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

I just received the results of my child’s auditory processing assessment and the report indicated that my child has difficulty or disordered auditory processing. What is next?

AUDITORY TRAINING

We want to help your child’s brain process sound more efficiently in order to make it easier for them in busy/noisy environments. Auditory training programs can be completed at home or at the Lakeside Hearing Clinic.

Depending on your child’s areas of weakness, your audiologist may recommend auditory training programs such as:

https://capdots.com/ (completed at-home with help of a parent/guardian)

https://www.hearbuilder.com/ (completed at home by your child)

Or, An individualized in-clinic training program designed by the audiologist which may include (but is not limited to): two ear listening tasks to activate the brain’s interhemispheric transfer function, sound/phoneme blending, and separating speech from noise. (price/length will vary based on need’s of child).

TECHNOLOGY

Your child’s ears detect/hear perfectly – and yet they are still struggling to listen in background noise. A traditional hearing aid will not help because your child doesn’t have a hearing loss.

However, your child will have an easier time listening in the classroom if we can boost the signal-to-noise (teacher’s voice-to-peer’s chatter) ratio. We can boost the signal-to-noise ratio if the child uses a personal remote microphone system.

What is a remote microphone system?

A very discreet ear level receiver (worn by the child) that connects via Bluetooth to a small transmitter (clipped to the teacher’s shirt). This brings the teacher’s voice directly into the child’s ear giving them that clear signal that will allow them to follow along more easily in the classroom.

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.

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