Auditory Processing Disorder: Hearing but not understanding
If you know a child who has difficulty understanding verbal instructions and who struggles with reading and spelling, they could have an auditory processing disorder.
Auditory Processing Disorder (APD) is a hearing disorder in which the ears process sound normally but the brain cannot always understand or ‘hear’.
Children with APD may exhibit signs of hearing loss, especially when there are competing sounds at even moderate levels, yet they pass standard hearing tests conducted in quiet.
Despite having normal intelligence they may need instructions repeated and may have difficulty following directions in the classroom. In particular they may not respond appropriately to instructions that are lengthy or that include more than one task.
Audiologist and CEO of SoundSkills, Dr Bill Keith, says “APD affects an estimated five per cent of children (more boys than girls) and most go undiagnosed”.
The team of experts at SoundSkills is dedicated to diagnosing and treating APD. SoundSkills’ audiologists, speech therapists and education adviser provide specialised testing and individually tailored remediation programmes.
“APD can present as a learning or behaviour problem and can cause under-achievement because these children are missing out on vital information,” says Dr Keith.
“The problem lies in the hearing pathways and centres in the brain. Children are unable to extract the message that they need to from all the sound and noise around them. Or they have trouble retaining auditory information unless it is brief.”
The condition often occurs in conjunction with other areas of difficulty such as Attention Deficit Hyperactivity Disorder (ADHD), Language and Phonological Awareness problems, and reading disorder. It can be the underlying cause of language, spelling, reading and learning disorders.
The underlying auditory problem should be addressed before trying to remedy the language, spelling, reading or learning difficulty.
The condition requires specialised testing and assessment, and individualised treatment. A multi-disciplinary team approach is necessary. But, says Dr Keith, “the good news is that there is now robust evidence for the effectiveness of a number of interventions.”
These are:
Information for the child, family and teachers so they understand the problem and learn some simple techniques to reduce the effects.
Hearing training therapy to improve listening skills.
Language therapy to improve understanding.
Fitting of a personal “FM” listening device (specialised for APD), particularly for classroom use, to transmit the voice of the teacher clearly, so that distance and background noise are no longer a problem.
The exciting conclusion from recent research at the University of Auckland by Dr Suzanne Purdy and her colleagues is that FM usage delivers a double benefit for children with APD.
Firstly it provides immediate assistance with hearing, but over time FM usage also can lead to an improvement in auditory skills so that use of the FM system may not be permanently necessary.
Says Dr Keith, “Assistive devices can’t normally cure hearing pathology, but thanks to the neuroplasticity of the brain they can apparently assist the development of improved auditory skills in some children with APD.”