children Initially Presenting with Speech Sound Disorder: Two Case Reports

Vollständiger Abstract

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Background and Clinical Significance: Children may experience substantial listening difficulty (LiD) despite clinically normal pure-tone thresholds. The longitudinal course of LiD in children initially referred for speech sound disorder (SSD) is not well documented. Case Presentation: We retrospectively reviewed two individuals first evaluated during the preschool years for SSD and followed through adolescence or adulthood. Available preschool records showed air-conduction thresholds no poorer than 20 dB HL. Tympanometry showed type C1 in the right ear and type A in the left ear in Case 1 and bilateral type-A tympanograms in Case 2; bone-conduction thresholds and objective auditory tests were not documented in the reviewed records. Both cases later showed reduced word recognition in speech noise relative to their good performance in quiet, although the quiet and noise presentation levels were not identical in Case 2. A Japanese mishearing checklist yielded 6/60 in Case 1 and 24/60 by caregiver report and 45/60 by self-report in Case 2. Preschool and school-age assessments identified broader phonological, language, memory, or sequential-processing weaknesses. Serial Auditory Processing Test (APT) findings were heterogeneous. Original numerical source data were retrieved for all four serial APT assessments: Case 1 at ages 11 and 14 years and Case 2 at ages 16 and 20 years. All APT findings are interpreted descriptively, not as evidence of improvement or a diagnosis of auditory processing disorder (APD). Both cases received speech–language intervention. Case 1 later received school accommodations, whereas Case 2 continued to require compensatory strategies and adjustments in educational and workplace settings. Conclusions: These cases describe the co-occurrence of early speech-language difficulties and later clinically significant LiD but do not establish causality, predictive markers, or an APD diagnosis. Their value is descriptive: they show how functional listening needs and support requirements changed across development in two selected clinical cases.