Auditory Processing Disorder

What is Auditory Processing Disorder (APD)?

Auditory Processing Disorder (APD), also known as Central Auditory Processing Disorder (CAPD), is a problem with the way individuals process sounds – particularly, speech sounds. Their ability to hear can be fine; consequently, the problem lies with the way the sounds are processed by the brain. "Something adversely affects the way the brain recognizes and interprets sounds, most notably the sounds composing speech."

Children with [auditory processing disorder] often do not recognize subtle differences between sounds in words, even when the sounds are loud and clear enough to be heard. These kinds of problems typically occur in background noise, which is a natural listening environment. So kids with APD have the basic difficulty of understanding any speech signal presented under less than optimal conditions." (kidshealth.org/parent/medical/ears/central_auditory.html)

"For example, the request 'Tell me how a chair and a couch are alike' may sound to a child with APD like 'Tell me how a couch and a chair are alike.' It can even be understood by the child as 'Tell me how a cow and a hair are alike.' These kinds of problems are more likely to occur when a person with APD is in a noisy environment or when he or she is listening to complex information." (taken from "Auditory Processing Disorder in Children," www.nidcd.nih.gov/health/voice/auditory.asp)

Symptoms

Children and adults with auditory processing disorder do not process auditory information normally. If the deficits are not identified or managed early, speech and language-processing problems can cause difficulty in reading development later.

The following is a list of possible symptoms that could indicate auditory processing disorder:

  • Easily distracted or unusually bothered by loud or sudden noises
  • Behavior or performance improves in quieter settings.
  • Difficulty following directions, especially multi-step directions
  • Difficulty with verbal (word) math problems
  • Language difficulty (e.g., confuses syllable sequences and has problems developing vocabulary and understanding language)
  • Appears disorganized and forgetful
  • Difficulty following conversations
  • Difficulty with reading, comprehension, spelling, and vocabulary

Causes

There is still so much that is unknown about auditory processing disorder, since numerous other processes, such as memory and attention, are involved in processing speech. It is often associated with other disorders such as dyslexia and attention deficit disorder (ADD). So many of the processes in the brain overlap, and the disorders dealing with speech and language are difficult to determine and are often misdiagnosed because many manifest the same or similar symptoms.

Although the underlying cause for APD in children and adults is still unknown, some believe that heredity or environmental factors are the triggers. Other causes of auditory processing disorder are thought to be head trauma or chronic ear infections, but usually the cause is unknown. Audiologists can determine if someone has APD by performing auditory-processing tests. Speech-language pathologists are aware of the symptoms and can often get an idea if auditory processing disorder may be present by working with an individual.

Overcoming Auditory Processing Disorder 

There are several helpful resources if you or your child has APD. Some simple steps can be taken to help alleviate some of the difficulty and offer aids to help the individual to be successful:

  • In the classroom, make sure the child is seated away from high-traffic areas like the doorway or near the teacher's desk.
  • Make sure the child has a written version of all notes and information given orally so he/she can follow along.
  • Make sure the student is placed close to the front of the class so he/she can hear the teacher or whoever is presenting information.
  • Give simplified, one- or two-step directions for all tasks.
  • Allow additional time for processing information.

The symptoms for auditory processing disorder can be very similar to those of dyslexia and can cause confusion. Dyslexia is defined by the International Dyslexia Association (2000) as a "language-based disability in which a person has trouble understanding words, sentences or paragraphs; both oral and written language are affected." Further-expanded definitions suggest that the disorder was "characterized by difficulties in single word decoding, usually reflecting insufficient phonological processing abilities" that are "often unexpected in relation to age and other cognitive and academic abilities" (Shaywitz, Fletcher, & Shaywitz, 1994)

This suggests that despite normal intelligence, vision, and hearing, there is a problem with the processing and acquisition of language. Here again, we have a co-morbid effect that makes it difficult in determining the exact deficit. Those with dyslexia often have auditory processing disorder, and research has shown that both benefit from language strategies that help the individual to identify and manipulate individual sounds within words. Phonics taught explicitly and sequentially, with both visual and oral representation, will increase success in the acquisition of these skills. A specific diagnosis of APD should be sought from an audiologist, but most of the suggested accommodations and interventions are helpful, whether the auditory processing issue is from APD or dyslexia.


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