“I think my child has a hearing problem. They don’t always follow directions and often need me to repeat things.”
There is a common misconception among the families in the speech and hearing world that a child who presents with an auditory processing disorder can’t hear or that a child who has difficulty answering questions or following directions has a hearing impairment. While the term may sound confusing as both issues concern the auditory system, they are in fact very different from one another. Below are some fast facts on what auditory processing is and is not.
What it is/may present with:
- Auditory processing disorders are conditions where children have difficulty processing the meaning of the sounds they hear.
- A disconnect between what the ear hears and the brain processes
- A breakdown in receiving, remembering, understanding, and then utilizing auditory information
- The inability to interpret, organize, or analyze what they’ve heard.
- May have difficulty following directions, especially more than one direction/step at a time
- May often need information repeated/rephrased
- May need extra pause time for processing before responding
- May look confused, give a blank stare, or often ask “huh?” or “what?”
- Appear easily distracted or bored, especially when conversations/activities don’t include visuals
- May become upset, angry, or frightened by loud noises and noisy environments
- Increased difficulty understanding speech in noisy environments
- Display poor memory for words and numbers
- May have difficulty with complex language such as word problems, riddles and jokes, or a long story
- Struggle to hear the difference in similar sounding words
- Have difficulty paying attention for appropriate amounts of time
- Have difficulty expressing complex speech
- Struggle with language skills, including reading/reading comprehension, spelling, vocabulary, and understanding information presented verbally
What it is not:
- A hearing impairment; all the parts of the hearing pathway are working well.
- ADHD, Dyslexia, or Sensory Processing (although many children with these disorders struggle with auditory issues as well)
- Not the result of more global deficits such as autism, intellectual disabilities, attention deficits, or similar impairments.
- Not defiance or laziness in a child
- It is not rare-research suggests it is in 2-7 percent of U.S. children
- Not a lack of intelligence
Diagnosing either hearing loss or APD requires a multidisciplinary team:
- A pediatric ear, nose, and throat (ENT) doctor will assess any medical problems with the hearing pathway (e.g. ear infection, fluid in the ears, etc.)
- An audiologist will test hearing sensitivity to determine if there is a hearing loss and administer the series of tests that will determine if APD is present.
- The speech language pathologist (SLP) will test developmental milestones in speech and written language.
- The teacher or an educational expert will look at/identify academic difficulties (as well as implement modifications to the classroom after diagnosis)
- A psychologist will evaluate cognitive functioning.
Things to remember:
- Even if your child has multiple symptoms of APD, only careful and accurate diagnosis can determine if APD is actually present.
- Although a multidisciplinary team approach is important in fully understanding all difficulties/aspects associated with APD, the diagnosis of APD can only be made by an audiologist.
- Treatment of APD is highly individualized. There is no one treatment approach that is appropriate for all children with APD.
For further information, call us at PlayWorks Therapy, Inc. for a language evaluation or ongoing therapy after your child has been diagnosed!
Therese Schmidt, MS, CCC-SLP