Auditory Processing Disorder (APD) - An Overview

Auditory Processing Disorder (APD) is a disability that affects how the brain processes spoken language. Kids with APD have difficulty interpreting and storing information despite normal hearing. In addition to hindering speech and language development, APD can affect other areas of learning, particularly reading and writing.

What is APD?

Ask a parent, teacher, audiologist, speech-language specialist, or psychologist this question, and you’ll hear many definitions. But despite differing opinions, there seems to be agreement on these points:

• Auditory processing disorders (APD) exist in some children, most with normal intelligence.
• There is a breakdown in receiving, remembering, understanding, and using auditory information.
• Hearing ability is adequate.
• There is a neurological basis.
• The child’s ability to listen is impaired.

What Skills Are Affected?

These are some of the auditory skills that may be affected:

• Phonologic awareness: Identifying sounds in words, the number of sounds in a word, and similarities among words; may show up in spelling, writing, and reading difficulties.
• Auditory discrimination: Recognizing differences when asked to say whether the sounds or words are the “same or different.”
• Auditory memory: Storing, or retaining, pertinent auditory information; may affect ability to follow oral directions, participate in discussions, and spell.
• Auditory figure-ground discrimination: Understanding spoken language in a noisy background; may show up more in noisy environments or when expected to listen for information.
• Auditory sequencing: Remembering the order of spoken words or sounds in a series.
• Auditory blending: Combining isolated sounds together to form words.

How Is APD Identified?

Identifying an auditory processing disorder requires input from the teacher, parents, and child; observation of the child in his classroom, and a review of past medical and educational records.

Prior to formal testing, the school nurse should do an audiologic screening. If there are concerns about hearing, a referral may be made to the family’s physician for further audiologic testing. Finally, an educational psychologist and a speech-language specialist may do a formal assessment. In other words, a team evaluates the strengths and needs of the child.

A variety of standardized tests measuring auditory skills may be given. Test scores compare the child’s performance to that of other kids his age. If a psychologist administers an individual test of intelligence, she’ll also compare scores on verbal and performance scales to see if there’s a true discrepancy — nonverbal subtest scores are much higher than those on verbal subtests.

Speech-language specialists may select standardized language tests that evaluate articulation, vocabulary, concepts, sentence recall, understanding of paragraphs, and ability to follow oral directions.

The way your child answers questions also reveals if skills are weak. His pattern of responding may suggest weak memory (focusing on or remembering only part of the question), poor discrimination (misunderstanding words), or problems with figure-ground discrimination (losing focus in background noise).

For example, when asked why cars have license plates, one child responded, “People get driver’s licenses so they won’t get arrested by the police. You have to have a license in order to drive.” He focused on the word “license” and either didn’t attend to or remember the part about cars.

What Techniques Help Kids with APD?

Your child’s specific areas of strength and need determine ways to help him. Following are some techniques that may be useful.

Modifications of the environment may reduce or eliminate poor listening conditions:

• Seat him away from visual, auditory, and motor distractions, such as fans, heaters, windows, doors, pencil sharpeners.
• Make sure light is on the speaker’s face, not his.
• Allow him to move to a quiet area or wear earplugs when doing silent reading and independent work.
• Wait for the room to become quiet before giving instructions or directions.
• Enforce appropriate speaker-listener manners — one person talks at a time; others listen quietly.
• Possible trial with an assistive listening device in certain cases (the efficacy of this modification has not been demonstrated).

Parents and teachers can use specific strategies to avoid a breakdown in auditory processing:

• Gain his attention before giving new work or directions.
• Speak clearly, with a moderate rate, and stand in one place, facing him.
• Allow him a longer time to respond, beyond what you might consider normal, when asking questions.
• Simplify/explain new vocabulary; encourage him to ask questions for clarification.
• Give concrete, interesting examples, demonstrations, and written or pictorial information when presenting new concepts orally.
• Break complicated directions into fewer parts and give him time to complete the first step before going on to the next part.
• Prior to a discussion, write down two or three main points for him to listen for. Then check for memory and understanding of those points.
• Use his strengths to convey information (e.g., if your child is a good reader, give reminders in writing; use closed captioning during TV or video programs.)
  Your child can use strategies to avoid auditory processing breakdowns, as well. Have him try these:
• Keep your eyes on the speaker, and try to get eye contact.
• Use good listening behavior — quiet body and closed mouth.
• Ask to have directions repeated or clarified when you feel confused or unsure of what to do.
• Re-auditorize, repeat information quietly to yourself, after directions or information are presented orally.
• Ask someone to explain what words mean, or use a dictionary or electronic thesaurus, when you aren’t sure.
• Visualize, make a picture in your mind, to help you remember important points.
• Wait until your parent or teacher finishes giving directions and answers questions before starting a task.
• Write down your assignments at school to help you remember what you’re supposed to do when you get home.

Remediation techniques involve direct intervention from a teacher or specialist:

• In collaboration with the classroom teacher and your child, decide which strategies to use at home and at school to help him bypass weak auditory skills.
• If the assessment team at school decides your child requires direct instruction from a speech-language specialist or special education teacher, IEP goals will be written to address his
  area(s) of need.

(*NOTE: Using EEG Biofeedback, Sensory Integration Training, Auditory Integration Training, Sound Therapy, and Hypnotherapy treatment plans that are customized for each patient's individual needs, The Attention & Achievement Center has produced significant improvements in the lives of patients with central auditory processing disorder (CAPD)).

For additional information, call the
Attention & Achievement Center at 925-280-9100

Disclaimer: The information presented here is for educational purposes only. It is not intended to replace the expert and professional advice of your physician, psychologist, or therapist. Always seek help from qualified professionals in the field of your interest. Our treatments are considered complimentary or alternative to traditional pharmacology and are not licensed or endorsed by the State of California, nor are we licensed healing arts practitioners by the State.