WHAT IS AUDITORY PROCESSING DISORDER (APD)?
What is Auditory Processing?
It is the ability to listen, comprehend, and respond to information that we hear through our auditory channels. This includes the detection of sound by the external ear and the transmission of sound through the auditory pathways to the brain.
There is a difference between the capacity to "hear sounds and speech," and the capacity to actually process what is heard. A child can receive a perfectly normal score on a conventional hearing test and still have a severe Auditory Processing Disorder. In more extreme cases, Auditory Processing Disorders can cause a child with perfectly normal cognitive skills to never be able to develop the capacity to speak.
Different types of Auditory Processing Disorder
Auditory Processing Disorder can manifest in a number of ways. Children may experience:
- Associative deficit - difficulty associating sounds with written language
- Auditory decoding deficit - problems recognising sounds and therefore decoding words or messages
- Auditory integration deficit - trouble combining auditory cues with other sensory cues that contribute to a message (eg. seeing a written word and knowing what it would sound like when spoken)
- Organisational deficit - difficulty in organising auditory information to effectively decode the meaning of a given message, often as a result of one of the above three problems
- Prosodic deficit - speaking in a monotone, without rhythm or intonation, and not perceiving these subtleties in other speakers
- Auditory hypersensitivity - background sounds cannot be ignored
Checklist of symptoms and subtypes seen in children with APD
The following checklist is drawn from a history questionnaire composed by Judith W. Paton, M. A., Audiologist, and Bonnie G. Rattner, Ed. D, Speech/Language Pathologist.
"Tolerance/Fading Memory” subtype
- Often seems to “ignore” people, especially if engrossed.
- Hears less well, or is less attentive/productive, in ordinarily busy surroundings.
- Difficulty following a series of spoken directions.
- Unusually forgetful of information previously memorized (such asmultiplication tables, correct spelling), or of household or school routines and responsibilities, despite frequent reminders.
- Difficulty with phonics (sounding out words) approach to reading.
- Confuses similar-sounding words; may learn words wrong.
- Poor speller:
- errors seem random (wrong sounds, sounds/syllables missing/added)Problems with speech clarity or articulation, or
with grammar, now or in the past.
- Marked difficulty reading or writing efficiently, despite knowledge of phonics.
- Needs to (or should) ask many extra questions to clarify task before starting; “doesn’t get the picture.”
- Interprets words too literally, becoming confused or suffering hurt feelings.
- Poor “communicator” — fails to explain, apologize, negotiate, defend.
- Speaks or writes “telegraphically” — omits facts or switches topic, so that audience cannot follow train of thought.
“Prosodic” subtype (often seen with NLD or non-verbal learning disability)
- Absorbs details and facts, but misses the “big picture” — cannot prioritize or summarize information.
- Insensitive to tone of voice; may misjudge speaker’s mood or be unintentionally tactless.
- Problems with cause-and-effect reasoning; difficulty surmising the unspoken rules of conversation, play, and other situations.
Narrowing the CAPD down into subtype(s) through audiologic testing helps determine the right kind of therapy and accommodation.
STRATEGIES FOR PARENTS OF CHILDREN WITH AUDITORY PROCESSING DISORDERS
1. Eliminating environmental distractions
Anything that can shift the child's focus from the required task should be kept to a minimum. Possible distractions include background noise (appliances, conversations, traffic, etc) and visual clutter (objects on table, crowded blackboard, etc). It is best to seat a child with APD towards the front of the classroom. Open-plan classrooms are overwhelming for children with this condition, so a structured setting is preferable.
2. Improving listening comprehension
Teachers and parents alike tend to deliver most instructions through speech. These can be more carefully structured so that a child with APD has the best possible chance of interpreting the intended message.
Some strategies for presenting information to a child with APD include:
- Making sure you have the child's attention before speaking
- Speaking clearly and slowly
- Keeping instructions to 8-word sentences or less
- Phrasing instructions as simply as possible
- Using words like 'first, then, after, before' to give the child a sense of sequence
- Rephrasing rather than repeating misunderstood instructions
- Being explicit when the topic is changed
- Presenting the same information in another medium (eg. pictures, writing)
- Using physical gestures to demonstrate a point
- Modulating the voice to emphasise the most important pieces of information
- Asking the child to reflect your information or instructions in his/her own words
- Encouraging the child to ask questions
- Revisiting material that was learnt earlier
- Pay attention to the child's demeanour - if he/she looks tired, take a short break where appropriate
- Expect that the child will not comprehend messages immediately - if you are frustrated, try not to let this show outwardly to the child
- Only ask the child to do one task at a time - if you are talking, make sure the child is only listening; if the child is writing, do not give further instructions
In specific environments, other techniques include using ear plugs/headphones , which may help to reduce unwanted auditory stimuli. Teachers and parents can also actively simplify the child's visual environment, especially in situations where learning may be challenging.
For more information: http://www.listen-up.org/edu/capd.htm
Becca Lynn at : http://www.bbbautism.com
Judith Paton at: http://www.judithpaton.com