Auditory Processing Disorder (APD)

Auditory processing is understood as the 'brainwork' of hearing. It concerns a specific set of processing skills which enable individuals to act on what they hear. This processing is reliant on how well the ear speaks to the brain, and how well the brain understands what the ear is saying. Each of us is reliant on adequate auditory processing skills to communicate, remember, prioritise attention to a task, persist, filter background noise from voices and learn new information. This disorder has on occasions been described as auditory dyslexia, auditory comprehension deficit and word deafness.

Auditory processing difficulties are frequently linked to maturational delays and range from mild to severe. The incidence of APD is gauged at 3 to 5 per cent of the population. While APD can be diagnosed as a single, stand-alone difficulty, it also coexists with Language Disorder, ADD, ADHD, Dyslexia and Specific Learning Difficulties with regularity. Interestingly, it is not uncommon for teachers and parents to anticipate a child may have ADHD or ADD and be surprised when an audiologist diagnoses severe APD. This is because there are many similarities in the behaviours and listening of children with these conditions.

Children diagnosed with APD usually exhibit a cluster of traits. When at kindergarten, they may enjoy music but have trouble learning the words and consistently have difficulty staying seated for story time. Naturally, the classroom is dominated by spoken language and the acoustic conditions are often poor. Therefore APD can be more apparent in the learning situation than in the home, and signs become stronger as the child progresses through school. Teachers find themselves instinctively touching these students and gesturing to gain and keep their attention as they seem 'tuned out' and respond indiscriminately to instructions or questions. Such children seem to prefer to play alone and avoid social groups. Much of play is about negotiating the rules of games, and this is something which the child with APD finds challenging.

As school progresses and instructions become more frequent and complex, teachers increasingly rely on the auditory modality to communicate with students. Students with APD tend to misunderstand what is said and respond by saying, 'What was that?', 'I don't get it', 'I didn't hear', 'It's too noisy' or 'Huh?' They have difficulty receiving or remembering verbal clues. As this becomes more apparent, hearing tests are called for and usually yield normal results, although a history of early ear infections may be recognised.

Parents and teachers describe these children as 'day-dreamers', or as having 'selective hearing', or being 'in a world of their own'. Their difficulty in catching essential information in the classroom, and even within the busy family situation, intensifies in noisy situations, as their capacity to filter distracting background noise from critical instruction is impaired. As a result students in the classroom can become anxious and stressed when required to listen. Despite looking like they are listening, and wanting to listen, they have trouble interpreting what they hear. Depending on personality traits, associated learning issues and their history of success verses failure, the student may ask for the information to be repeated, or rely on others to re-explain and show them what to do. On the other hand, they may look as though they are not interested or have a short attention span. They may appear distracted, disorganised or dependent, or they may take on the role of class clown or the joker.

Without identification by a qualified audiologist, intervention and proactive management, prolonged Auditory Processing Difficulties have an impact on speech and broad-based literacy development. The erosion of learning skills is inevitable despite an individual's good intentions and sound intellectual abilities. Their enduring struggle to pay attention, to discriminate, associate, integrate and organise what is heard takes its toll on verbal communication, friendships, confidence and schoolwork. Unchecked, auditory processing problems can be at the root of slowing of school performance, increasing off-task responses, poor motivation, forgetfulness and growing disruptive behaviours in the classroom. Students often find support in simple management or compensatory strategies such as receiving short, focused directions and sitting close by when instructions are being given, and benefit when teachers provide additional visual clues (assignments or directions on the board or in a notebook) and arrange a peer tutor as a back up system.

Auditory Processing Disorder Links
http://www.asha.org
http://pages.cthome.net/cbristol/capd.html
http://www.edaud.org
http://www.nidcd.nih.gov/health/voice/auditory.asp