What is it?
Auditory Processing Disorder (APD) refers to difficulties with the way the brain processes auditory information. Simply put, children with APD can't process the information they hear in the same way as others because their ears and brain don't fully coordinate. APD is an auditory deficit that is not the result of other higher-order cognitive, language, or related disorder such as autism, ADHD, or intellectual disability. Children with APD have normal hearing.
How is it diagnosed?
There are many disorders that can affect a person's ability to understand auditory information. Because diagnosing APD can be difficult, a multidisciplinary approach is best. An educational specialist may report on academic difficulties; a psychologist may shed light on cognitive function; and a speech-language pathologist may investigate written and oral language. However, it is important to note that none of the tools these professionals use are diagnostic tool for APD, and the actual diagnosis of APD must be made by an audiologist.
Five main “problem” areas can affect children with APD:
-Auditory figure-ground problems: when a child can't pay attention if there's noise in the background. Noisy, low-structured classrooms can be very frustrating.
-Auditory memory problems: when a child has difficulty remembering information such as directions, lists, or study materials. It can be immediate ("I can't remember it now") and/or delayed ("I can't remember it when I need it for later").
-Auditory discrimination problems: when a child has difficulty hearing the difference between similar words or sounds (coat/boat or ch/sh). This can affect following directions, reading, spelling, and writing.
-Auditory attention problems: when a child can't stay focused on listening long enough to complete a task or requirement, such as listening to a teacher in class.
-Auditory cohesion problems: when higher-level listening tasks are difficult. Auditory cohesion skills require drawing inferences from conversations, understanding riddles, or comprehending verbal math problems and also require heightened auditory processing and language levels. They develop best when all the other skills (levels 1 through 4 above) are intact.
Treating APD
There is not one “cure-all” treatment for APD. A child’s treatment program must be individualized. Treatment often focuses on these three areas
1. Changing the learning or communication environment
-This helps improve access to auditory information that is presented
2. Recruiting higher-order skills to help compensate for the disorder
-Using language, problem-solving, memory, attention, other cognitive skills to help overcome the disorder
-Teaching body control, paraphrasing, subvocalizing, visualizing, and requesting clarification during demanding auditory tasks (e.g. metacognitive skills)
-Teach children to advocate for themselves and be an active participant in listening activities throughout the day
3. Remediation of the auditory deficit itself
-May be 1:1 direct therapy
Impacts of APD on Literacy
APD results in the inability or reduced ability to discriminate, recognize or understand auditory information. It is characterized by inefficient auditory processing abilities which can cause deficits in phonological awareness. Phonological awareness is an important skill when learning to read.
Classroom and Home Strategies for APD
-Reduce background noise, when possible (think lawn mowers outside, other students talking, fans, air conditioners, clocks ticking, etc.)
-Have the student sit in the front of the class or near the teacher
-Use a listening “cue” when getting the student's attention (e.g. “Ok, it’s time to listen.”)
-Encourage the use of assistive devices in class, such as a personal FM system
-Take tests or work on assignments/homework in an area away from distractions
