Auditory Processing Disorder

Definition

Auditory processing disorder (APD), commonly known as central auditory processing disorder (CAPD), is a hearing problem that affects 5%, roughly 2.5 million children, of school-aged children. (KidsHealth) It can also be found in middle schoolers and high schoolers, but it is commonly found by the age of 7 or 8. APD refers to how the central nervous system processes auditory information. (American Speech Language-Hearing Association) Kids who have APD cannot process what they hear the same way their peers do. Their brains and ears do not fully coordinate because something interferes with the way their brain recognizes or interprets sounds. Kids who have this condition struggle the most with speech. They are thought to have the ability to hear normally and can hear sounds that are delivered one at a time in a quiet setting. The problem revolves around speech and sounds. They have a hard time differentiating between sounds in words, even when they are said loud and clear. It is hard for them to register what people are saying and remembering what they have previously heard. Problems also arise when it comes to learning how to read and when they express themselves because they confuse the sounds of different words.

It is important to catch APD early because treatment can help. A child who receives the right therapy can lead a successful life.

According to KidsHealth, a child with APD may experience a broad range of symptoms.

Instructional Strategies

Learning Disabilities Association of America suggests plenty of strategies that can be done both at home and at school. Parents and teachers should work together to help and accommodate their child and student.

Parents:

Should reduce background noise at work and provide a quiet place for their child to do work.
Have your child look at you when you are speaking.
Use simple, expressive sentences.
Ask your child to repeat the direction back to you and keep repeating them until directions are completed.
Teach your child to write notes to themselves, wear a watch, and maintain household routines. Organization and scheduling helps.
Build your child’s self-esteem.
Keep in regular contact with educators.

Teachers:

Alter seating plans to accommodate students with APD.
Provide visual aids to supplement auditory instruction.
Speak clearly and rephrase information.
Provide written instruction or a homework list.
Provide additional aids like a tape recorder, or photocopies of notes taken by other students.
Assign a homework buddy that can help.

Accommodations that be put in place:

FM system: Auditory trains are electronic devices where a teacher wears a microphone and the students wear headphones so it reduces background noise.

Research

In early 2018, Autism Speaks and Royal Arch Masons announced they would fund study research that is aimed to develop intervention for people who have auditory processing disorders. In this study, they specifically looked at the overlapping of children that are on the autism spectrum and have auditory processing disorder. The motive behind the research is to deepen the understanding of brain-activity and its relationship with sound.

“Autism and Auditory Processing Disorder: What's the Connection?” Autism Speaks, 2018, www.autismspeaks.org/expert-opinion/autism-and-auditory-processing-disorder-whats-connection.

The American Speech-Language-Hearing Associate had a team that did thorough research on APD. In their research, they reviewed the historical perspective of people who either had or have APD and its history. They developed tests on how to diagnose APD and how to evaluate patients so the proper diagnosis can be given to an individual. They worked with subjects and monitored behavior when it comes to frequencies and tones and speech in each ear of someone with APD. The research team came up with guidelines on how to interpret tests as well as different kinds of APD tests.

Working Group on Auditory Processing Disorders. “(Central) Auditory Processing Disorders.” American Speech-Language-Hearing Association, American Speech-Language-Hearing Association, 1 Jan. 2005, www.asha.org/policy/TR2005-00043/

This study focused on the needs of individuals who have normal hearing pure tone sensitivity but experience auditory processing difficulties. It has a great focus on how people who have APD may have low self-esteem, anxiety, and depression. The objective of the research was to define a baseline for European APD by experienced clinicians and researchers. Its secondary objective was to find issues that may need addressing in the future and how to further assist those with APD.

Iliadou, Vasiliki (Vivian), et al. “A European Perspective on Auditory Processing Disorder-Current Knowledge and Future Research Focus.” Frontiers in Neurology, Frontiers Media S.A., 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5702335/

Useful Websites

KidsHealth highlights all the important topics about APD. It explains what it is, what the symptoms are, and what both parents and teachers can do to help students that have APD. https://kidshealth.org/en/parents/central-auditory.html

Learning Disabilities Association America thoroughly explains all the symptoms of APD. They also give a list of strategies that can be used to assist children with APD. https://ldaamerica.org/types-of-learning-disabilities/auditory-processing-disorder/

Hearing Health Foundation discusses both symptoms and signs of APD, they also discuss the demographics of those who have APD and how it may overlap with other disabilities.

https://hearinghealthfoundation.org/about-auditory-processing-disorder/

Understood gives a list of symptoms that can be seen from people of all ages. It is not always easy to recognize APD, and it looks different depending on the age of the person. While the first two websites focus on younger students, they detail what can be seen from preschoolers, grade-schoolers, middle-schoolers, and high-schoolers.

https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/auditory-processing-disorder/auditory-processing-disorder-what-youre-seeing

Sources

“Auditory Processing Disorder.” Hearing Health Foundation, 2018, hearinghealthfoundation.org/about-auditory-processing-disorder/.

“Auditory Processing Disorder.” Edited by Thierry Morlet, KidsHealth, The Nemours Foundation, Sept. 2014, kidshealth.org/en/parents/central-auditory.html.

“Auditory Processing Disorders (APD) in Children.” American Speech-Language-Hearing Association, ASHA, 2015, www.asha.org/public/hearing/understanding-auditory-processing-disorders-in-children/.

“Central Auditory Processing Disorder (CAPD).” Centre for ADHD Awareness Canada, 2017, caddac.ca/adhd/understanding-adhd/in-education/central-auditory-processing-disorder-capd/.

“Types of Learning Disabilities.” Learning Disabilities Association of America, 2014, ldaamerica.org/types-of-learning-disabilities/auditory-processing-disorder/.

“What Is Auditory Processing Disorder?” Child Mind Institute, Child Mind Institute, 26 Mar. 2018, childmind.org/article/what-is-auditory-processing-disorder.

Symptoms:

Is easily distracted and is bothered by loud or sudden noises
Noisy environment may upset or distract them
Their behavior and performance is better in quieter settings
They have difficulty following direction, simple or complicated
Difficulties in reading, spelling, writing, and other speech-language difficulties
Verbal math problems may be difficult
May be disorganized and forgetful
Conversations flow may be hard to follow
May ask to repeat thing several times
May process thoughts and ideas slowly and have difficulty explaining them

Diagnosis:

Hearing Health Foundation says that children who have APD may be weak in one or all of these four basic skills. Audiologist typically look to see if they show any signs of weakness in the following skills:

Auditory Discrimination— the ability to notice and distinguish between distinct and separate sounds.

Figure-to-Ground Discrimination— the ability to differentiate important sounds from background noise, to follow verbal instruction or to pick one voice from auditory clutter.

Auditory Memory— the ability to remember things we heard, in both the short or long-term.

Auditory Sequencing— ability to understand and recall the order of sounds.

There is no clear evidence on what causes APD. It can be head trauma, lead poising, or chronic ear infection could play a role.

Sometimes it’s hard to diagnosis right away because it may overlap with other disabilities, so it should be made clearly that APD is an auditory deficit and is not a result of other higher-order cognitive, language, or related disorder.