Welcome to Portland APD, a practice devoted to the diagnosis of auditory processing disorders. admin
• Problems hearing in noise?
• Mis-hears fine auditory differences?
• Frequent mis-hearings?
• Problems at school or work?
• Poor at following complex directions?
• History of ear infections or head injury?
• YET, passes regular hearing tests.
What is Auditory Process Disorder?
Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is an umbrella term for a variety of disorders that affect the way the brain processes auditory information.
Individuals with APD usually have normal structure and function of the outer, middle and inner ear (peripheral hearing). However, they cannot process the information they hear in the same way as others do, which leads to difficulties in recognizing and interpreting sounds, especially the sounds composing speech.
It is thought that these difficulties arise from dysfunction in the central nervous system.
What are typical behaviors of people with APD?
Acts as though a hearing loss is present; says “huh?” or “what?” a lot. Needs frequent repetitions or rephrasing.
but passes regular hearing tests.
has difficulty understanding speech in the presence of competing background noise or in reverberant acoustic environments.
had a history of ear infections or ventilation tubes or a history of head injury or had significant jaundice at birth.
has difficulty understanding on the telephone, or avoids using the telephone.
has difficulty following rapid speech.
has difficulty understanding speakers who have an accent.
often accused of “selective listening” or not paying attention.
difficulty remembering the lyrics to songs; often believes the lyrics to be different from what others hear.
has academic difficulties, including reading, spelling and/or learning problems.
finds it hard to remember information given verbally.
has difficulty localizing the source of a signal.
has difficulty carrying out a verbal multi-part instruction, but does fine when given a written list of things to do.
Can anything be done?
Improvement of listening environment
Children with APD show difficulty listening in noise to a signal that they can process in a quiet environment. All classrooms are inherently noisy environments. Immediate ways to improve the auditory environment in a classroom include placing the child’s desk at a distance from the teacher in which the child can easily read the teacher’s lips while simultaneously listening. A light tap on the child’s shoulder can be used by the teacher to alert the child that something important is about to be said. Seating the child near a highly achieving classmate with permission for the two to be “study buddies” can allow the child to take cues from the buddy about important auditory instructions or meaning. Soundfield or personal FM systems have had great success in making it easier for the child to differentiate the teacher’s voice from typical classroom noise.
For years persons with hearing loss have been using compensation strategies that help them to function in challenging listening environments. Although hearing loss, per se, is not the problem for children with APD, the same strategies can be useful to smooth socially rough patches, and gain cooperation from communication partners. For example: most people respond poorly to a request for repetition that is packaged as a constant stream of “huh?” or “what?” But a “huh?” that is replaced with “excuse me, I didn’t quite catch what you said” improves tempers all around.
Multiple research studies show that practice in focused listening to challenging stimuli requiring an interactive response and giving immediate feedback improves the listening ability of children with APD. Many computer games (used with earphones) are available that provide listening practice and which also sustain children’s attention. All musical training is a form of focused listening. Participation in individual music lessons, as well as participation in band, orchestra, choir or small musical groups provides auditory training that provides challenge to the child with Auditory Processing difficulties.
Let’s get started
Do the above characteristics sound familiar? Testing for Auditory Processing Disorders could be the next logical step.