Assessing central auditory processing in bilinguals’ native language yields more accurate results

Purpose: While central auditory processing disorder (CAPD) evaluations assess specific auditory skills necessary for efficient processing and understanding of complex auditory signals, many tests included in these evaluations rely heavily on language. This poses an issue for non-native English speakers, and it remains unclear whether testing these individuals in a secondary language produces an accurate clinical assessment and diagnosis. Our study aimed to determine the most appropriate language for CAPD assessment in bilingual speakers.Method: Twenty-five Spanish-English bilingual speakers participated in this repeated measures study to assess binaural processing performance when evaluated using test materials in their native (Spanish) and secondary (English) languages. Binaural integration and separation were assessed using dichotic digits, competing words, and competing sentences. Participants completed these assessments twice—once in Spanish, once in English. Performance on the binaural tasks was compared between languages to determine if the language used for instruction and assessment impacted auditory processing performance.Results: Performance varied by language for more challenging auditory tasks (i.e., dichotic digits, competing words) with participants performing poorer when materials were administered in English. Increasing age emphasized these language differences and revealed interaural asymmetries.Conclusions: These findings suggest testing Spanish-English bilinguals with English materials may provide inaccurate representations of their binaural processing abilities, even when they are considered to be proficient in English. Impaired performance may more likely be attributed to language differences rather than true auditory processing deficits. Therefore, non-native English speakers should be assessed for CAPD using test materials in their native language whenever possible.