The Effect of Presentation Level on the SCAN-3 in Children and Adults

Purpose

The pediatric and adult versions of the SCAN-3 test (Keith, 2009a, 2009b) are widely used to screen and diagnose auditory processing disorders. According to the instruction manual, the test administration is flexible in that it may be administered through an audiometer at 50 dB HL or a portable CD player at the patient or administrator's most comfortable listening level (MCL). Because MCL may vary across individuals, even in those with normal hearing sensitivity, this study explored whether the presentation level affected scores on the SCAN-3 for both pediatric and adult populations.

Method

Twenty-two young adults and 23 children with normal hearing sensitivity and middle ear function were administered the SCAN-3 three different times at 1-month intervals, at 40, 50, and 60 dB HL. The stimulus level of the SCAN-3 was counterbalanced across participants to eliminate test order effects. In addition, MCL was measured in the pediatric participants during each session.

Results

MCL varied significantly across children as well as between test sessions, ranging from 40 to 75 dB HL. Performance on 3 of the 4 subtests administered, as well as composite scores, was significantly different across presentation levels (based on scaled scores). Effect sizes were also calculated and found to be strong. The number of composite scores interpreted as within normal limits versus borderline or disordered was also statistically different across presentation levels.

Conclusions

Presentation level appears to affect performance on auditory figure ground, monaural low-redundancy, and binaural integration types of auditory processing tasks that are measured by the SCAN-3. In children, MCL was found to vary significantly both between and within individuals. Although several professions outside audiology are qualified to administer the SCAN-3, it is likely that many of these individuals administer the test without an audiometer and would use an MCL to determine presentation level. It is recommended that SCAN-3 users administer the test through an audiometer at 50 dB HL, rather than with a portable CD player, using MCL values to avoid any presentation level effects.

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