Auditory Processing Disorders
A (central) auditory processing disorder means that a child has difficulty processing or interpreting speech sounds. Examples include:
- Difficulty understanding speech in an environment with background noise (such as a noisy classroom)
- Poor comprehension of spoken instructions
- Difficulty discriminating and identifying individual speech sounds
APD is not the same as hearing loss or a hearing impairment. Children with APD can often hear normally; however, these children demonstrate difficulties in interpreting speech sounds and / or processing auditory information in the presence of background noise. The causes of APD are unknown. Children who have had persistent or chronic middle ear infections are at the greatest risk.
Indications for Referral
Your child may need a referral to the Division of Audiology at Cincinnati Children's Hospital Medical Center if he / she:
- Has poor reading, spelling, or listening skills
- Needs frequent repetitions, saying "what?" or "huh?"
- Is easily distracted by background noise
- Is unable to work independently
- Has difficulty following multi-step directions
- Has difficulty with phonics or speech sounds
- Has normal I.Q. scores but below-average academic performance
- Has a speech-language delay that does not improve with therapy
- Has a short attention span
Keep in mind that most children display some of these characteristics and do not have auditory processing disorders. Consistent behavior patterns, difficulty in school and failure to fulfill academic potential may be warning signs for APD.
Evaluation
An APD evaluation includes testing from an interdisciplinary team. This team is comprised of an audiologist, pediatrician, educators, and speech-language pathologist. A psychologist may also be involved.
An audiologist will administer the following assessments:
- Routine hearing test
- Speech discrimination tests in a quiet environment
- Immittance tests
- Otoacoustic Emissions Test
- Behavioral auditory test battery for APD
When should my child be tested for APD?
Initial testing for APD can occur between the ages of 5 to 7 with an APD screening. A screening may be conducted if a child is doing poorly in school due to difficulties in following directions or responding to auditory information.
Comprehensive diagnostic testing occurs when a child is 8 years or older, when his/her auditory processing system is more developed.
How can my child be helped?
If the interdisciplinary team diagnoses your child with APD, we will recommend individual management strategies for him / her.
These strategies may include:
Direct Interventions: use specialized speech-language therapy and auditory training, including phonemic and / or phonological awareness training, memory exercises, and listening training.
Learning Accommodations: Classroom modifications may include acoustic room treatment to reduce echoes and background noise. Verbal classroom activities may also be modified to improve listening skills. These changes may include repeating or rephrasing instructions, slowing down the rate of speech, and providing more visual cues. Assistive listening equipment, such as a wireless microphone / headset or speakers in the classroom may be used to amplify and enhance the teacher's voice and minimize background noise.
Self-Help Strategies: A speech-language pathologist or an audiologist may help your child develop self-help techniques to improve overall communication.
Rev. 11/07
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