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Auditory Processing Disorder (APD), defined

Auditory processing is understood as the 'brainwork' of hearing. It concerns a specific set of skills which enable individuals to act on what they hear. Many refer to auditory processing as 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 Disorder (APD) is frequently linked to maturational delays and can range from mild to severe. The incidence of APD is gauged at about 5% of the child population. However, some researchers believe it may be closer to 10%. 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 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 characteristics. 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 are usually more apparent in the learning situation than in the home, and signs become stronger as the child progresses through school. Teachers find themselves instinctively gesturing to these students to gain and keep their attention as they seem ‘tuned out’ and respond indiscriminately to instructions or questions. These children often prefer to play alone and avoid social groups.

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, 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 Disorder 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 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), or have access to a peer tutor as a backup system. Listening devices such as a sound-field system in the classroom, or personal fm systems, positively help to make speech clearer in noise for students identified with APD.

Auditory Processing Disorder is not curable, but seems treatable. It is commonly treated with a range of one-on-one interventions; hearing training programmes and exercises and speech / listening therapy. It is also treated through a specialised Auditory Integration Listening Program or an Auditory Stimulation Program. Always seek advice from a qualified audiologist on the best available therapies as not all therapies persuasively offered are proven.

Finally, keep a positive and realistic attitude. Children with APD can be just as successful as any of their classmates.

Helpful links

http://www.auditoryprocessing.com.au

http://kidshealth.org/parent/medical/ears/central_auditory.html

http://www.adelaidehearingconsultants.com.au/

http://www.earscience.org.au/auditoryprocessingdisorder.html

http://www.nidcd.nih.gov/health/voice/auditory.asp