Gary Pillow, Audiologist, Virginia: Auditory Processing Disorders

Introduction

People know that we hear with our ears, but we should all remember that it is our brain that makes use of the information we hear. If the brain is unable to correctly process what is said, the message is lost or misunderstood. This is known as auditory processing disorder (APD).

Studies have shown that we begin to develop our listening skills even before we are born, and that one day-old infants with normal hearing can already identify the difference between certain sounds. Continued development of good hearing skills is critical for successful learning. Unfortunately, all children may not have good listening abilities. When a child's brain has difficulty processing speech, he or she may need special help to learn to listen more effectively.

What is Auditory Processing Disorder?

Auditory processing disorder may be described as difficulty in processing auditory information although hearing sensitivity and intellectual ability are unimpaired. In general, internationally known authority, Dr. Jack Katz, describes auditory processing (AP) as "what we do with what we hear."

What are the causes of APD?

There are many causes of Auditory Processing Disorder, or APD. One cause is middle ear infection or otitis media. A large percentage of children who have APD also have a significant history of ear infections during the first two years of life. Frequent ear infections may also be associated with hearing loss and may cause delayed language and speech development.

Imagine trying to learn a foreign language while wearing earplugs. This is a little like what children with APD face in the classroom on a daily basis. It is easy to understand how they could fall behind academically, lose self-esteem, or be labeled as having behavioral problems.

What symptoms are associated with APD?

Some common symptoms associated with APD include:

not listening carefully to instructions
being easily distracted by background noise
difficulty with phonics or speech sounds, spelling and/or reading
poor learning through the auditory or hearing channel
behavioral problems
below average academic performance

Can anything be done to help children with APD?

Much can be done to help children who show symptoms of auditory processing disorders, once it is identified by a specially trained audiologist. If your child exhibits two or more of the symptoms listed, make an appointment with a specialist as soon as possible.

Screening tests are available for children as young as three years. A child five years or older may be administered a full AP test battery. The AP test battery should not only measure hearing, but also should identify the presence or absence of APD.
The audiologist should then classify the type and severity of the child's AP disorder, and provide recommendations to help the child in school and at play.

Special language treatment such as sound blending and auditory memory exercises
Listening training in the presence of background noise
Self help techniques to improve overall communication
Activities which may be used by the teacher in the classroom or by parents at home

Preferred seating to enable the child to easily see the teacher's face and the blackboard

Acoustic room treatment to reduce background noise and the echo or reverberation

Use of FM auditory enhancement systems

With these systems the teacher wears a wireless microphone which transmits her speech signal directly to the child's ear or through a strategically placed speaker, while she moves around the classroom.

There are several ways to provide more understandable hearing in the classroom. Auditory and listening skills, which are critical for learning, may be improved through individual programs. Treatment for APD is based on a child's individual hearing needs.
These intensive language treatment programs are usually managed by a speech-language pathologist or an educational audiologist, and are often very helpful. Classroom teachers can also use specific strategies to assist the child with auditory processing disorder.

A stable sound environment is needed for learning through listening. Background noise and echoing make classroom listening extremely difficult for children who have APD. Minor modifications can make a major difference in improving the listening quality of a classroom. Special FM listening systems are available to help make the teacher's voice understandable to the child who might otherwise become confused or tired during a normal school day. These systems trigger a significant improvement in APD children.
Many children have difficulty using their good hearing in learning to read and spell. An auditory processing disorder may cause problems with:

If you know a child who has these symptoms, consult a hearing healthcare professional as soon as possible. The sooner APD is diagnosed, the sooner the child can learn and benefit from his or her new listening skills.