Factor Analysis of Auditory Processing Measures in School-Age Children: Evidence for a Four-Factor Structure.

PURPOSE: Traditional auditory processing (AP) test batteries rarely include validated measures of spatial speech segregation, despite clinical guidelines demonstrating the importance of spatial hearing. This study aimed to explore the factor structure of nine AP tests in school-age children, hypothesizing a multifactor model that includes degraded speech processing, dichotic listening, temporal processing, and spatial processing, using both traditional tests and the Listening in Spatialized Noise-Sentences (LiSN-S) test. METHOD: A retrospective, cross-sectional study examined clinical AP measures through factor analysis. The sample included 68 children (24 girls, 44 boys), 8.0-10.67 years of age, referred for AP evaluation from 2012 to 2025. All had normal hearing (thresholds ≤ 20 dB HL), normal middle ear function, no neurological or psychological conditions, English spoken as primary language, and typical cognitive functioning. The sample size met guidelines with a 7.6:1 participant-to-variable ratio. RESULTS: A four-factor solution accounting for 68.7% of the variance was identified: (1) dichotic processing (27.81%; Competing Sentences = 0.98, Competing Words-Free Recall = 0.76), (2) degraded speech processing (15.48%; Auditory Figure Ground = 0.88, Time Compressed Sentences = 0.51, Phonemic Synthesis = 0.47), (3) spatial processing (13.62%; LiSN-S spatial advantage = 0.69, high cue = -0.42), and (4) temporal processing (11.82%; Frequency Pattern Test = 0.73). Intercorrelations were moderate (r = .08-.45), and internal consistency ranged from α = .64 to Spearman-Brown coefficient = .80 for multi-item factors. CONCLUSION: A multidimensional model of AP was supported, emphasizing the need for including spatial processing measures in routine AP assessment batteries. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.33228396.