Previously known as Central Auditory Processing (CAP)
Auditory Processing is the ability to make sound through the ear and having it travel to the language area of the brain to be interpreted. A breakdown in this process is called an auditory processing disorder or “delay.” This deficit is present despite having normal hearing. A recommendation of auditory processing testing is typically made for children who struggle with focusing in the classroom or seem inattentive or distracted, particularly in the presence of background noise. Many times the identification of auditory processing skills is not a thorough evaluation as it is critical to also determine language processing skills (receptive language skills) by way of a Speech-Language Pathologist.
What’s The Problem?
If your child is struggling with attention, focus in the classroom, is felt to be a daydreamer, or misses instructions both at home and in the classroom, struggling with reading skills and/or is exhausted after a day spent listening at school, an auditory processing test is warranted.
How Can We Help?
HearSay has become known for their testing of both auditory processing and language processing assessments as one of the clinicians is a dually certified Audiologist and Speech-Language Pathologist. As a result, both areas of difficulty can be analyzed carefully and completely to determine how these integrate or are posing challenges in academics and listening skills, attention, and learning beginning reading skills.
What Can You Do?
Speech / Audiology Assessments and Therapy are often covered by extended benefits, please feel free to ask us for more information or contact your benefits provider.
Symptoms of Auditory Processing Disorder
APD can affect people in many ways. A child with APD may appear to have a hearing impairment, but this isn't usually the case and testing often shows their hearing is normal.
It can affect the ability to:
- understand speech – particularly if there is background noise, more than one person speaking, the person is speaking quickly, or the sound quality is poor
- distinguish similar sounds from one another – such as "shoulder versus soldier" or "cold versus called"
- concentrate when there's background noise – this can lead to difficulty understanding and remembering instructions, as well as difficulty speaking clearly and problems with reading and spelling
- enjoy music
Many people with APD struggle with focusing in classrooms and on the job, which can lead to frustration. Difficulties with reading and written language often accompany APD. It is also most commonly misdiagnosed as ADHD. Often this population is exhausted after a day of listening because of the effort needed to pay attention.
Checklist for Processing Difficulties
- Normal pure tone hearing
- Difficulty following oral directions; inconsistent responses
- Short auditory attention span; fatigues easily
- Poor short-term and long-term memory
- Daydreams; appears not to listen
- Difficulty hearing with background noise
- Difficulty localizing sounds
- Academic and/or speech-language problems
- Disruptive behaviours; impulsive, frustrated
- Requests repetition; asks ‘huh?’
- History of ear infections
- Word retrieval problems
- Neutral, generic language
- Misuse of words with a similar phonetic structure
- Creative, original language; describes or circumlocutes
- Delayed responses; uses fillers
- Frequently answers ‘I don’t know’ or ‘I forgot’
- Repeats or rehearses comments
- Difficulty localizing sounds
- Inconsistency in learning; needs review
- Recognizes errors but can’t correct them
- Incomplete sentences or thoughts
- Pragmatic problems; disruptive behaviour
- Age-appropriate IQ and vocabulary; academic deficits; learning disabled
AUDITORY PROCESSING INTERVENTION
Auditory processing disorder (APD) is a term for a variety of disorders that affect the way the brain processes auditory information. Individuals with APD usually have normal structure and function of the outer, middle, and inner ear (peripheral hearing). However, they cannot process the information they hear in the same way as others do, which leads to difficulties in recognizing and interpreting sounds, especially the sounds composing speech. It is thought that these difficulties arise from dysfunction in the central nervous system.
It can affect both children and adults. Cooper and Gates (1991) estimated the prevalence of adult APD to be 10 to 20%. It has been reported that males are twice as likely to be affected by the disorder as females, and that prevalence is higher in the elderly and increases with age.
Intervention for APD
The audiologist may suggest the following strategies:
- Often APD is not a stand-alone difficulty. Language processing difficulties and receptive language skills assessment and therapy may be warranted. This would be conducted by a Speech-Language Pathologist.
- If background noise is a challenge, use of a sound dampening ear filter in one ear will aid in listening.
- Various computer-based modules are also an excellent source for improving auditory processing skills in your own home while progress is monitored by the Audiologist remotely. This prevents the client and family from having to travel extensively to the test clinic and activities can be targeted in the comfort of your own home.
- Depending on the severity of APD, an assistive listening device (i.e. FM or Soundfield) may be recommended for school, workplace and/or at home.
Treating APD with Lifestyle Changes
Since auditory processing difficulties vary based on surroundings and development, its therapies vary by setting and age as well. The following lifestyle changes can make a difference for children and adults with APD.
At school, teachers can:
- Improve classroom acoustics. APD makes it hard to screen out background noise. Adding bookshelves, carpeting, and drapes to a classroom absorbs the extra sound.
- Seat children near the front of the class, away from an open door or a pencil sharpener or other classroom items that make noise, like fans or fish tanks.
- Provide attention prompts and cueing system. Periodically touch her shoulder to remind her to focus.
- Streamline communication. Establish eye contact and insert pauses to allow time for sorting information. Ask questions to see if the child is following the lesson and rephrase material that has been misunderstood.
- Use visual aids. Jot instructions or key words on the board and provide simple written or pictorial outlines.
- Build in listening breaks. Children with APD have to work harder than do other kids to pay attention and may need more frequent downtime to consolidate information.
- Use a microphone and headset. The teacher’s voice is amplified through a microphone connected to the student’s Bluetooth earpiece. This helps to focus attention on the teacher and bring the teachers voice to ear level.
- Ask children, “What are you going to do? What did I ask you to do?” This will give teachers a chance to determine if children have misheard directions.
At home, parents of kids with APD can:
- Boost auditory attention with games and CD’s. Games like Simple Simon teach a listening strategy and provide a chance to practice. A story tape, such as Peter Pan, can have the same benefit. Each time Captain Hook sees the crocodile, have your child raise his hand.
- Look ahead and pre-teach. Go over the basic concepts in upcoming assignments and help your child learn any new words that show up.
- Develop routines. Provide a structure to help your child focus in chaotic environments. Before going to his school locker, for instance, have him check his assignment book and list what he needs to take home.
At home, family members of adults with APD can:
- Eliminate distracting noises (turn off the TV, radio or computer) before speaking with your partner.
- Touch your partner on the arm or shoulder before speaking, allowing him time to shift his focus from what he was doing to the conversation you are having.
- Ask your partner to repeat what you’ve said, to make sure it was understood.
- Speak concisely, eliminating superfluous detail.
- Use relaxation techniques to clear your mind before important conversations.
- For some topics, e-mail or text works best.
Support groups – both online and in person – can help parents and adults connect with people who are experiencing similar difficulties and give ideas of treatment or accommodations that have helped.