Auditory processing disorder

Auditory processing disorder also known as central auditory processing disorder, auditory perceptual disorder or central auditory disorder, is a hearing problem that affects about 3-5% of school-aged children. Auditory processing disorders affect the auditory areas of the brain. Auditory processing disorder is a problem with recognizing and interpreting the meaning of sounds. Children with auditory processing disorder have normal hearing but can’t process what they hear in the same way other kids do. This is because their ears and brain don’t fully coordinate together to understand sound. Something interferes with the way the brain recognizes and interprets sounds, especially speech. These difficulties make it hard for children to work out what a sound is, where the sound came from and when the sound happened. And this means it’s hard for children to listen properly when there’s background noise or the sound is muffled.

Children with auditory processing disorder have trouble listening, learning and concentrating in noisy environments like the classroom. auditory processing disorder is often associated with various learning disabilities. Children with auditory processing disorder experience difficulties in less-than-ideal (noisy) listening situations and may have difficulties with reading, spelling, attention, and language problems. It is likely that many processes and problems contribute to auditory processing disorder in children.

Auditory processing disorder isn’t related to hearing loss or impairment and it isn’t an intellectual disorder.

Auditory processing disorder can also look like a language problem, a learning difficulty or attention deficit hyperactivity disorder (ADHD), but it isn’t these things either.

Because auditory processing disorder looks like other problems and often happens with other disorders like language and reading difficulties, it can be hard to diagnose.

Auditory processing disorder can’t be cured, but with the right therapy and support, children with auditory processing disorder can be successful in school and life. Early diagnosis is important. If auditory processing disorder isn’t caught and treated early, a child can have speech and language delays or problems learning in school.

Auditory processing disorder is an audiological diagnosis, and therefore, the audiologist is the professional who generally makes the diagnosis. To properly diagnose auditory processing disorder, special tests need to be administered by an audiologist. Individuals with auditory processing disorder usually pass standard hearing tests because standard hearing tests are designed to test the quietest sounds one can hear. auditory processing disorder may be present with or without hearing loss.

Auditory processing disorder is common in older adults, particularly when hearing loss is present. In adults, neurological disorders such as stroke, tumors, degenerative disease (such as multiple sclerosis), and head trauma can contribute to auditory processing disorder.

Auditory processing disorder in children and adults often is best managed by a multidisciplinary team of professionals that may include audiologists, speech-language pathologists, psychologists, and teachers, to evaluate and treat hearing, language, cognition, and academic issues.

Although auditory processing disorder treatment is usually determined based on the likely cause of auditory processing disorder, a variety of treatment approaches may be recommended. These approaches can include medical treatment, hearing aid amplification, assistive listening devices, auditory training, and special listening strategies. Treatment strategies are usually provided by audiologists, although physicians, speech-language pathologists, psychologists, teachers, and other professionals may be involved.

Your audiologist might suggest strategies your child can use to improve her listening in noisy environments. The audiologist might also recommend that your child uses a personal FM or sound amplification system. This will help your child hear the teacher’s voice more clearly, even when there’s lots of background noise.

Your child might be referred to a speech pathologist to work on his language skills. Your child might also see a special education teacher for extra help at school, especially with reading and writing.

Treatment for auditory processing disorder is tailored to each child. It’s a good idea to talk with your audiologist or speech pathologist about what sort of treatment will work best for your child.

Auditory processing disorder causes

The cause of a child’s auditory processing disorder is unknown. Evidence suggests that head trauma, lead poisoning, and chronic ear infections could play a role. Sometimes, there can be more than one cause.

Auditory processing disorder signs and symptoms

Children with auditory processing disorder are thought to hear normally because they can usually hear sounds that are delivered one at a time in a very quiet environment (such as a sound-treated room). The problem is that they usually don’t recognize slight differences between sounds in words, even when the sounds are loud and clear enough to be heard.

These kinds of problems usually happen when there is background noise, which is often the case in social situations. So kids with auditory processing disorder can have trouble understanding what is being said to them when they’re in noisy places like a playground, sports events, the school cafeteria, and parties.

Symptoms of auditory processing disorder can range from mild to severe and can take many different forms. If a child has auditory processing disorder, you might notice that he has difficulties with:

• listening and hearing, especially if there’s a lot of background noise and distractions
• following instructions
• staying focused – for example, he might be easily distracted
• remembering spoken instructions
• telling the difference between letters that sound similar, like ‘k’ and ‘g’, or ‘t’ and ‘d’
• remembering to say the beginning or end sounds of words when he’s reading.

This means that auditory processing disorder can appear as problems with learning, listening and communication, as well as reading and writing.

If you think your child might have a problem processing sounds, ask yourself:

• Is my child easily distracted or unusually bothered by loud or sudden noises?
• Are noisy environments upsetting to my child?
• Does my child’s behavior and performance improve in quieter settings?
• Does my child have trouble following directions, whether simple or complicated?
• Does my child have reading, spelling, writing, or other speech-language difficulties?
• Are verbal (word) math problems hard for my child?
• Is my child disorganized and forgetful?
• Are conversations hard for my child to follow?

Auditory processing disorder is often misunderstood because many of its symptoms can happen with other problems, like learning disabilities, attention deficit hyperactivity disorder (ADHD), and even depression.

Auditory processing disorder diagnosis

If you think your child is having trouble hearing or understanding when people talk, have an audiologist (hearing specialist) examine your child. Only audiologists can diagnose auditory processing disorder. Audiologists diagnose auditory processing disorder in consultation with a range of professionals including speech pathologists, psychologists, and teachers.

Auditory processing disorder is usually diagnosed once children start school. Because most tests done to check for auditory processing disorder require a child to be at least 7 or 8 years old, many children aren’t diagnosed until then or later. Diagnosis is important so that your child can get support for classroom learning.

Auditory processing disorder test

If the audiologist thinks the problem might be auditory processing disorder, the audiologist will do an auditory processing assessment. This includes diagnostic hearing tests for hearing loss and auditory processing tests.

An auditory processing test involves several short tests like listening to and repeating words and sounds back to the audiologist. The audiologist uses equipment to change the words and sounds so they’re harder to understand – for example, the equipment might add background noise or play words or sounds at the same time.

You can ask your audiologist for more information about the tests before your child has them.

Audiologists look for five main problem areas in kids with auditory processing disorder:

• Auditory figure-ground problems: This is when a child can’t pay attention if there’s noise in the background. Noisy, loosely structured classrooms could be very frustrating.
• Auditory memory problems: This is when a child has trouble remembering information such as directions, lists, or study materials. It can be immediate (“I can’t remember it now”) and/or delayed (“I can’t remember it when I need it for later”).
• Auditory discrimination problems: This is when a child has trouble hearing the difference between similar words or sounds (COAT/BOAT or CH/SH). This can affect following directions and reading, spelling, and writing skills, among others.
• Auditory attention problems: This is when a child can’t stay focused on listening long enough to complete a task (such as listening to a lecture in school). Kids with Cauditory processing disorder often have trouble maintaining attention, although health, motivation, and attitude also can play a role.
• Auditory cohesion problems: This is when higher-level listening tasks are difficult. Auditory cohesion skills — drawing inferences from conversations, understanding riddles, or comprehending verbal math problems — need heightened auditory processing and language levels. They develop best when all the other skills (levels 1 through 4 above) are intact.

Auditory processing disorder treatment

A child’s auditory system isn’t fully developed until age 15. So, many kids diagnosed with auditory processing disorder can develop better skills over time as their auditory system matures. While there is no known cure, speech-language therapy and assistive listening devices can help kids make sense of sounds and develop good communication skills.

A frequency modulation (FM) system is a type of assistive listening device that reduces background noise and makes a speaker’s voice louder so a child can understand it. The speaker wears a tiny microphone and a transmitter, which sends an electrical signal to a wireless receiver that the child wears either on the ear or elsewhere on the body. It’s portable and can be helpful in classroom settings.

A key part of making the frequency modulation (FM) system effective is ongoing therapy with a speech-language pathologist, who will help the child develop speaking and hearing skills. The speech-language pathologist or audiologist also may recommend tutoring programs.

Here are some of the most helpful assistive technology tools for auditory processing disorder:

• Personal listening devices can help kids hear a teacher’s voice more clearly. With a personal listening device, the teacher wears a clip-on wireless microphone. The mic transmits her voice directly to a student’s personal speaker or earpiece. Some personal listening devices are called frequency modulation (FM) listening systems because they rely on the same FM frequencies radio stations use. Some newer personal listening devices use Wi-Fi or Bluetooth to transmit a voice.
• Sound field systems are specialized speaker systems for classrooms, which often have sound issues. There may be areas where sound echoes or is muffled. A sound field system broadcasts the teacher’s voice to speakers placed in certain locations in the room. This helps to distribute the teacher’s voice evenly throughout the classroom, so all students can hear it well. Some systems include a pass-around microphone for kids to use during class discussions.
• Noise-canceling headphones can help block out background noise for kids who are sensitive to sound. Kids may find it helpful to connect their headphones to a white noise app that plays sounds like rain or static. If kids need to listen to audio, they can listen through the headphones to help filter out distracting background noises.
• Audio recorders allow kids to record classroom lectures or discussions. This way they can listen to a lecture several times if they didn’t comprehend it well enough the first time. It also may help to be able to pause the recording or play it at a slower speed to improve understanding. Some note-taking apps or devices allow kids to synchronize their handwritten or typed notes to an audio recording. This can make it easier to navigate an audio recording.
• Captioning allows kids to read text that matches what’s being said. This can make it easier for kids with auditory processing disorder to understand spoken language. A classic example is closed captioning on television. Movies and some Internet videos, like those on YouTube, also offer captioning. Keep in mind that captioning may not be helpful if your child has reading issues.
• Text-to-speech software lets kids see text and hear it read aloud at the same time. Kids click on or highlight words, and the words are read by a computer-generated voice. This may help kids with auditory processing disorder who also struggle with reading skills, such as decoding. Some kids may have trouble understanding certain text-to-speech voices. If this happens, experiment with different voices and reading speeds to see which ones work best. Another option is audiobooks, which use human voices for narration.

Several computer-assisted programs are geared toward children with auditory processing disorder. They mainly help the brain do a better job of processing sounds in a noisy environment. Some schools offer these programs. If your child has auditory processing disorder, ask school officials about what’s available.

At Home

Strategies applied at home and school can ease some of the problem behaviors associated with auditory processing disorder.

Children with auditory processing disorder often have trouble following directions, so these suggestions may help:

• Reduce background noise whenever possible at home and at school.
• Have your child look at you when you’re speaking.
• Use simple, expressive sentences.
• Speak at a slightly slower rate and at a mildly increased volume.
• Ask your child to repeat the directions back to you and to keep repeating them aloud (to you or to himself or herself) until the directions are completed.
• For directions that are to be completed later, writing notes, wearing a watch, or maintaining a household routine can help. So can general organization and scheduling.
• It can be frustrating for kids with auditory processing disorder when they’re in a noisy setting and need to listen. Teach your child to notice noisy environments and move to quieter places when listening is necessary.

Other tips that might help:

• Provide your child with a quiet study place (not the kitchen table).
• Maintain a peaceful, organized lifestyle.
• Encourage good eating and sleeping habits.
• Assign regular and realistic chores, including keeping a neat room and desk.
• Build your child’s self-esteem.

At School

It’s important for the people caring for your child to know about auditory processing disorder. Tell teachers and other school staff about the auditory processing disorder and how it may affect learning. Children with auditory processing disorder aren’t typically put in special education programs, but you may find that your child is eligible for a 504 plan through the school district that would outline any special needs for the classroom.

Some things that may help:

• changing seating plans so your child can sit in the front of the classroom or with his or her back to the window
• study aids, like a tape recorder or notes that can be viewed online
• computer-assisted programs designed for kids with auditory processing disorder

Stay in touch with school staff about your child’s progress. One of the most important things that both parents and teachers can do is to acknowledge that auditory processing disorder is real. Its symptoms and behaviors are not something that a child can control. What the child can control is recognizing the problems associated with auditory processing disorder and using the strategies recommended both at home and school.

A positive, realistic attitude and healthy self-esteem in a child with auditory processing disorder can work wonders. And kids with auditory processing disorder can go on to be as successful as their classmates. Coping strategies and techniques learned in speech therapy can help them go far.