Auditory and Speech Performance Test for Children (ASPT-C)

Abstract

The Auditory and Speech Performance Test for Children (ASPT-C) is a standardized, computer-administered screening instrument developed by Hale Hancer and colleagues in 2024. Designed to assess auditory and speech processing abilities in pediatric populations aged 6 to 12 years, the instrument specifically targets difficulties in discriminating speech under both optimal and acoustically challenging listening conditions. Central to the ASPT-C is its dual-metric evaluation paradigm, which simultaneously captures response accuracy and processing latency (reaction time in milliseconds) across four distinct computerized subtasks comprising 15 trials each (totaling 60 stimulus items). These tasks systematically vary linguistic meaningfulness (real meaningful word pairs versus meaningless pseudoword rhyming pairs) and acoustic complexity (quiet baseline versus competitive background noise). Psychometric evaluation of the ASPT-C in clinical cohorts of children with specific learning difficulties (SLD) and neurotypical peers demonstrated robust structural validity and high diagnostic utility. Exploratory factor analysis revealed a clear two-factor structure corresponding to Accuracy (explaining 37.80% of the variance) and Reaction Time (explaining 28.85% of the variance), collectively accounting for 66.65% of the total variance. Reliability evaluations showed excellent internal consistency for the total reaction time scale (Cronbach’s α = .93; subtask α ranging from .77 to .90), with total accuracy yielding a Kuder-Richardson Formula 20 (KR-20) coefficient of .70. Test-retest reliability across multi-week intervals exhibited high stability for both Reaction Time (r = .93; intraclass correlation coefficients [ICC] = .67–.80) and Accuracy (r = .89; ICC = .49–.76). By providing an objective, dual-channel profile of auditory-cognitive performance, the ASPT-C represents an advanced psychometric solution for the early detection of central auditory processing deficits and language-based learning impairments in educational and clinical settings.

Keywords

auditory processing disorder, speech perception in noise, specific learning difficulties, reaction time chronometry, pediatric audiology, speech recognition screening, auditory discrimination, psychoacoustics, phonological processing, neurodevelopmental assessment

Authors

The Auditory and Speech Performance Test for Children (ASPT-C) was developed and validated by a multidisciplinary team of clinical audiologists, neurophysiologists, and biostatisticians in Turkey:

• Hale Hancer, Ph.D. — Department of Audiology, Faculty of Health Sciences, Başkent University, Ankara, Turkey.
• Erhan Kiziltan, M.D., Ph.D. — Department of Physiology, Faculty of Medicine, Başkent University, Ankara, Turkey.
• Pinar Civak Tan, Ph.D. — Department of Audiology and Speech Disorders, Faculty of Health Sciences, Ankara University, Ankara, Turkey.
• Derya Gokmen, Ph.D. — Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey.
• Serhat Hayme, Ph.D. — Department of Biostatistics and Medical Informatics, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey.
• Suna Tokgoz Yilmaz, Ph.D. — Department of Audiology, Faculty of Health Sciences, Ankara University, Ankara, Turkey.

Purpose

The principal objective of the Auditory and Speech Performance Test for Children (ASPT-C) is to identify, quantify, and screen for subtle auditory processing vulnerabilities that undermine speech perception, particularly within degraded or noisy acoustic environments. While routine clinical pure-tone audiometry evaluates peripheral hearing thresholds, it fails to capture higher-order central auditory and phonological decoding operations. Children who display normal peripheral audiometric profiles often experience significant comprehension deficits in classroom environments, where ambient background noise, reverberation, and competing chatter obscure linguistic signals. The ASPT-C bridges this clinical gap by offering a standardized, chronometric, and behavioral screening protocol tailored for school-age children aged 6 to 12 years (with heightened sensitivity documented across 7 to 10 years).

A primary clinical purpose of the ASPT-C is the differential screening of auditory and linguistic deficits common in neurodevelopmental conditions, particularly specific learning difficulties (SLD), dyslexia, and central auditory processing disorder (CAPD). Children with learning difficulties frequently present with underlying temporal processing, phonological awareness, and acoustic discrimination deficits that impair their reading, spelling, and academic achievement. By evaluating how accurately and swiftly a child distinguishes phonemically similar rhyming pairs (both meaningful words and phonotactically valid nonwords/pseudowords), the instrument elucidates the extent to which auditory perceptual limitations reflect bottom-up sensory decoding problems versus top-down linguistic lexical retrieval difficulties.

In educational and clinical research, the ASPT-C serves as an objective outcome measure for auditory training therapies, speech-language interventions, and classroom acoustic accommodations. The test design moves beyond traditional paper-and-pencil or subjective rating forms by leveraging millisecond-accurate computer chronometry. By documenting both hit rates and latency variations, the tool provides clinicians with granular insight into the neurocomputational effort required for speech processing, revealing compensatory processing strategies that might otherwise remain masked in basic accuracy assessments.

Psychological Construct

The ASPT-C measures the overarching construct of Auditory and Speech Performance, operationalized through two interrelated functional domains: Auditory/Speech Accuracy and Response Time (Chronometric Processing Speed). Rather than evaluating isolated auditory sensation, the instrument measures the real-time cognitive decoding of acoustically degraded, phonetically complex speech stimuli.

1. Accuracy Domain

The accuracy dimension reflects the behavioral precision with which the pediatric auditory system can discriminate, recognize, and categorize speech sounds under varying linguistic and signal-to-noise ratios. It encompasses four primary cognitive-perceptual components:

• Auditory Discrimination: The bottom-up sensory capacity to detect minimal acoustic differences between paired auditory stimuli without requiring semantic lexical access (assessed via meaningless pseudoword rhyming pairs).
• Auditory Recognition: The cognitive matching of incoming non-lexical acoustic tokens against stored acoustic-phonetic prototypes in working memory.
• Speech Discrimination: The phonemic differentiation of meaningful lexical items that differ by discrete phonological features (such as voicing, place, or manner of articulation) within rhyming word pairs.
• Speech Recognition: The retrieval of semantic representations from the mental lexicon following acoustic processing, reflecting the interaction of sensory encoding and higher-level language knowledge.

Accuracy is formally evaluated across two environmental conditions: clean listening conditions (quiet baseline) and compromised conditions featuring multi-talker or continuous background speech noise. Performance decrements in noise reflect deficits in auditory figure-ground segregation and binaural speech-in-noise resolution.

2. Response Time Domain

The response time domain measures central processing efficiency and cognitive load, recorded in milliseconds from stimulus offset to motor response execution. In pediatric neurodevelopment, response latency is a critical indicator of neural conduction efficiency, temporal resolution, and executive control. The components of this domain parallel those of accuracy:

• Auditory Discrimination Reaction Time: Processing speed during low-level sensory acoustic contrast detection.
• Auditory Recognition Reaction Time: Latency involved in structural representation matching devoid of semantic interference.
• Speech Discrimination Reaction Time: Temporal cost of resolving competitive lexical-phonological boundaries.
• Speech Recognition Reaction Time: Duration required for complete lexical access, semantic confirmation, and motor initiation.

Elevated reaction times in children, even in the presence of intact accuracy, reflect excessive cognitive listening effort, neurocomputational delays in temporal auditory sequencing, or compensatory reliance on conscious linguistic inference.

Theoretical Framework

The conceptual foundation of the ASPT-C integrates principles from Information Processing Theory, modern psychoacoustic models of auditory scene analysis, and structural guidelines for diagnostic test accuracy (Bossuyt et al., 2015; Streiner et al., 2015). At its core, the test relies on the theoretical distinction between bottom-up sensory-acoustic analysis and top-down cognitive-linguistic processing during auditory perception.

Bottom-Up Acoustic Analysis vs. Top-Down Lexical Processing

Auditory perception operates along a hierarchical processing axis. When auditory stimuli enter the peripheral ear, the central auditory nervous system (CANS) must perform fine-grained spectrotemporal analyses to extract formant transitions, voice-onset times (VOT), and envelope fluctuations. In favorable acoustic environments, healthy neurotypical children readily process these cues with minimal cognitive overhead. However, when ambient noise is introduced, peripheral acoustic representations are partially masked, requiring the brain to engage top-down phonemic restoration, working memory capacity, and lexical knowledge to fill in missing auditory information.

The ASPT-C incorporates this theoretical dynamic by juxtaposing meaningful lexical words against meaningless pseudowords. According to the Dual-Route model of speech and reading processing, meaningful words allow listeners to utilize lexical-semantic pathways to facilitate auditory recognition (top-down support). Conversely, meaningless pseudoword rhyming pairs preclude semantic bootstrapping, forcing the child to rely entirely on the sub-lexical, acoustic-phonetic route (pure bottom-up discrimination). Discrepancies between meaningful and pseudoword performance reveal whether a child suffers from a fundamental auditory-perceptual processing deficit or an inability to mobilize higher-order language scaffolds.

Mental Chronometry and Cognitive Listening Effort

The theoretical framework also draws heavily upon mental chronometry, initially formulated by Franciscus Donders and elaborated in modern cognitive science. Traditional pediatric audiology often relies on percentage-correct metrics, which can produce ceiling effects in mild or subclinical processing disorders. By recording reaction time in milliseconds, the ASPT-C operationalizes cognitive listening effort. Under degraded listening conditions (speech-in-noise), additional neurocomputational resources are allocated to perceptual disambiguation, resulting in systematic latency shifts. This latency penalty exposes vulnerable auditory pathways that appear functionally preserved under static accuracy scores alone.

Validity

The validation protocol for the ASPT-C was executed in strict accordance with modern diagnostic development guidelines (Bossuyt et al., 2015; Boateng et al., 2018; de Vet et al., 2011). The validation cohort comprised Turkish children divided into two primary groups: children diagnosed with Specific Learning Difficulties (SLD) and age-matched neurotypical peers with typical development.

Construct and Known-Groups Validity

Construct validity was demonstrated using a known-groups comparative paradigm. Analysis revealed statistically significant differences between children with SLD and neurotypical controls across both Accuracy and Reaction Time parameters (p < .001). Children with SLD exhibited systematically lower accuracy scores and prolonged reaction times across all four tasks, with performance divergence becoming most pronounced in the noise-degraded and meaningless pseudoword conditions. This confirmed the test’s ability to reflect differences in central auditory efficiency and phonological processing capacity between clinical and non-clinical groups.

Developmental and Age-Related Validity

The researchers investigated developmental trajectories across childhood age bands (6–12 years, focused on 7–10 years). In the neurotypical developmental group, significant age-related improvements were observed in Accuracy scores, reflecting neurobiological maturation of the central auditory pathways and refinement of phonemic categorization. Conversely, Reaction Time exhibited stable chronometric characteristics across narrow age bands in typical children, whereas children with SLD demonstrated atypical reaction time variance, supporting the construct that latency captures processing inefficiencies distinct from standard age-graded accuracy acquisition.

Content and Face Validity

Content validity was established through formal expert panel reviews composed of academic audiologists, speech-language pathologists, and cognitive physiologists. The stimulus pool was curated to ensure phonemic balance, strict rhyming concordance, and developmental appropriateness of the lexical inventory for elementary school children. Stimuli were matched for syllabic length, phonetic transitions, and phonetic complexity to avoid extraneous articulatory confounds.

Reliability

The ASPT-C demonstrates strong psychometric reliability across both internal consistency parameters and temporal stability metrics, supporting its operational readiness as a screening tool.

Internal Consistency

Internal consistency was examined separately for the continuous Reaction Time dimensions and the dichotomous Accuracy tasks:

• Reaction Time: The total Reaction Time scale exhibited excellent internal consistency, yielding an overall Cronbach’s α of .93. Across individual task subscores, Cronbach’s α values ranged from .77 to .90, indicating high homogeneity of chronometric latency measurements across diverse acoustic conditions.
• Accuracy: For the dichotomous accuracy trials (scored correct/incorrect), the total scale achieved a Kuder-Richardson Formula 20 (KR-20) coefficient of .70, demonstrating acceptable overall internal consistency for a multidimensional cognitive-perceptual screening instrument. Subtask KR-20 indices ranged from .20 to .56, reflecting intentional task-difficulty gradients and the targeted brevity (15 items) of each discrete sub-condition.

Test-Retest Stability

Temporal stability was evaluated by administering the test twice across a multi-week interval to representative samples under standardized laboratory settings:

• Reaction Time Stability: Pearson correlation coefficients for Reaction Time reached r = .93, with intraclass correlation coefficients (ICC) across tasks ranging from .67 to .80, indicating substantial to excellent temporal reproducibility of processing speed.
• Accuracy Stability: Pearson correlation for Accuracy scores was r = .89, with task ICC values ranging between .49 and .76, confirming reliable tracking of perceptual accuracy across time without pronounced practice-effect distortion.

Factor Analysis

The dimensional structure of the ASPT-C was evaluated through Exploratory Factor Analysis (EFA) to verify whether the 60 items across four subtasks mapped onto theoretical constructs of accuracy and temporal speed.

Factor Extraction and Variance Explained

EFA extracted two robust, orthogonal factors with eigenvalues exceeding the Kaiser criterion (> 1.0). Together, these two factors accounted for 66.65% of the total cumulative variance in auditory and speech performance:

• Factor 1 (Accuracy Dimension): Accounted for 37.80% of the total variance. All accuracy subtask scores loaded heavily onto this factor, reflecting the shared cognitive substrate of signal extraction, phonemic discrimination, and categorical auditory recognition.
• Factor 2 (Reaction Time Dimension): Accounted for 28.85% of the total variance. Latency variables across all four listening tasks loaded cleanly on this factor, confirming that central processing speed represents an independent psychometric construct from categorical hit-rate accuracy.

Structural Implications

The statistical independence of the Accuracy and Reaction Time factors validates the dual-metric architecture of the ASPT-C. Because processing speed and hit-rate accuracy loaded onto distinct psychometric axes, clinical assessment cannot rely on accuracy alone without risking diagnostic omission. The emergence of two clean factors demonstrates that children may preserve normal accuracy while exhibiting delayed processing speed (indicative of compensatory processing), or conversely display impulsive, inaccurate responses with short latencies.

Instrument / Measurement Tool

The ASPT-C is an electronic, computerized screening instrument administered via a standardized digital interface using calibrated supra-aural or circumaural headphones. Key structural specifications include:

• Format: Computer-administered, interactive behavioral screening test.
• Target Population: Children aged 6 to 12 years (primary clinical sensitivity: 7 to 10 years), covering neurotypical children and those evaluated for specific learning difficulties (SLD), dyslexia, or central auditory processing issues.
• Test Structure: Four distinct subtasks consisting of 15 stimulus trials each (total: 60 items):
• Task 1: Meaningful rhyming word pairs presented in quiet.
• Task 2: Meaningful rhyming word pairs presented in background noise.
• Task 3: Meaningless (pseudoword) rhyming word pairs presented in quiet.
• Task 4: Meaningless (pseudoword) rhyming word pairs presented in background noise.
• Stimulus Presentation: Pre-recorded acoustic tokens calibrated to a standardized sound pressure level (typically 65 dB SPL) with speech-shaped or multi-talker babble noise presented at fixed signal-to-noise ratios (SNRs).
• Response Modality: High-precision electronic input interface (such as a dual-button response box, designated keyboard keys, or calibrated touchscreen).
• Scoring and Outputs:
• Accuracy Score: Dichotomous (1 = correct discrimination/recognition, 0 = incorrect response). Maximum score per task = 15; total scale maximum = 60.
• Reaction Time (RT): Millisecond chronometry recorded from stimulus termination to physical response trigger. Calculated as mean latency across correct trials per subtask and overall.

Permissions & Fee and Test Year

The Auditory and Speech Performance Test for Children (ASPT-C) was developed and officially published in 2024. The instrument, its algorithmic processing scripts, and associated acoustic stimulus banks were created by researchers at Başkent University, Ankara University, and Erzincan Binali Yıldırım University.

The ASPT-C was introduced to the scientific community through peer-reviewed publication in the Canadian Journal of Speech-Language Pathology and Audiology (CJSLPA). Academic and non-commercial research use may be arranged by contacting the corresponding authors (Başkent University Department of Audiology) or consulting the original publication for administrative software access. Clinical licensing, institutional deployment, or digital software distribution may require authorization from the primary developers and rights-holding academic institutions.

References

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Bossuyt, P. M., Reitsma, J. B., Bruns, D. E., Gatsonis, C. A., Glasziou, P. P., Irwig, L., Lijmer, J. G., Moher, D., Rennie, D., de Vet, H. C., Kressel, H. Y., Rifai, N., Golub, R. M., Altman, D. G., Hooft, L., Korevaar, D. A., & Cohen, J. F. (2015). STARD 2015: An updated list of essential items for reporting diagnostic accuracy studies. BMJ, 351, h5527. https://doi.org/10.1136/bmj.h5527

de Vet, H. C. W., Terwee, C. B., Mokkink, L. B., & Knol, D. L. (2011). Measurement in medicine: A practical guide. Cambridge University Press. https://doi.org/10.1017/CBO9780511996214

Hancer, H., Kiziltan, E., Civak Tan, P., Gokmen, D., Hayme, S., & Yilmaz, S. T. (2024). Development, validity, and reliability of the Auditory and Speech Performance Test for Children. Canadian Journal of Speech-Language Pathology and Audiology, 48(1), 29–42.

Streiner, D. L., Norman, G. R., & Cairney, J. (2015). Health measurement scales: A practical guide to their development and use (5th ed.). Oxford University Press. https://doi.org/10.1093/med/9780199685219.001.0001

Items of the Scale