How many times are we faced with parents complaining that their children have hearing difficulties, yet the audiogram shows no impairment? There should be a (hopefully) growing awareness among clinicians that some of these children have more than just particularly anxious parents. The process of transforming an acoustic signal at the neural level, culminating finally in auditory perception, is what we know as auditory processing. According to the Medical Research Council pamphlet on auditory processing disorder, as many as 10 per cent of children may suffer from the condition, resulting in difficulties with: understanding when listening; expressing themselves clearly using speech; reading; remembering instructions; understanding spoken messages; and maintaining focussed attention.

The two-volume publication Handbook of (Central) Auditory Processing Disorder, by Frank E Musiek (a professor of otolaryngology) and Gail D Chermak (an audiologist), is not so much a useful ‘handbook’ as an exhaustive reference work (of over 800 pages!). Perhaps this reflects greater interest and research in the US. The first volume certainly goes into great detail when explaining the neuroscience underlying auditory processing disorder. Perhaps more helpful for ENT clinicians are the sections on differential diagnosis and test battery considerations, but probably only for those who wish to develop an interest in the screening and diagnosis of auditory processing disorder.

Is there anything that can be done for patients with auditory processing disorder? The second volume certainly provides a multitude of intervention options (the effectiveness of many being debatable, but references are provided throughout). The text is so detailed that, again, only an audiologist who wishes to develop a special interest in this area would probably attempt to read the book cover to cover. The other professional groups primarily targeted by this book are speech and language therapists, psychologists, clinical scientists, and graduates who wish to use it as a textbook. Otorhinolaryngology surgeons are conspicuous by their absence from the intended audience, and I would quite agree that this book is probably only for those of us (such as myself) who wish to develop a special interest in auditory processing disorder.