Auditory Processing Disorder

Children with Auditory Processing Disorder often do not recognise subtle differences between sounds in words, even when the sounds are loud and clear enough to be heard. These kinds of problems usually occur in background noise, which is a natural listening environment. So, children with Auditory Processing Disorder have the basic difficulty of understanding any speech signal presented under less-than-optimal conditions. 

The causes of Auditory Processing Disorder are unknown. But evidence suggests links to head trauma, lead poisoning, and chronic ear infections. Because there are many different possibilities, even combinations of causes each child must be assessed individually. 

Children with Auditory Processing Disorder are thought to hear normally because they can usually detect pure tones that are delivered one by one in a very quiet environment (such as a sound-treated room). Those who can normally detect sounds and recognise speech in ideal listening conditions are not considered to have hearing difficulties. 

However, the ability to detect the presence of sounds is only one part of the processing that occurs in the auditory system. So, most children with Auditory Processing Disorder do not have a loss of hearing sensitivity but have a hearing problem in the sense that they do not process auditory information normally. 

If the auditory deficits aren’t identified and managed early, many of these children will have speech and language delays and academic problems. 

Symptoms of APD can range from mild to severe and can take many different forms. If you think your child might have a problem processing sounds, consider these questions: 

• Is your child easily distracted or unusually bothered by loud or sudden noises? 
• Are noisy environments upsetting to your child? 
• Does your child’s behaviour and performance improve in quieter settings? 
• Does your child have difficulty following directions, whether simple or complicated? 
• Does your child have reading, spelling, writing, or other speech-language difficulties? 
• Is abstract information difficult for your child to comprehend? 
• Are verbal (word) math problems difficult for your child? 
• Is your child disorganised and forgetful? 
• Are conversations hard for your child to follow? 

Auditory Processing Disorder is an often-misunderstood problem because many of the behaviours noted above also can appear in other conditions like learning disabilities, Attention Deficit Hyperactivity Disorder (ADHD), and even depression. Although Auditory Processing Disorder is often confused with ADHD, it is possible to have both. It is also possible to have Auditory Processing Disorder and specific language impairment or learning disabilities. 

Audiologists (hearing specialists) can determine if a child has Auditory Processing Disorder. Although speech-language pathologists can get an idea by interacting with the child, only audiologists can perform auditory processing testing and determine if there really is a problem. 

Some of the skills a child needs to be evaluated for Auditory Processing Disorder don’t develop until age 7 or 8. Younger Children’s brains just haven’t matured enough to accept and process a lot of information. So, many children diagnosed with Auditory Processing Disorder can develop better skills with time. 

Once diagnosed, children with Auditory Processing Disorder usually work with a speech therapist. The audiologist will also recommend that they return for yearly follow-up evaluations. 

The five main problem areas that can affect both home and school activities in children with Auditory Processing Disorder are: 

• Auditory Figure-Ground Problems: When a child can’t pay attention if there’s noise in the background. Noisy, low-structured classrooms could be very frustrating
• Auditory Memory Problems: When a child has difficulty remembering information such as directions, lists, or study materials. It can be immediate (“I can’t remember it now”) and/or delayed (“I can’t remember it when I need it for later”)
• Auditory Discrimination Problems: When a child has difficulty hearing the difference between words or sounds that are similar (COAT/BOAT or CH/SH). This can affect following directions, and reading, spelling, and writing skills, among others
• Auditory Attention Problems: When a child can’t stay focused on listening long enough to complete a task or requirement (such as listening to a lecture in school). Children with Auditory Processing Disorder often have trouble maintaining attention, although health, motivation, and attitude also can play a role
• Auditory Cohesion Problems: When higher-level listening tasks are difficult. Auditory cohesion skills — drawing inferences from conversations, understanding riddles, or comprehending verbal math problems — require heightened auditory processing and language levels. They develop best when all the other skills (levels 1 through 4 above) are intact

Strategies applied at home and school can ease some of the problem behaviours associated with Auditory Processing Disorder. Because it’s common for children with Auditory Processing Disorder to have difficulty following directions, for example, these tactics might help: 

• Since most children with Auditory Processing Disorder have difficulty hearing amid noise, it’s very important to reduce the background noise at home and at school
• Have your child look at you when you’re speaking
• Use simple, expressive sentences
• Speak at a slightly slower rate and at a mildly increased volume 
• Ask your child to repeat the directions back to you and to keep repeating them aloud (to you or to himself or herself) until the directions are completed
• For directions that are to be completed at a later time, writing notes, wearing a watch, and maintaining a household routine also help. General organisation and scheduling also can be beneficial

It’s especially important to teach your child to notice noisy environments, for example, and move to quieter places when listening is necessary.