What is Auditory Processing?
Auditory processing refers to what the brain does with sound and the function of the brain after the ear hears it. A developmental function, auditory processing begins development even before birth. There are different types of auditory processing skills that develop at different times and include auditory decoding skills, auditory figure ground skills, dichotic skills, auditory memory, auditory comprehension and auditory cohesion.
How is Auditory Processing Disorder (APD) Diagnosed?
Audiologists assess auditory processing development using a variety of tests designed to evaluate different auditory processing skills. However, there is some controversy over exactly what qualifies for the diagnosis of an auditory processing disorder. Individuals may have strengths and weaknesses in terms of their auditory processing abilities so it is important to identify any weaknesses in the development of the auditory processing system. A weakness in even one area can negatively affect the development of a child. For example, a child could have adequate auditory decoding skills, auditory memory skills, auditory comprehension and cohesion skills, but a weakness in auditory figure ground skills. This student may have great academic skills and considered extremely smart, but his or her behavior in the classroom may interfere with his or her ability to learn.
What is the Difference between an Auditory Processing Evaluation and an Audiological Evaluation?
An audiological evaluation tests the integrity of the auditory system at the ear level and its ability to detect the presence of sound. An auditory processing evaluation, on the other hand, challenges the auditory system using different listening tasks to determine the effectiveness of the system in terms of interpreting and making sense of the sounds that it hears. The results of an auditory processing evaluation are then compared to normative data to determine if the system is developing on time or if it is delayed in the development of particular skills.
At What Age Can a Child Be Tested for APD?
There is a gross misunderstanding regarding the age at which a child can be tested for APD. On one side, the fact remains that it may be difficult to get a true diagnosis of APD in children younger than the age of seven. However, this does not mean that a child cannot be tested before the age of seven. On the contrary, an early diagnosis is extremely important in the treatment of an auditory processing disorder. A specialist can administer a complete auditory processing battery by the age of five provided that the child has enough speech and language to respond to the testing. An experienced audiologist can also evaluate the auditory processing development of children under the age of five as well as non-verbal children with the use of case history information, observation and both formal and informal testing procedures, where a child can be idenfitied as at risk for an auditory processing disorder. It is crucial that a young child be auditorily connected to his or her environment in order to develop the auditory processing skills essential to the development of speech and language. A child who is not auditorily connected may be described as a selective listener, in his or her “own world” and spacey. Sometimes these children appear as if they have a hearing loss, or what is sometimes called “functionally deaf.”
What are the Early Warning Signs of APD?
The most important early warning sign of APD is a child who has a speech and/or language delay. This includes children who are not auditorily connected, not babbling adequately or on time, as well as those who are not developing two-way communication skills. If a child shows significant sensitivity or fear of normal environmental sounds, then this is an early indicator of a possible APD.
What are the Most Common Symptoms of an Auditory Processing Disorder?
There are many different auditory processing skills, so weaknesses in different skill areas will produce varying symptoms. In fact, it often becomes confusing when a child can perform some tasks well while struggling with others. A child with a weakness in the area of auditory decoding, for example, will often have difficulty learning to read. If that child is strong visually, however, then he or she may compensate well in this area. A child might also have weaknesses in the area of auditory figure ground skills leading to attention difficulties, being easily distracted and sometimes developing a fear of noisy places or certain sounds (often described as sound sensitivities). Generally, a listener will misunderstand a spoken word or phrase. Auditory processing problems are sometimes most apparent in school when a child has difficulty learning to read, comprehending reading, following instructions or understanding abstract material. Additional symptoms of APD include:
- Difficulty paying attention
- Poor listening skills
- Trouble carrying out multiple-step instructions
- Delayed response time
- Behavior difficulties
- Difficulty with reading, spelling, vocabulary and language skills
- Easily frustrated
- Difficulty developing social skills or recognizing social cues
- Misinterpreting messages or often misinterpreting one word for another
- Slow to develop speech and language skills
- Articulation weaknesses
- Difficulty with phonemic awareness
- Unable to understand sarcasm or the punch line to a joke
What Causes Auditory Processing Deficits?
The cause of APD is often unknown. Even if your child can hear normally, he or she may struggle using what is heard to develop speech and language. Communication relies on taking in complicated perceptual information from the outside world, organizing that information and interpreting it into meaningful language. The reasons why a child may have delays in auditory processing development are often difficult to understand, although APD is often associated with:
- Attention deficit disorder
- Pervasive developmental disorder
- Autism spectrum disorder
- Speech and language disorder
- Reading and learning challenges
- Other developmental delays
Auditory deprivation is one factor that can cause auditory processing delays, which is often associated with chronic middle ear pathology such as ear infections or chronic fluid. Other factors can include Bio-medical, environmental and genetic factors.
Is APD a Lifelong Disability?
According to neuroscience and brain plasticity research, we can change the way in which the brain processes information. However, although this research shows that we can make these changes throughout or lifetime, this is not to say that we can always make up for what we lost along the way. It is for this reason that early identification and treatment for APD is extremely important. Basically, APD is not a lifelong disability, although its effects on speech, language and learning can be.
Is There Help for APD?
An underdeveloped auditory system can improve, and in some cases, catch up, through repeated auditory stimulation. Essential for this process is a daily auditory diet. Individuals with auditory processing delays find listening to be a lot of work and therefore tend to be selective listeners. Auditory processing development is dependent on being auditorily connected and in developing good listening skills, so poor listeners will continue to fall behind in auditory skill development. In order to improve auditory processing skills, one must first improve listening skills. This can be quite difficult with an auditory processing disorder, which is why fun and motivating listening activities as well as a “daily listening diet” are essential to the improvement of auditory processing.
How Do I Know if My Child has APD?
If you suspect that your child may have difficulty processing auditory information, then you should seek a complete auditory processing battery performed by an audiologist. There are many red flags that suggest an auditory processing disorder may be present and many screening devices available. However, since there are so many different auditory processing skills and related factors, a complete auditory processing battery is the only way to identify the specific auditory processing skill in which a child or adult is displaying weaknesses.
Can APD Affect Adults?
There are many adults who have grown up unaware of their auditory processing weaknesses. While research that suggests the existence of APD dates back over forty years, it was not until recently that professionals accepted APD as an important factor relating to developmental delays, especially in the areas of speech, language, learning and social skill development. Undiagnosed, APD in adults can manifest as anxiety disorder, depression, fear of failure and social inadequacies.
Can Adults with APD Find Help?
According to neuroscience research, there is a brain plasticity that exists throughout our lifetime. Science also suggests that we can change the way the brain processes information. Changing our already-learned behavior or sense of self is more difficult but it is helpful to simply understand if an APD exists as well as how it affects the development of the individual. This understanding is the first important step in the healing process.
How Does The Listening Lab Help?
The Listening Lab recommends a daily listening diet that is critical to remediating auditory processing problems. While other types of “therapy” administered once or twice a week can prove helpful, the habit of being a poor listener continues to impede auditory development once the child has left the therapeutic environment. The Listening Lab helps by promoting proper listening skills through listening games and exercises that not only strengthen auditory processing skills, but also make listening fun. The daily listing diet from TheListeningLab.com is not a replacement for therapy, but instead a supplement that keeps children with auditory processing weaknesses from falling back into old habits on a daily basis once therapy is over.