What is Auditory Processing?

Auditory Processing Disorder (APD)

Auditory processing describes what happens when your brain recognises and interprets the sounds around you. Humans hear, when energy that we recognise as sound, travels through the ear and is changed into electrical information that can be interpreted by the brain.

Auditory Processing involves a complex set of skills that are essential for listening and communication comprehension:

Sensation – identify sound existence
Localisation – find the source of the sound in location to the listener
Auditory attention –focus on the speaker for an age appropriate amount of time
Auditory figure-ground – distinguish the main speaker from background noises
Auditory discrimination – recognises patterns and differentiates words and sounds that are similar in sound.
E.g. fat/cat or death/deaf
Auditory closure – understanding the whole word or a message when part of it is missing. This skill is often used in loud settings where only partial information is heard
Auditory synthesis – blend individual sounds (phonemes) into words. e.g. m of mat
Auditory analysis – identifying phonemes (e.g., /d/ in dog), morphemes (prefixes, e.g., /re-/ in repeat and suffixes, e.g., /-s/ in hats), and other grammatical information
Auditory association – attach meaning to sounds
Auditory memory – remember oral information. Involves short- and long-term memory

What is Auditory Processing Disorder (APD)?

When a child has difficulty with processing information, it usually means that something is adversely affecting the processing or interpretation of information. Children with auditory processing difficulty typically have normal hearing and intelligence but they have trouble processing information they hear.

APD is an often misunderstood problem because many of the behaviours can appear in other conditions like learning disabilities, attention deficit hyperactivity disorder (ADHD), and even depression. Although APD is often confused with ADHD, it is possible to have both. It is also possible to have APD and specific language impairment or learning disabilities.

This is a complex problem affecting about 5% of school-aged children. These children are unable to process the information they hear in the same way as others because their ears and brain don't fully coordinate. Something adversely affects the way the brain recognises and interprets sounds, most notably the sounds composing speech.

Children with Auditory Processing Disorder (APD) often do not recognise subtle differences between sounds in words, even when the sounds are loud and clear enough to be heard. These kinds of problems usually occur in background noise, which is a natural listening environment. So, children with APD have the basic difficulty of understanding any speech signal presented under less than optimal conditions.

Detecting APD

Children with APD are thought to hear normally because they can usually detect pure tones that are delivered one by one in a very quiet environment (such as a sound-treated room). Those who can normally detect sounds and recognise speech in ideal listening conditions are not considered to have hearing difficulties.

However, the ability to detect the presence of sounds is only one part of the processing that occurs in the auditory system. So, most children with APD do not have a loss of hearing sensitivity, but have a hearing problem in the sense that they do not process auditory information normally. If the auditory deficits aren't identified and managed early, many of these children will have speech and language delays and academic problems. Symptoms of APD can range from mild to severe and can take many different forms.

Many children display some of these behaviors at some time, however, a child with APD will display these behaviors more consistently and more frequently as compared with other children of the same age.

Typical Characteristics in Preschool Aged Children

May demonstrate delayed speech and language abilities or articulation errors that are not consistent with age
Have difficulty following instructions at home or at school that other children of the same age can follow easily
Have an easier time following daily routines like putting your bag away on arrival at Kindy, than following new, verbally presented instructions
Ask for repetitions frequently
Demonstrate signs of frustration or confusion which can manifest as either refusing to participate at all to staring blankly when confronted with new instructions or activities
Have difficulty understanding instructions in a noisy environment
Have difficulty learning nursery rhymes or simple songs
Demonstrating no interest in having a book read to him/her or ignoring the text completely
Demonstrates social communication difficulties, such as hurt feelings or frequent misunderstandings, more than other children
Avoid talking to other children or adults
Be highly distractible, especially in noisy situations
Fails to exhibit steady progression in the production and/or comprehension of more complex language and new vocabulary
Fails to respond to or show curiosity about new sounds or demonstrates no attention or interest when spoken to

Typical Characteristics in Primary School Aged Children

Behaves as if hearing loss is present, despite normal hearing tests, especially in noisy environments
Demonstrates greater difficulty with verbal that nonverbal tasks
Demonstrates significant fluctuation in ability levels across tests of speech, language or cognitive processes, with weaknesses in those areas considered to be more auditory in nature
Exhibits a delay in the content, use or form of language
Exhibits articulation errors that persist longer thatn they should
Easily distractible
Refuse to participate in classroom discussions or otherwise offers inappropriate or off-topic contributions
Difficulty following multistep instructions
Poor reading and spelling skills
History of chronic ear infections
Poor music or singing skills
Poor problem solving skills
Poor social communication skills or difficulty making and keeping friends
Relies heavily on memorization when learning new information
Needs a high degree of external organization in the classroom to begin and complete required tasks
Expresses frustration with certain tasks

How can we help?

The JIAS Individual Programme

Auditory processing disorders can affect development of speech, language and communication as well as reading and spelling, resulting in dyslexia and/or problems with talking and understanding. Johansen Individualised Auditory Stimulation (JIAS) can help to improve these difficulties.

Some Practical Ideas

Here are some practical ideas to help in the classroom or at home. The most effective way, however, is to treat the cause.

Reduce the background noises by using soft furnishings on hard surfaces such as curtains, throws, pillows, carper squares. Soft furnishings absorb noises
Sit away from noise sources, (e.g. doors, windows, pipes)
Use ear plugs during individual work time or test taking
Provide quiet isolated work areas
Give directions in small steps
When speaking use simple, expressive sentences. Speak slower and a little louder
Sit close to teacher (preferential sitting)
Face the child and maintain eye contact while speaking
Provide breaks to prevent frustration or becoming overwhelmed
Give additional time to process the oral directions and questions
Re-phrase and reinforce verbal instruction
Demonstrate or model the lesson or assignment
Have the child repeat the questions or directions aloud for comprehension
Use a computer or overhead to provide visual clues
Provide written notes and assignments for the child to refer back to, instead of relying on memory
Use manipulatives during lessons
Use graphic organizers that include pictures
Use outlines and study guides to keep the child on task and organised
Use color-coded organisation ideas: color code each subject. Everything pertaining to that subject is one color – readings, assignments, notes, etc

References: Kids Health from Nemours (2007), Florida Department of Education (2001) Technical Assistance Paper: Auditory Processing Disorder.

Bellis, Terri James (2002): When the brain can’t hear. Unraveling the mystery of Auditory Processing Disorder.