Auditory Processing Disorder


Presented for The Parish School
Rachael von Eschenbach, M.S. CCC-SLP


I. Auditory Processing

A. Definition: the ability of the auditory system to perceive, attend, remember, and attach meaning to auditory information OR "The ear talks to the brain, and the brain understands what the ear tells it."

B. The pathway of auditory information from the ear to the brain

  1. Outer ear (ear canal, eardrum) to middle ear (series of bones) to inner ear (cochlea)
  2. Auditory nerve to brain stem through brain's complex neural pathways to the auditory cortex
  3. Brain must perceive message, attend to message, remember message, recognize the grammatical structure and meaning in order to process auditory signal

C. Normal auditory processing occurs in a wide variety of listening conditions-varying rate/length of signal, complexity of signal, competing noise

D. Receiving high quality input into the nervous system is crucial in a child's development of expressive/receptive language and basic listening skills.

II. (Central) Auditory Processing Disorder

A. Definition- describes people who have normal hearing but have unusual difficulty processing auditory information, especially in unfavorable listening conditions OR " Their ears are able to hear the words, but their brain is not able to perceive them well enough to understand them"

B. Frequently Co-occurring disorders

  1. Expressive/Receptive Language Disorder
  2. Language/Learning Disabilities
  3. ADD/ADHD

III. Contributing Factors

A. No Direct Causal Factors

B. Genetics

C. Ear Infections

D. Allergies

E. Environment-most often the deciding factor for the extent to which CAPD affects a child's potential to communicated and learn

IV. Characteristics of Children with (Central) Auditory Processing Disorder

A. In General- they have difficulty applying meaning to auditory information, especially in unfavorable listing conditions OR " I heard you, but I don't know what you said."

B. Each child with CAPD is a unique combination of a few or many of the following characteristics:

  1. Most are male
  2. Normal peripheral hearing test
  3. Low performance in listening situations despite IQ within normal limits
  4. Inconsistent responses to auditory information-concrete interpretation of language
  5. Difficulty understanding sentences in noise
  6. Difficulty understanding spoken directions
  7. Difficulty following conversations and other rapid speech
  8. Difficulty discriminating/identifying speech sounds-difficulty rhyming, discrimination similar words, manipulating phonemes
  9. Poor articulation of sounds and words
  10. Difficulty with reading and spelling
  11. Speak loudly, especially in background noise
  12. Frustrate/fatigue easily in listening situations
  13. Reduced attention to auditory information,easily distracted, restless
  14. Reduced tolerance for moderate to loud sound
  15. Word retrieval difficulties
  16. Auditory memory, auditory sequencing difficulties-difficulty remembering info presented verbally for both short and long term memory.
  17. Poor organizational skills, require externally structured environment and organizational tools to be successful
  18. Areas of strength often include experiential learning, visual and tactile modalities, puzzles, building, gross motor skills, not-verbal interaction, sometimes music.

V. Screening and Assessment

A. Purpose of screening

  1. To determine the likelihood of the presence of APD
  2. To answer the questions:
  • Is there a need for further assessment?
  • Is the child capable of participating in a full evaluation?
  • Would the results of an evaluation add information that would affect the management of the child's difficulties?

B. What it involves

  1. Input from the child's team of professionals
  2. Administration of an auditory perceptual battery of tests, comparison with hearing testing, speech/language/psyco educational testing

C. Purpose of a diagnostic auditory processing assessment

  1. To identify the presence of (C)APD by separating auditory processing skills from co-occurring language/cognitive/attentional issues
  2. To define the disorder for development of a deficit specific management program
  3. To answer the following questions:
  • What specific processes are affected?
  • Is there a specific sight of dysfunction?

D. What it involves

  1. Administration of tests of central auditory function by an audiologist in a sound proof room, under head phones
  • Listening tests
  • Electrophysiological measures

VI. Interventions for (Central) Auditory Processing Disorder

A. Environmental modifications/classroom based strategies

  1. Slow rate, as short and simple speech as necessary, allow for extra processing time
  2. Check frequently for understanding
  3. Teaching style includes experiential activities and visual cues such as writing, pictures, gestures and incorporates movement, music and repetition whenever possible
  4. Teaching should be systematic and sequenced
  5. Seat child as close to teacher as necessary
  6. Assistive Listening Devices-FM trainer-increases the level of the teacher's voice in relation to background noise-helps child focus auditorily on classroom tasks

B. Remediation Activities

  1. Phonemic Awareness Activities-manipulation sounds and syllables with words
  2. Auditory Closure Activities-deducing meaning when part of the word or message is missing
  3. Listening and recognizing prosodic and temporal aspects of speech-listening to tone of voice, stress in sentences, differences in speed, loudness, rhythm
  4. Fast ForWord Computer Program
  5. Therapeutic Listening Programs-Auditory Integration Training, The Listening Program

C. Compensatory Strategies

  1. Establishing active listening behaviors
  2. Re-auditorization for memory long enough to process auditory information
  3. Learning how to visualize
  4. Listening when background noise is present
  5. Establishing visual attention to task/speaker's mouth
  6. Becoming their own learning advocate-initiating requests for help/clarification

VII. Suggestions for Parents

A. Get child's visual attention before speaking

B. Shorten your sentences, speak slowly, alter your pitch to stress what is important

C. Monitor listening situation

D. Break new information into small chunks, use simple vocabulary

E. Consult w/teacher/SLP about key phrases to use

F. Be abreast of successful strategies used at school for following through at home

G. Check for comprehension of auditory information

H. Visually represent daily routines and upcoming events with calendars and schedules

I. Do homework in a quiet place.

VIII. Factors that Contribute to Each Child Reaching Their Communication and Learning Potential

A. Education of family and child

B. Teamwork of family and professionals

C. Patience

 

 

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