Posted on Thursday, October 17, 2013

Recognizing an Auditory Processing Disorder

Child covers his eyes in frustration with his auditory processing disorder

If a child has an auditory processing disorder (APD) it means he/she has a problem discerning sounds, like those in a classroom, or understanding language the way an average student might. Recognizing the signs and symptoms of this deficit of language and hearing is key to getting a proper diagnosis and the correct treatment.

Children with an auditory processing disorder have a harder time discerning and organize sounds the way an average student might.

Auditory Processing Disorder Examined

There are many different aspects of an ADP and symptoms for one individual might be different for another. Still, there are certain markers of this condition that a parent or teacher can learn to recognize.

Difficulty Understanding in a Noisy Environment: According to the American Speech-Language-Hearing Association (ASHA) children with an APD might, "have difficulty understanding speech in noisy environments, following directions, and discriminating (or telling the difference between) similar-sounding speech sounds."

Asks to Have Things Repeated or Clarified: Sometimes a child may behave as if a hearing loss is present, often asking for repetition or clarification. Teachers and parents may assume the child wasn't listening, chastising a child in this situation creates feelings of shame and will further inhibit them from communicating. If your child shows signs of an APD, auditory processing disorder, make sure they are tested by an audiologist in order to rule out and communication or hearing problems.

Not Following Direction: Does your child seem confused by directions, respond inappropriately to something asked—handing a towel when asked for a bottle, or consistently asks for things to be repeated? Children with an auditory processing disorder have difficulty with language. They can also have issues with speech—how they express themselves. For a clearer understanding on the difference between speech and language, this is how it is described by kidshealth.org:
• Speech is the verbal expression of language and includes articulation, which is the way sounds and words are formed.
• Language is much broader and refers to the entire system of expressing and receiving information in a way that's meaningful. It's understanding and being understood through communication — verbal, nonverbal, and written

Difficulty Tolerating Noisy Environments:An inability to tolerate noisy environments can be a sign of an auditory processing disorder. When sounds are a problem for a child, an abundance of them can be overwhelming. Children who have this sign of an ADP might show increased irritability in noisy environments, increased inability to page attention, or other exaggerated reactions.

Voice: Children with an auditory processing disorder might exhibit a speaking style that seems monotone, with little inflection or changes in pitch. Please note, these general symptoms of APD don't necessarily indicate the presence of an APD, but these markers should lead to testing which can conclusively diagnose the condition.

Speech Problems: If a child says words incorrectly, has delays in language and communication, feels more comfortable with gestures, these could be signs that your child is not hearing everything said or not processing sound in the correct way. Please note, a lisp is not typically associated with hearing loss and is a relatively common speech disorder.

Disinterest in Social Interaction: A seeming disinterest in social interaction can be masking a child’s inability to understand and therefore interact with children as easily as he/she sees his peers doing.

Diagnosing an Auditory Processing Disorder

Diagnosing any child with an APD is done with a strict evaluation performed by an audiologist. According to the American Speech-Language-Hearing Association (ASHA), "the actual diagnosis of APD must be made by an audiologist." Audiologist have the specialized training and sophisticated equipment necessary to evaluate the presence of an APD and to determine its exact nature. Listening and processing comprehension can occur at many different levels, thus ASHA also notes that, "it is necessary to determine the type of auditory deficit a given child exhibits so that individualized management and treatment activities may be recommended that address his or her specific areas of difficulty."

Testing Done by an Audiologist

Some of the test and audiologist will use to evaluate your child can be found below. This is a partial list that gives an idea of the complex nature of diagnosing hearing and listening problems.

• Aural Health Review: Checks ear anatomy, presence of chronic fluid; blood tests such as lead levels; metabolic functioning tests
• Tympanogram: Acoustic reflex measure of middle ear health; determines possible hearing loss (Aural Health Review and Tympanogram definition thanks to: Autism Sight and Hearing Loss)
• Behavioral Hearing Test—Patient is asked to respond to auditory stimulation. (Not appropriate for all ages or children.)
• Auditory Brainstem Response Testing—Comfortable earphones placed on the ears emitting a sound picked up by delicate equipment that measures how a child’s brain responds.
• Central Auditory Processing Evaluation—A series of tests designed to determine if a child has a problem with discerning certain sounds.
• Otoacoustic Emissions—A soft sponge earphone is placed in the ear canal to measure the presence or absence of typical “echo” responses to sound.

In addition to diagnosing APD an audiologist can also make sure that there are no issues with hearing loss. Obtaining the most accurate assessment of your child's speech and hearing problems helps to ensure that he or she receives the treatment options best suited for optimal development of language and communication.

If you'd like to learn more, see your hearing health provider. If you need help finding a hearing health provider click HERE to be connected with the largest network of trusted hearing health professionals in the nation!

Further Reading
Further insight into what constitutes an Auditory Processing Disorder can be found in an article on the Hearing Journal, Pathways: Audiology Must Take its Rightful Place on the Autism Team by Carol A. Lau.

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