Q) Where can I purchase the LiSN-S test?
The LiSN-S is distributed by Phonak Communications AG. Contact your local distributor.
Q) What normative data exists for the LiSN-S?
Norms exist for North American English, and Australian English. North American English can be used in the United States and Canda; Australian English can be used in Australia, New Zealand and the United Kingdom. Norms exist for individuals aged from
6 to 60 years. People over 60 years of age will be compared to 60 year old norms.
Q) How does the LiSN-S software decide whether a person’s results are consistent with
a Spatial Processing Disorder (SPD)?
The typical pattern of results of a person with SPD will be normal scores on low cue SRT and talker advantage and depressed scores on high cue SRT, spatial advantage and total advantage. In other words, SPD is diagnosed by looking at the individual’s pattern of results. However there are many small variations to this typical scenario such as performance just inside normal limits on spatial advantage or performance well above normal limits on another measure, and these can be more difficult for a clinician to interpret. As such, NAL developed the pattern score which quantifies the relationship between the different LiSN-S scores and provides a more rigorous method for deciding whether a person has SPD.
Pattern score is calculated automatically in the LiSN-S and it is based on the relationship between the scores. The software decides which explanation of results will be provided. For more information on the LiSN-S pattern measure click here.
Q) Will the LiSN-S identify all types of CAPD?
CAPD is an umbrella term which includes a number of different auditory processing areas. The LiSN-S was designed to diagnose spatial processing disorder (SPD) which is one type of CAPD. SPD manifests as difficulty understand speech in noisy places (such as a classroom) due to an inability to separate speech from background noise. This is thought to be caused by binaural processing deficits. The LiSN-S will not diagnose other types of CAPD and it is up to the individual clinician which other CAPD tests they choose to use to assess other areas.
Q) Can the LiSN-S be used to assess people with a hearing loss?
Version 2.000 of the LiSN-S software was the first version to incorporate a prescribed gain amplifier which allows the software to be used with hearing-impaired individuals. It is appropriate for use with people who have up to a moderately- severe sensorineural hearing loss. Research at NAL has shown that all people with a hearing impairment will also have spatial processing deficits to some extent. Assessment with the LiSN-S PGA (quick version) can help in both setting realistic expectations with clients as well as determining whether advanced directional microphones or an FM system may be required. For FAQ for the LiSN-S PGA click here.
Q) I have an older version of the LiSN-S. How do I upgrade my software?
Upgrades to the LiSN-S are released periodically by Phonak and are made available via the internet. If your computer is connected to the internet you will be alerted when you open the LiSN-S if an upgrade is available. However, the first time you upgrade your software, you may need to do so manually. To check manually if an upgrade is available go to the Help menu in the LiSN software and select Internet Upgrade Service. The Phonak Live-Update screen will then appear and will prompt you to download any available upgrades. Follow the prompts provided on this screen.
Q) You said that two languages are available in the LiSN-S. How do I know if the software is using the correct language?
It is important, when you first install the LiSN-S and after any upgrades, to check the language setting. Go to the Configuration menu in the LiSN-S software. Select test language. Select the language appropriate for your region. Instructions for how to change the test language are also provided in the LiSN-S user guide.
Q) Can I use different headphones than the ones provided with the software?
No. The use of other headphones will invalidate the results of the test as the spatial qualities of the speech stimuli may be affected.
Q) I have a child with ADHD, can they be tested on the LiSN-S?
You can assess a child with ADHD on the LiSN-S as the LiSN-S controls for attention about as much as it is possible to do in a behavioural test. This is accomplished through the use of advantage measures. If a child has poor attention throughout the testing, scores should be elevated for all four test conditions, but the advantage measures will be unaffected. Consequently constantly poor attention will neither cause a spatial processing disorder to appear when it’s not present, nor mask its appearance when it is present. However, if attention fluctuates during the test period (about 15 minutes) then it is possible that low attention during any one condition of the LiSN-S could lead to spurious results.
Therefore, we recommend that the clinician monitor the child’s behaviour closely during testing and if attention seems to be waning stop testing until the child’s attention is regained. If the child’s ADHD is controlled with medication then testing should be done with the child medicated. It may also be worth discussing with the parent whether there
is a time of day when the child attends better than others, and scheduling their appointment for this time.
Q) How long does it take to complete the test?
LiSN-S testing should take approximately 15 minutes with an additional two minutes instruction time.
Q) Does it matter when the test is done?
In the case of younger children it is preferable to perform the testing in the morning as this is when they are least likely to be fatigued and optimum performance can be obtained. With older children and adults timing of the test is less critical.
Q) My child has language delays can they still be assessed on the LiSN-S?
As long as your child is capable of repeating short sentences they should be able to be assessed on the LiSN-S. The language demands in the LiSN-S have been minimized as much as possible as all of the words used in the test sentences are acquired by typically developing children by four years of age. If a child has delayed language to an extent where they cannot accurately repeat the sentences regardless of whether they heard them, scores should be elevated for all four LiSN-S test conditions, but the advantage measures will be unaffected. Consequently a language delay will neither cause a spatial processing disorder to appear when it’s not present, nor mask its appearance when it is present.
For example, below are the LiSN-S results of a child with a severe language processing disability. This child was a female aged 6 years, 9 months, who had a percentile rank of
0.2 on the verbal comprehension scale of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Her performance score was in the 21st percentile for her age and her processing speed score not able to be interpreted.
Q) Can the LiSN-S be used on multiple computers?
As the LiSN-S requires the Phonak soundcard to be connected for the test to run, it is not possible to run the same copy of the test on multiple computers simultaneously.
Q) Is the LiSN-S being developed in other languages?
You will need to contact Phonak regarding test development in other languages.
Q) What if my client fails the LiSN-S?
We will address this question separately for people with normal hearing and people with a hearing loss.
Normal-hearing clients: If your client fails the LiSN-S then there are three main options for you to consider. A person with SPD requires a better signal-to-noise ratio (SNR) to understand speech because of their inability to make use of spatial cues. This improvement in SNR could be accomplished through the use of an FM system. In the case of children, you can also make some improvement to the SNR by modifying their classroom environment. For example, moving the child so they are seated at the front of the classroom and away from external noise will increase their ability to hear their teacher. Click here for a list of suggested management strategies for SPD. Finally, the LiSN and Learn auditory training program has been found to be effective at remediating SPD in normal-hearing children. The LiSN & Learn is a computer based training program which is usually completed in the home. Click here for further information on the program.
Hearing-impaired clients: The Quick version of the LiSN-S provides clinical recommendations regarding how best to rehabilitate each client based on their test results. At this stage, we do not have any research that would suggest training with the LiSN & Learn auditory training program would be beneficial.
Q) Does a diagnosis of spatial processing disorder on the LiSN-S test enable us to say a child has CAPD, given the AAA and ASHA recommendations about diagnosing CAPD on the basis of failing two tests in a battery?
Yes. A diagnosis of spatial processing disorder on the LiSN-S test indicates that the child has this particular form of CAPD. This can be seen from two different perspectives. Firstly, the AAA and ASHA recommendation is appropriate only when the type of CAPD in question is expected to cause abnormal test results on at least two tests in the battery. If we view the LiSN-S test as a single test, then our research results indicate that children with spatial processing disorder typically pass all other tests that are commonly used in CAPD test batteries. Secondly, the LiSN-S test comprises four sub-tests, and the results of all four sub-tests are taken into account in determining whether the pattern of results is consistent with spatial processing disorder. A composite spatial pattern score outside the normal range, accompanied by low scores for spatial advantage, total advantage and high cue, but relatively normal scores for the low cue and talker advantage conditions, provides a reliable basis for detecting spatial processing disorder. That said, it is more important to look at the magnitude of any deficits revealed by LiSN-S (or, we contend by any other test) than to simply regard the results as "pass" or "fail".
Q) Who should I contact if I have questions about the LiSN-S which are not answered here?
If you have a question about the LiSN-S which is not answered here please contact your local Phonak office.