Speech Pathology Associates


Auditory Processing Improvement

Ten year old Kelly seems to pay attention when the teacher works with her one-on-one. But when there are group discussions, she spends most of her time looking out the window. The teacher is complaining she doesn't participate in class and Kelly is getting lower grades as a result.

Daniel who is 12, was supposed to be home in time for his dentist's appointment at 3:30 PM. But when he finally walked in the house at 5:00, he was surprised to hear about the appointment and that his mother had reminded him about it that morning.

Normal kids? Or is something else going on?

Life is complicated these days, for children as much as adults. There's a lot to remember and a lot to do. But sometimes a child may seem to be more than simply distracted by a complex life. Although their hearing may be normal, kids with an auditory processing disorder (APD) can't process the information they hear in the same way as others because their ears and brain don't fully coordinate.

What Are the Signs and Symptoms of APD?

Symptoms of APD can range from mild to severe and can take many different forms. If you think there may be a problem with how your child processes what he or she hears, ask yourself these questions:

  • Is my child easily distracted or unusually bothered by loud or sudden noises?
  • Are noisy environments upsetting to my child?
  • Does my child's behavior and performance improve in quieter settings?
  • Does my child have difficulty following directions, whether simple or complicated ones?
  • Does my child have reading, spelling, writing, or other speech-language difficulties?
  • Is abstract information difficult for my child to comprehend?
  • Are verbal (word) math problems difficult for my child?
  • Is my child disorganized and forgetful?
  • Are conversations hard for my child to follow?

These, as well as other behaviors, may be signs of an auditory processing disorder (APD). It's an often-misunderstood problem because many of the behaviors noted above may also appear in other conditions such as learning disabilities, attention deficit hyperactivity disorder (AD/HD), and even depression. But kids with APD can have a coexisting disorder - the most commonly seen is AD/HD. Although APD is often confused with AD/HD, it is possible to have both.

What Causes APD?

The possible causes of APD are varied and can include head trauma, chronic ear infections, and unknown reasons. Because there are many different possibilities - even combinations of causes - each child has to be assessed on an individual basis.

How Is APD Diagnosed?

Audiologists (specialists in hearing) and speech language pathologists can determine if your child has APD. Auditory processing testing can determine if there really is a problem.

However, some of the skills a child needs to be evaluated for an auditory processing disorder don't develop until 8 or 9 years old. The auditory center of the brain isn't fully developed at age 7, 8, and 9 - the most common ages seen for auditory processing tests. These kids' brains just haven't matured enough to accept and process a lot of information. Therefore, some younger children diagnosed with APD may develop better skills with time.

Once diagnosed, children with APD usually work with a speech therapist. The audiologist will also recommend that your child return for yearly follow-up evaluations.

What Are the Problem Areas for Kids With APD?

Here are the five main problem areas that can affect both home and school activities in children with APD.

  1. Auditory Figure-Ground Problems: This is when the child can't pay attention when there's noise in the background. Noisy, low-structured classrooms could be very frustrating to this child.
  2. Auditory Memory Problems: This is when the child has difficulty remembering information such as directions, lists, or study materials. It can be immediate (i.e., "I can't remember it now") and/or delayed (i.e., "I can't remember it when I need it for later").
  3. Auditory Discrimination Problems: This is when the child has difficulty hearing the difference between sounds or words that are similar (COAT/BOAT or CH/SH). This problem can affect following directions, reading, spelling, and writing skills, among others.
  4. Auditory Attention Problems: This is when the child can't maintain focus for listening long enough to complete a task or requirement (such as listening to a lecture in school). Although health, motivation, and attitude may also affect attention, among other factors, a child with CAPD cannot (not will not) maintain attention.
  5. Auditory Cohesion Problems: This is when higher-level listening tasks are difficult. Auditory cohesion skills - drawing inferences from conversations, understanding riddles, or comprehending verbal math problems - require heightened auditory processing and language levels. They develop best when all the other skills (levels one through four above) are intact.

If your child has APD, there are strategies that can be used at home and school to alleviate some of the problem behaviors associated with APD.

How Can I Help My Child?

Difficulty with following directions is possibly the single most common complaint about children with APD. Some of things you can do that may help:

  • Reduce background noise.
  • Have your child look at you when you're speaking.
  • Use simple, expressive sentences.
  • Speak at a slightly slower rate and at a mildly increased volume.
  • Ask your child to repeat the directions back to you aloud and to keep repeating them aloud (or to himself or herself) until the directions are completed. Make certain your child understands the directions and isn't just copying your words. You can be more certain of this if your child is able to rephrase the directions. For example, "Take the garbage to the side of the house," may be restated as, "You want me to take the garbage to the side of the house, not to the front."

For directions that are to be completed at a later time, writing notes, wearing a watch, and maintaining a household routine also help. General organization and scheduling also seem to be beneficial for many children with APD.

It's especially important to teach your child to be responsible and actively involved in his or her own success. Your child can be encouraged to notice noisy environments, for example, and move to quieter places when listening is necessary.

These other home strategies may also be helpful:

  • Provide your child with a quiet study place (not the kitchen table).
  • Maintain a peaceful, organized lifestyle.
  • Encourage good eating and sleeping habits.
  • Assign regular and realistic chores, including keeping a neat room and desk.
  • Begin an auditory processing improvement program.

These are all very important goals. Your modeling of these behaviors goes far toward encouraging them in your child.

What treatments are available for APD?

Much research is still needed to understand Auditory Processing Disorder problems, related disorders, and the best intervention for each child or adult.

Much of this information has been provided by Kids Health.

The Listening Programs

The Listening Programs are auditory therapy programs that are easy to do at home, are enjoyable and very successful in strengthening auditory and related abilities. The Listening Programs can benefit anyone, but specifically individuals who have difficulties in the areas of auditory perception, processing and memory.

The Listening Programs were designed to help balance, strengthen, and/or restore our ability to listen to and process sounds across the full auditory spectrum, from 20 Hz to 20,000 Hz. This can result in marked improvements across the human continuum, from academic performance to emotional balance. Using The Listening Programs help build stronger multi-sensory pathways in the brain. The brain receives especially rich auditory stimulation, and its ability to process sound improves.

One of the most important things that both parents and teachers can do is to realize that APD is real. Symptoms and behaviors are not within the child's control. What is within the child's control is recognizing the problems associated with APD and applying the strategies recommended both at home and school.

A positive, realistic attitude and healthy self-esteem in a child with APD can work wonders. Kids with APD can go on to be just as successful as other classmates. Although some children do, however, grow up to be adults with APD, with coping strategies and by using techniques taught to them in speech therapy, they can be very successful adults.