Auditory Processing Disorder (APD)
What is it and what are the symptoms
Auditory processing disorder (APD) is hearing loss that impacts the brain’s interpretation of sounds. The auditory system is comprised of two parts: the peripheral auditory system (made up of the outer, middle, and inner ear) and the central auditory system (made up of the auditory pathway to the brain. The central auditory system is responsible for receiving, remembering, understanding, and using auditory information. If the problem is in the peripheral auditory system, the person is likely to experience hearing trouble, however, if the issue lies within the central auditory system, the issue is typically comprehension and understanding what they are hearing.APD is what happens when the auditory pathway is unable to transfer the information to the brain for utilization. There are four types of APD, consistent of auditory discrimination, auditory figure-ground discrimination, auditory memory, and auditory sequencing. Auditory discrimination is the ability to notice, compare and distinguish the distinct and separate sounds in words which is a vital skill for reading. Auditory figure-ground discrimination is the ability to pick out important sounds from a noisy background. Auditory memory is the ability to remember something heard either a long time ago or very recently. Auditory sequencing is the ability to understand and recall the order of words. It is typical to experience symptoms such as difficulty concentrating or following conversations, requiring information to be repeated, easy distractability, difficulty organizing time, following routines and planning steps for a project, poor auditory attention, problems sounding out words while reading, problems with oral or written expression, and delayed responses to verbal instructions or requests. In order to diagnose APD, an audiologist will measure the physiological response of the auditory system to sound during an examination.
Functional implications
Kids with APD may miss social cues due to their extreme focus on the actual words being communicated to them. It may be hard for the to pick up on sarcasm and nonverbal forms of communication. As a result of this, they may draw back and avoid socializing due to the stress that comes with having to keep up with conversations. They may struggle in school as well, difficulty with understanding what is being said is tiring and requires great amounts of effort to do so. School can present them with an overwhelming amount of noise, testing can be difficult and exhausting.
Who can help
Pediatricians can suspect an issue and be the primary source for referencing to a specialist. Psychologists can provide CBT (cognitive behavioral therapy) to assist with any emotional-related issues to APD. Common co-existing health issues such as anxiety and depression are often. In addition to this, a psychiatrist can further evaluate for learning differences and ADHD which is often diagnosed as well. Audiologists can evaluate for APD and make a formal diagnosis and speech-language pathologists can work on sound discrimination, active listening skills and using appropriate language in social situations. Occupational therapists can also aid in this process by tying any social or emotional issues tied into their functional performance during ADL/IADL tasks.
What can schools do
Accommodations under an IEP or a 504 plan can be granted for the child to increase his/her success. Things like getting extended time for reading or writing, being seated near the teacher, frequent check-ins with teachers, use of pictures and symbols to enhance spoken lessons, quiet and separate work spaces or copies of notes from each lesson can be provided.
What to do at home
Making sure there is a designated space for your child to complete homework in a quiet setting with minimal distractions can help. Using visual schedules, checklists and sticky notes can help to stay on task and keep organized. When giving directions, give them one step at a time as this can be easier to follow instead of multi-step instructions. Establishing eye contact is also important and when talking to your child, keeping background noise at a minimum can help them feel less overwhelmed and help their focusing ability.
