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Objectives: Auditory processing disorder (APD) is due to the deficits in perceptual processing of acoustic information in the auditory system, characterized by poor speech perception of noise, regardless of normal hearing. The variability in speech function of APD children can be partly explained by changes in the encoding of spectro-temporal modulations (STMs) which have been overlooked, despite their significance. Given that enhancing STM sensitivity and its processing can be an appropriate way to improve the listener’s ability to retrieve and integrate speech segments covered by noise, we decided to evaluate the effects of STM-based auditory training on speech perception in noise and the reliability of this training in children with APD.
Methods: Thirty-five children with APD (8-12 years old) were randomly divided into the training (n=17) and control groups (n=18) to evaluate the effectiveness and reliability of STM training on speech in noise perception. The intervention group was trained to detect STM by 120 trials every day for ten days. The STM detection thresholds and speech perception in noise were evaluated before and immediately after the finalization of formal training sessions in both groups. To address the training reliability, the tests were repeated one month after practice in the training group. 
Results: Following the completion of STM auditory training, the trained APD children improved notably in STM detection tasks and speech in noise tests (P<0.05). The post-training progress of STM detection thresholds and consonant-vowel in the noise test was preserved for one month after training (P>0.05), but the word in the noise test, especially in the right ear, was not retained (P<0.05).
Discussion: Auditory spectro-temporal modulation training can lead to better processing of STM modulation. Its effects can be generalized to higher-order processing, such as speech perception in noise. Auditory training based on STM processing enhancement can play an essential role in improving speech comprehension in the noise abilities of children with APD. 

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