What is APD?

Auditory Processing Disorder (APD), also known as central auditory processing disorder, is a disruption of sound along the pathway from the ear to the brain, which interferes with understanding.
Between 2-3% of children are affected by APD (Chermak & Musiek, 1997), some children have a delay in the maturation of the auditory system, and some have an otherwise harmless developmental abnormality in the anatomy of the auditory system. Some children may have been negatively affected by frequent ear infections, or premature birth, while others have no clear cause for the disorder. Currently, it appears that boys are more likely to have APD than girls. In adults, traumatic brain injury and advanced age account for a great deal of cases.

Does Your Child Have APD

Early identification of an auditory processing disorder and early intervention are key to helping a child with APD.

Some possible signs that your child may have APD include, but are not limited to:

  • Appears to have hearing loss despite normal hearing
  • Difficulty hearing in noise
  • Difficulty following oral instructions
  • School performance poorer than expected
  • Easily distracted by noise
  • Mishearing or misunderstanding
  • Frequent requests for repetition
  • Short attention span for listening
  • Poor reading or spelling abilities
  • Poor musical ability
  • Disruptive behaviours
  • History of multiple ear infections

Diagnosing APD

If you think your child is having trouble hearing or understanding when people talk, have an audiologist (hearing specialist) exam your child. Only audiologists can diagnose auditory processing disorder.

Audiologists look for five main problem areas in kids with APD:

  1. Auditory figure-ground: This is when a child can’t pay attention if there’s noise in the background. Noisy, loosely structured classrooms could be very frustrating.
  2. Auditory memory: This is when a child has difficulty remembering information such as directions, lists, or study materials. It can be immediate (“I can’t remember it now”) and/or delayed (“I can’t remember it when I need it for later”).
  3. Auditory discrimination: This is when a child has difficulty hearing the difference between words or sounds that are similar (COAT/BOAT or CH/SH). This can affect following directions and reading, spelling, and writing skills, among others.
  4. Auditory attention: This is when a child can’t stay focused on listening long enough to complete a task or requirement (such as listening to a lecture in school). Kids with CAPD often have trouble maintaining attention, although health, motivation, and attitude also can play a role.
  5. Auditory cohesion: 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 1 through 4 above) are intact.

Helping Your Child

Since most of the tests done to check for APD require a child to be at least 7 or 8 years old, many kids aren’t diagnosed until then or later.

A child’s auditory system isn’t fully developed until age 15. So, many kids diagnosed with APD can develop better skills over time as their auditory system matures. While there is no known cure, speech-language therapy and assistive listening devices can help kids make sense of sounds and develop good communication skills.

A frequency modulation (FM) system is a type of assistive listening device that reduces background noise and makes a speaker’s voice louder so a child can understand it. The speaker wears a tiny microphone and a transmitter, which sends an electrical signal to a wireless receiver that the child wears either on the ear or elsewhere on the body. It’s portable and can be helpful in classroom settings.

A crucial part of making the FM system effective is ongoing therapy with a speech-language pathologist, who will help the child develop speaking and hearing skills. The speech-language pathologist or audiologist also may recommend tutoring programs.

Several computer-assisted programs are geared toward children with APD. They mainly help the brain do a better job of processing sounds in a noisy environment. Some schools offer these programs, so if your child has APD, be sure to ask school officials about what may be available.

School Accommodations

Various school accommodations may be required for children with APD at school.

For in-class learning:

  • The student has preferential seating; near the teacher
  • The student sits away from any doors and windows
  • Tennis balls under the chairs to reduce background noise
  • Provide visual instructions; write instructions on the board
  • Have a student in the class be a notetaker for them
  • Allow student to use assistive listening device like an FM system
  • Provide access to computer-assisted programs designed for kids with APD
  • Student may want to wear earplugs when working in class

For Classwork and test taking:

  • Quiet area for independent work
  • Extended time for testing
  • Oral response for tests are acceptable

For class preparation:

  • The student be able to become familiar with the subject matter before it is taught in class
  • Provide the student with a tape recorder and written homework instructions that can be viewed online

Tips for Home

Kids with APD often have trouble following directions, so these suggestions may help:

  • Reduce background noise whenever possible at home and at school.
  • 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 and to keep repeating them aloud (to you or to himself or herself) until the directions are completed.
  • For directions that are to be completed later, writing notes, wearing a watch, or maintaining a household routine can help. So can general organization and scheduling.
  • It can be frustrating for kids with APD when they’re in a noisy setting and they need to listen.
  • Teach your child to notice noisy environments and move to quieter places when listening is necessary.

Other tips that might help:

  • 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.
  • Build your child’s self-esteem.

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