Auditory Processing

 

“Auditory Processing” is also sometimes referred to as “Central Auditory Processing.”   When we hear something, our hearing system passes the information through elaborate steps through the brain. An auditory processing system that is working well will pass this information completely. Any problems along the way may result in an auditory processing disorder.

 

 

A person with an auditory processing disorder may have difficulty identifying, discriminating, and understanding auditory information, even though his hearing may be fine.

 

 

Auditory processing problems can show up in different ways, depending upon which particular area or areas are affected.  An individual with an APD may have normal hearing, yet difficulty listening, following directions, paying attention, and/or remembering information. Sometimes a child’s speech sound development, vocabulary, sentence structure, expressive organization, phonics skills, reading, spelling, writing, and learning of math concepts may be affected. 

 

 

Due to the difficulty in accurately processing information, a child with an APD may give the appearance of not hearing or being confused, frequently asking, “What?” when someone speaks to him. In the child’s attempt to cope with an APD, he may be easily distractible, fidgety, or impulsive. As such behaviors are similar to those seen in individuals with an attention deficit disorder (ADD), a child with an APD may be misdiagnosed. Due to his difficulties, the child may become frustrated and angry or socially withdrawn. At the end of the school day, he may be very tired due to the stress of working hard to try to understand. Such difficulties may take their toll on a child’s self esteem.

 

 

 

A history of middle-ear fluid and/or infections is one possible cause of an APD. When a child has fluid in his middle ears, he is literally trying to hear “under water” or more precisely, “through water”. The job of the middle-ear system is to conduct sound from the outside through to the inner ear. The middle ear, which is normally air filled, contains three tiny bones that send sound vibrations to the inner ear, which is the hearing receptor. If the middle ear is fluid filled, the sound information may become distorted and transmitted inaccurately to the inner ear for processing through the brain. During the first three years of life, a child’s language foundation is being developed in the brain. He is learning to perceive and recognize sounds and words and attach meaning to them. If the information the child is taking in is distorted due to middle-ear problems, the foundation will be faulty. Although the child’s middle-ear problems may be intermittent, they can cause lasting processing, language, and learning difficulties for the child. While on the topic of middle-ear fluid and infections, it is important to realize that some children do not show signs of fluid being present. Also, after treatment for an ear infection, the fluid may remain in the ear for several weeks or even a few months, causing continued hearing difficulties. 

 

As most of the children with an APD are male, there may also be biological and developmental considerations when pinpointing the cause.

 

 

 

No, in fact many children with an APD are very bright and can do amazing things despite their difficulties. The knowledge and ability of some children may be greatly underestimated due to weaknesses in self expression (i.e., they cannot efficiently express their knowledge.) While having an APD is not a reflection of a child’s innate intellectual skills, it can interfere with a child’s ability to access information from the world. Most of our learning occurs through listening and reading, and if these skills are impaired, the child may not be able to keep up with the learning rate and opportunities of their non-affected peers. It is important to note, however, that an APD can co-occur with other problems (e.g., attention deficit disorder, learning disabilities, dyslexia), so it may take a team of professionals to provide an accurate diagnosis in order to appropriate treatment to begin.

 

 

 

First, since it is important to rule out a hearing problem, a complete hearing assessment should be conducted by an audiologist. A speech-language pathologist could then provide the child with a speech and language evaluation.  Testing results, along with parent and teacher reports may lead to suspicions of an APD or other learning disorder. To rule out or confirm these suspicions, the child may be referred to a psychologist in order to conduct a learning assessment, as well as to an audiologist for an auditory processing evaluation. However, it may not be possible to reliably assess a child’s auditory processing skills below the age of 10 years, due to maturational considerations. With this information, the team of professionals may be able to arrive at a diagnosis and can provide recommendations for treatment and classroom accommodations.

 

 

First of all, there is no “cure” for an APD, but there are many exercises that can be used to strengthen a child’s skills, as well as strategies the child and adults in his environment can use to help him deal with his difficulties.

 

The speech-language, psychological, and auditory processing evaluations given to the child will provide specific information regarding his strengths and weaknesses. At our center, the speech-language pathologist assigned to a child will consider all of the test results, along with the parent and teacher observations and concerns, and will develop a treatment plan. For example, if a child’s APD diminishes his ability to accurately discriminate (i.e., tell the difference between) sounds, a portion of his therapy sessions may be devoted to improving his sound discrimination abilities. The same child may also have difficulty with speech sound production and accurate use of grammar, so these areas will be targeted for remediation, as well. If an APD leads to attention, listening, and direction following issues, the therapist may employ the use of auditory and visual cues to help the child stay focused for better processing of information. 

 

Strategies can also be taught to the child to help him deal with some of his weaknesses. An older child, for example, may be taught how to use visualization strategies and mnemonic devices to help him recall information. Strategies in the home may involve the use of visual schedules (i.e., pictures showing the steps of what the child is to do in completion of everyday chores and personal needs), while classroom accommodations may include preferential seating and/or the use of classroom amplification. Again, each child’s needs are unique and require a team effort.