Auditory Processing Evaluation and Therapy

/Auditory Processing Evaluation and Therapy
Auditory Processing Evaluation and Therapy 2017-06-01T07:11:47+00:00

What is Auditory Processing?

Auditory processing is a complex series of processes, which make sound meaningful to various centres in the brain. These processes include:

  • coordinating information between ears
  • routing signals to appropriate recognition centres
  • inhibiting meaningless input, and
  • associating and coordinating information with other sensory systems.

Auditory processing refers to the way the brain processes auditory information collected from the ears, such as: determining where a sound is coming from; differentiating speech from other noise; recognizing the differences between sounds and remembering them, and recognizing acoustic patterns.

Children with auditory processing weakness often have difficulty keeping up with the natural flow of conversation; understanding speech in less than optimal conditions; understanding complex verbal directions, and often become easily distracted in the presence of background noise.  Many of these children will exhibit academic difficulty (specifically related to language arts) if deficits remain unidentified and unmanaged. 

What are common signs of APD?

  • Poor listening
  • Difficulty reading
  • Short attention span
  • Difficulty following verbal directions
  • Doesn’t participate in conversations
  • Language delay
  • Often shows frustration
  • Difficulty distinguishing speech sounds; especially in a noisy environment
  • Functions better in a quiet environment
  • Memory problems
  • Easily distracted

How do I find out if my child has APD?

An auditory processing assessment must be conducted by a registered Audiologist. The audiologist will begin by taking a detailed case history from the parent and also look at any supporting documents such as information from the physician, teacher, speech-language pathologist etc., if available.

Next, the audiologist will evaluate the child’s hearing and middle ear function. The audiologist will then administer some APD behavioral tests in order to assess performance on various auditory tasks in different listening conditions.

APD tests include:

  • Auditory pattern ordering: reproducing the pattern heard
  • Auditory closure: filling in the gaps that are missing based on knowledge of the language
  • Binaural separation: detecting the appropriate message while ignoring other competing voices or noise
  • Binaural integration: fusing or integrating information from both ears
  • Temporal gap detection: detecting the difference in emphasis i.e. ‘the quarter- back threw the ball’ vs. ‘I want my quarter back’
  • Auditory figure ground: filtering out steady state background noise
  • Spatial processing: determining where sound is in space in order to focus on target speech while ignoring distracting speech
  • Phonemic Synthesis: blending individual speech sounds into words

The diagnostic assessment is based on consensus from the Canadian Interorganizational Steering Group for Speech-Language Pathology and Audiology www.speechandhearing.ca

How is APD managed?

The audiologist will review the test results with the parent/caregiver and provide a detailed report with recommendations based on the specific findings.

Auditory processing management is divided into three main categories:

  1. Environmental modification and teaching suggestions to improve the individual’s access to auditory information
  2. Provision of   compensatory strategies designed to teach the child how to overcome residual dysfunction and maximize the use of auditory information
  3. Remediation techniques designed to enhance discrimination, interhemispheric transfer of information, and associated neuro-auditory functions (Bellis, 1996)

Environmental Modification:

Some common environmental recommendations for children with APD are:

  • Reduce external visual and auditory distractions as much as possible
  • Preferential seating in the classroom near the teacher and away from auditory and visual distractions and noise sources like heating and cooling systems
  • Avoid asking the child to listen and write at the same time. Sometimes a buddy can share notes with the child or the teacher may provide the child with notes
  • Encourage the child to ask questions for clarification
  • To improve the listening situation, the audiologist may recommend the use of a device that transmits the teacher’s voice directly to the child’s ear through a headset. This is called an FM system.
  • Use visual aids and write instructions to supplement spoken information
  • Use simple, brief directions
  • Speak slowly and clearly but not exaggerate speech
  • Recognize fatigue and give breaks when needed

Compensatory Strategies: Self Advocacy, listening strategies, and coping skills are provided to help the individual manage difficult listening situations.

Auditory Processing Remediation

We offer various auditory processing therapy programs based on the individual’s auditory profile. We offer one on one auditory training with a speech pathologist; one on one speech and language therapy; interactive online auditory training programs, and an integrated auditory/motor/education program through the Interior Development Centre

One on one auditory training with a speech/language pathologist:

Our Therapy Program for children 7 years of age and older with Auditory Processing difficulties was adapted from the work of Dr. Terri Bellis, Ph.D., University of South Dakota, Dr. Gail Chermak, Ph.D., Washington State University, and from the Buffalo Model by Dr. Jack Katz, Ph.D, University of Kansas Medical Center. It focuses on “what we do with what we hear”.

The child’s individual diagnostic profile will direct intervention. Individual therapy may focus on Phonemic Training and Phonemic Synthesis, Speech-in-Noise Desensitization, Auditory Memory and Sequencing Training, and/or Localization of Sound Training. In addition to therapy; self-advocacy, coping skills, and acoustic environmental recommendations will be provided.

One on one speech/language therapy:

Children with auditory processing weakness may also have weakness in the area of oral language. Children with oral language difficulties experience not only communicative problems but also academic problems. Delays or disorders in oral language development will be evaluated in comprehension of single words, receptive/expressive language skills, language/working memory, and processing language increasing in complexity. Language intervention will target specific skill building, compensatory strategies and environmental adaptations; and is offered over 12-week blocks.

Interactive Online Auditory Training:

Interactive online auditory training is offered based on areas of weakness. Research validated programs such as Eearobics, Hear Builders, CAPDOTs, Sound Auditory Training, Fast Forward and LACE are offered in the clinic with audiologic monitoring or from the comfort of home.

Interior Development Centre:

Our research-validated program is designed to stimulate a child’s sensory development with one integrated program. Enhancing one’s sensory development builds the foundation for more integrated skills such as fine and gross motor development, language and communication. Research has indicated that doing activities that work the auditory, tactile, vestibular, visual and proprioceptive systems in an integrated manner works better than each one alone. The outcome is a better-integrated and balanced child who will perform better in school and at home.

Integrated Auditory / Motor Therapy:

The therapy targets individuals exhibiting difficulty with auditory integration. The aim of the program is to improve the interhemispheric transfer of auditory information, coordination of information between both ears, and the association and coordination of auditory information with other sensory systems. It is based on the scientific principles of neuroplasticity and is deficit specific, evidence-based with measurable success.

Motor Development delays can present several challenges for children, and yet there is strong evidence that daily physical movements integrated into a child’s life can help increase their academic achievement. The motor development part of this program will explore the unique learning needs children with motor impairments and/or delays face while incorporating the vestibular, proprioceptive, tactile and visual systems. Children will experience fun, active, and developmentally appropriate activities that will help increase coordination, balance and motor skills.

The integrated auditory/motor therapy incorporates principles and therapies from Integrated Listening Systems (iLs). The iLs program utilizes a simultaneous, multisensory approach to improve processing. The fundamental tenet of iLs is that multisensory inputs from visual, motor and auditory systems must be efficiently and rapidly processed for optimal brain function. The program is based on the premise that higher cognitive functions such as the acquisition of speech and language, reading, writing, spelling, math skills, and communication are dependent upon accurate processing of incoming sensory inputs. Even behaviours such as attention, concentration, memory, reasoning, planning and social skills are equally dependent on accurate and efficient processing of information.


The adage “we read with our ears” holds much truth and emphasizes the importance of the auditory system in reading. The visual symbol must be decoded into sound before it has any meaning. Sound brings the symbol to life. As the eyes move from letter, or from word to word, the auditory interpretation centre (Wernicke’s area) translates the symbol into meaning. Our program aims to improve auditory processing skills such as decoding, phonemic awareness, processing speed, sound discrimination etc.

An intensive, intervention program for students struggling with reading and/or math will offered over a 12-week session. This dynamic program will instruct students in the five critical areas of reading – Phonemic Awareness, Phonics, Fluency, Vocabulary and Comprehension as well provide programming to support those children struggling with math. Using systematic instruction that begins with simple concepts and moves to more complex skills. Ongoing assessment and progress monitoring will provide robust data to inform instruction and show students’ progress.

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