Auditory Processing Disorders

Auditory Processing Disorders

What is an Auditory Processing Disorder?

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.

Auditory Processing Disorder can be caused by a measurable neurological defect located in the higher auditory neural pathways. A person has normal hearing but an out-of-synch arrival time of the electrical impulses from the ears through the brainstem to higher cortical functions causes faulty interpretation of heard signals.

There's no clear agreed-to definition of Auditory Processing Disorder, but 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.


Why is Understanding APD Important?

A child with Audiory Processing Disorder can often have the same types of behavioral problems as a child with ADD. It's easy to see, however, that using the techniques appropriate for an ADD child will not be very effective with a child suffering from auditory processing issues, who can have very specific auditory skills needing to be developed. These affected skills can include:

  • 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 to Know if Your Child has Auditory Processing Issues

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 audiologist, 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.

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Challenges and Strategies

Auditory Processing Disorders Challenges & Strategies by Age Group

What you should know about auditory processing disorders:

  • Auditory processing disorders are often referred to as central auditory processing disorders (CAPD).
  • Auditory processing disorders can occur without any kind of hearing loss.
  • Auditory processing disorders affect how the brain perceives and processes what the ear hears.
  • Like all learning disabilities, auditory processing disorders can be a lifelong challenge.
  • Many of the difficulties that are experienced by people with auditory processing disorders are also common to people with attention deficit disorders.
  • Auditory processing disorders may run in families.
  • Auditory processing disorders can affect a person's ability to interact socially.
  • There are different types of auditory processing disorders, each affecting different aspects of auditory information processing.

Many people experience problems with learning and behavior from time to time, but if a person consistently displays difficulties with these tasks over time, testing for auditory processing disorders by trained professionals should be considered.

Early Childhood

Common Difficulties:

  • Learning to speak
  • Understanding spoken language
  • Separating meaningful sounds from background noise
  • Remembering stories or songs
  • Staying focused on a person's voice
  • Unusual sensitivity to noise
  • Confusing similar sounding words
  • Difficulty in understanding speech


Accommodation & Modification Strategies:

  • Keep directions simple - only tell your child one step at a time
  • Give directions both orally and visually - show your child what you mean
  • Speak slowly - especially when your child is hearing information for the first time
  • Maintain eye contact while speaking
  • Limit background noise when teaching new information or giving directions
  • Provide specific opportunities to practice skills that build vocabulary, rhyming, segmenting and blending words
School-Age Children

Common Difficulties:

  • Remembering and following spoken directions
  • Remembering people's names
  • Sounding out new words
  • Seeming to ignore others when engrossed in a non-speaking activity
  • Understanding people who speak quickly
  • Finding the right words to use when talking


Accommodation & Modification Strategies:

  • Combine oral teaching with visual aids
  • Ask that teachers and others make it physically, visually or audibly clear when they are about to begin something important so that nothing is missed
  • Have a note-taking buddy who will make sure that information was understood
  • Request seating close to teacher
  • Have child repeat back information or instructions to build comprehension skills and make sure messages are understood correctly
Teenagers & Adults

Common difficulties:

  • Talks louder than necessary
  • Remembering a list or sequence
  • Often needs words or sentences repeated
  • Poor ability to memorize information learned by listening
  • Interprets words too literally
  • Hearing clearly in noisy environments


Accommodation & modification strategies:

  • Find or request a quiet work space away from others
  • Request written material when you attend oral presentations
  • Ask for directions to be given one at a time, as you go through each step
  • Take notes or use a tape recorder when getting any new information, even little things

Auditory Integration Training

Auditory processing difficulty is one of the most common childhood issues - one that is often confused with ADHD. It is not an issue of hearing, but of the speed of processing which cause difficulty following multiple step directions, especially in a challenging environment like a classroom. By failing to follow the sequence of commands, information is no long meaningful or actionable, and over time the person learns to tune-out instructions, making them appear inattentive. Auditory processing issues can make reading speed and comprehension challenging as well.

After more than 25 years in the auditory processing field we have developed our own proprietary treatment system by incorporating the best of the Tomatis and Berard techniques. Our hybrid system allows auditory training to be conducted in the client’s own home. This is a huge leap forward in the ease and accessibility of treatment, which previously required clients to come into the office twice daily for 30-60 minutes, with a minimum of three hour window between visits.

We begin by identifying the challenges in the auditory cortex across the spectrum of sounds and circumstances. We then incorporate our findings into a music based training system which uses sounds that module in duration, intensity, and frequency. The client simply wears a specialized set of headphones and listens to an audio recording created specifically for then, for just an hour a day.

Using this system we can retrain the auditory system in the brain, the outcomes of which frequently are: improved communication and verbal skills, improved socialization, improved reading comprehension, and a reduction of sound sensitivity.

We are one of only a few facilities in the world training in both Berard Auditory Integration Training and Tomatis effect.


  Disclaimer:  Our treatments can improve brain function but are not a cure. Results vary for different individuals. Each person's experience is unique, and what works for one patient may not work for another.       Statistical data doesn't apply to individual patients, as no treatment is effective for 100% of patients.

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