How to help a child with auditory processing problems
Auditory Processing Disorder (for Parents)
What Is Auditory Processing Disorder?
Auditory processing disorder (APD) is a hearing problem that affects about 3%–5% of school-aged children.
Kids with this condition, also known as central auditory processing disorder (CAPD), can't understand what they hear in the same way other kids do. This is because their ears and brain don't fully coordinate. Something interferes with the way the brain recognizes and interprets sounds, especially speech.
With the right strategies, kids with APD can be successful in school and life. Early diagnosis is important. If the condition is not identified and managed early, a child is at risk for listening and learning problems at home and school.
Trouble Understanding Speech
Kids with APD are thought to sense sound normally because they usually can hear sounds that are delivered one at a time in a very quiet environment (such as a sound-treated room). The problem is that they usually don't easily recognize slight differences between sounds in words, even when the sounds are loud enough to be heard.
These kinds of problems usually happen in a poor listening situation — such as when there's background noise or in a reverberant room like an auditorium — which often is the case in social situations. Kids with APD can have trouble understanding what is being said to them when they're in noisier places like a classroom, playground, sports event, school cafeteria, or party.
What Are the Signs & Symptoms of Auditory Processing Disorder?
Symptoms of APD can range from mild to severe and can take many different forms. If you think your child might have a problem processing sounds, ask yourself:
- Does my child often mishear sounds and words?
- Are noisy environments overwhelming when my child is trying to listen?
- Does my child's listening behaviors and performance improve in quieter settings?
- Does my child have trouble following verbal directions, whether simple or complicated?
- Does my child have trouble with spelling or phonics?
- Are verbal (word) math problems hard for my child?
- Are conversations hard for my child to follow?
APD is often misunderstood because many of its symptoms are similar to those found in other disorders.
Also, APD symptoms can be hidden by other problems, like speech-language delays, learning disabilities, attention deficit hyperactivity disorder (ADHD), and depression. Auditory memory deficits, auditory attention problems, and sound sensitivity are not symptoms of APD, but also may involve trouble with using sound information correctly. Seeing an audiologist, and other related specialists, can help parents understand these conditions.
What Causes Auditory Processing Disorder?
Often, the cause of a child's APD isn't known. Evidence suggests that children with head trauma, lead poisoning, seizure disorder, or chronic ear infections are more at risk. Sometimes, there can be more than one cause.
How Is Auditory Processing Disorder Diagnosed?
If you think your child is having trouble hearing or understanding when people talk, have an audiologist (hearing specialist) examine your child. Only audiologists can diagnose auditory processing disorder.
The most common way to diagnose APD is to use a specific group of listening tests.
Audiologists often look for these main problem areas in kids with APD:
- Auditory figure-ground: This is when a child has trouble understanding speech when there is speech babble or ambient noise in the background. Noisy, loosely structured or open-air classrooms can be very frustrating for a child with APD.
- Auditory closure: This is when a child can't "fill in the gaps" of speech when it is more challenging. This can happen in a quieter situation but is more common when the speaker's voice is too fast or is muffled, making it hard for the child to make sense of the sounds and words.
- Dichotic listening: This is when a child has trouble understanding competing, meaningful speech that happens at the same time. For example, if a teacher is talking on one side of the child and another student is talking on the other side, the child with APD cannot understand the speech of one or both of the speakers.
- Temporal processing: This is the timing of a child's processing system, which helps them recognize differences in speech sounds (such as mat versus pat).
It also helps them understand pitch and intonation (for example, asking a question instead of giving a command), understand riddles and humor, and make inferences. - Binaural interaction: This is the ability to know which side speech or sounds are coming from, and to localize sound in a room. Although less common, this problem happens in children with a history of brain trauma or seizure disorders.
Most traditional APD tests require a child to be at least 7 years old. So, many kids aren't diagnosed until first grade or later. Newer electrophysiology tests (which use noninvasive electrodes to check the body's response to speech) can give some early information about the central auditory system in kids younger than 7.
How Can Parents and Teachers Help?
The auditory system isn't fully developed until kids are about 14 years old. Many kids diagnosed with APD can develop better listening skills over time as their auditory system matures.
There's no known cure, but different strategies may help with listening and also improve the development of the auditory pathway over time, especially when started at younger ages. These include:
- physical accommodations to improve the listening environment
- individual therapies
- help from other professionals to manage non-listening symptoms. For example, a child may benefit from:
- speech-language therapy for language deficits
- counseling to help with depression or anxiety
- art therapy or music therapy to build self-esteem
- occupational therapy to help with sensory issues or auditory timing concerns
One common physical accommodation is a remote microphone system, previously known as a frequency modulation (FM) system. This assistive listening device emphasizes a speaker's voice over background noise, making the voice clearer so a child can understand it. The person talking wears a tiny microphone transmitter, which sends a signal to a wireless receiver that the child wears on the ear or to a speaker box.
Other physical accommodations often focus on optimizing a kid's access to speech. Optimizing speech means reducing the interference of other things, like background babble, sound and sight distractions, and poor classroom acoustics. In a classroom, for example, the teacher might slow down their speech, speak clearly and deliberately (Think Mr. Rogers!), and seat the child where they can see and hear them better.
Some individualized therapies also may help kids improve the growth of their auditory pathway. These usually are recommended by the audiologist based on the results of a child's tests and concerns. 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 setting. Some schools offer these programs. If your child has APD, ask school officials about what's available.
Strategies used at home and school can ease some of the issues associated with APD.
At Home
At home, these strategies that can help your child:
- Reduce background noise whenever possible.
- Have your child look at you when you speak. This helps give your child visual clues to "fill in the gaps" of missing speech information.
- Use strategies like "chunking," which means giving your child simple verbal directions with less words, a key word to remember, and fewer steps.
- Speak at a slightly slower rate with a clear voice. Louder does not always help. (Again, think Mr. Rogers!)
- Ask your child to repeat the directions back to you to ensure they understand.
- For directions to be completed later, writing notes, keeping a chore chart or list, using calendars with visual symbols, and maintaining routines can help.
- Many kids with APD find using close captions on TV and computer programs helpful.
Encourage kids to advocate for themselves. Telling adults when listening is hard for them can help. But shy kids might need to use agreed-upon visual cards or signals for coaches, parents, and teachers.
Most important, remind your child that there's nothing to be ashamed of.
We all learn in different ways. Be patient. This is hard for your child and takes time. Your child wants to do well, and needs patience, love, and understanding while they work toward success.
At School
Teachers and other school staff may not know a lot about APD and how it can affect learning. Sharing this information and talking about it can help build understanding about the disorder.
APD is not technically considered a learning disability, and kids with APD usually aren't put in special education programs. Depending a child's degree of difficulty in school, they may be eligible for an accommodation plan such as an individualized education program (IEP) or a 504 plan that would outline any special needs for the classroom. Accommodations for APD often fall under the disability category of "Other Health Impairment."
Other helpful adjustments are:
- strategic (or preferential) seating so the child is closest to the main person speaking.
This reduces sound and sight distractions and improves access to speech. - pre-teaching new or unfamiliar words
- visual aids
- recorded lessons for later review
- computer-assisted programs designed for kids with APD
Stay in touch with the school team about your child's progress. One of the most important things that parents and teachers can do is acknowledge that the APD symptoms your child has are real. APD symptoms and behaviors are not something that a child can control. What your child can do, with the help of caring adults, is recognize the problems from APD and use the strategies recommended for home and school.
A positive, realistic attitude and healthy self-esteem in a child with APD can work wonders. Kids with APD can be as successful as their classmates. With patience, love, and support, they can do anything they work toward.
Auditory Processing Disorder Factsheet (for Schools) (for Parents)
Reviewed by: Mary L.
Gavin, MD
en español Hoja informativa sobre el trastorno del procesamiento auditivo (para las escuelas)
What Teachers Should Know
Auditory processing disorder (APD) is a hearing problem that affects about 3%–5% of school-aged children.
Kids with this condition, also known as central auditory processing disorder (CAPD), can't understand what they hear in the same way other kids do. This is because their ears and brain don't fully coordinate. Something interferes with the way the brain recognizes and interprets sounds, especially speech.
Kids with APD often have trouble recognizing differences between sounds in spoken words, even when the sounds are loud and clear enough to be heard. This usually happens when there's background noise, like in a typical classroom.
Kids with APD may need to use a remote microphone system, previously known as a frequency modulation (FM) system. This assistive listening device emphasizes a speaker’s voice over background noise, making the voice clearer so a child can understand it.
These problem areas can affect students with APD:
- Auditory figure-ground: This is when a child has trouble understanding speech when there is speech babble or ambient noise in the background. Noisy, loosely structured or open-air classrooms can be very frustrating for a child with APD.
- Auditory closure: This is when a child can't "fill in the gaps" of speech when it is more challenging. This can happen in a quieter situation but is more common when the speaker's voice is too fast or is muffled, making it hard for the child to make sense of the sounds and words.
- Dichotic listening: This is when a child has trouble understanding competing, meaningful speech that happens at the same time. For example, if a teacher is talking on one side of the child and another student is talking on the other side, the child with APD cannot understand the speech of one or both of the speakers.
- Temporal processing: This is the timing of a child's processing system, which helps them recognize differences in speech sounds (such as mat versus pat).
It also helps them understand pitch and intonation (for example, asking a question instead of giving a command), understand riddles and humor, and make inferences. - Binaural interaction: This is the ability to know which side speech or sounds are coming from, and to localize sound in a room. Although less common, this problem happens in children with a history of brain trauma or seizure disorders.
If the auditory deficits aren't identified and managed, many students with APD will face academic challenges.
Students with APD can benefit from working with a speech and language therapist, in addition to getting regular evaluations by audiologists.
What Teachers Can Do
APD is an auditory issue and not a cognitive, speech, or language disorder. Your student may feel embarrassed to let you know they did not understand what you said or directions you gave. Making sure that students with APD write down assignments and helping them stay organized may ease their frustration and boost their self-esteem in the classroom.
It can help to speak at a slightly slower rate with a clear voice. Louder does not always help. (Think Mr. Rogers!)
Teachers also can help students with APD by:
- using strategic (or preferential) seating so the child is closest to the teacher. This reduces sound and sight distractions and improves access to speech.
- pre-teaching new or unfamiliar words
- using visual aids
- recording lessons for later review
Reviewed by: Mary L. Gavin, MD
Date reviewed: February 2021
Hearing Loss - HCW
About 12% of children suffer from HCW, a disorder that inhibits the brain's ability to distinguish and process sounds. Learn more about hearing impairment (AIA).
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Don't you think that your words, questions and requests fly past your child? As if he lives in an invisible soundproof ball? If your child often looks at you with a blank look and asks again: “Huh? What?”, then you know what we are talking about.
Or maybe you noticed it yourself - that the world sounds “distorted”, as if you are listening to everything through the phone and the signal constantly disappears, breaking off words?
These are the main signs of auditory processing disorder (auditory perception), a learning disorder that affects the brain's ability to process and distinguish sounds. People with HRS have difficulty receiving, processing, and using auditory information. They can hear but have difficulty understanding what they have heard. Although NSV is not as well known as other learning disorders, it is believed that about 7% of children have some form of auditory processing problem.
HRS is a diagnosis that encapsulates three areas of disorder. Lois Kam Heymann describes it this way:
⚡️ The first problem occurs in the area of the brain responsible for analyzing sounds. The ears normally hear and send information through the auditory pathways to the central auditory nervous system, but as the signal travels, the brain has difficulty distinguishing the acoustic characteristics of the received sound.
For example, he does not recognize how the sound "P" differs from the sound "B".
⚡️ The second problem arises during the linguo-phonemic analysis of sound signals. The brain has difficulty mixing the sounds of letters to understand a word and retain its meaning. For example, the combination of sounds “K-O-T” will not be identified as the name of an animal.
⚡️ The third problem arises during the semantic processing of speech. So we associate the sound of the word "cat" with the image of a fluffy ball lying on the floor in the living room.
When one of these processing processes is interrupted in a person with HRS, there is a gap between what was said and what was understood.
Symptoms of EAR
In simple terms, EAR is an impairment in the brain's ability to distinguish and process audio information. A person with NSV may not have hearing problems. Typically, the brain of a person with NSV perceives sounds incorrectly, affecting its ability to distinguish between similar sounds (eg: “yes” and “ha”).
Here's how NRW can manifest itself:
👉 Often asks “huh?” So what?"
👉 Ignores what was said
👉 Low ability to concentrate attention
👉 difficulties in the implementation of complex instructions
👉 difficulties to listen in noisy places
👉 Sounds or words
👉 Delay of speech development
👉 Divine and inattentive behavior
👉 Social skills are poorly developed
👉 Difficulties in learning to read
👉 Problems with spelling
Some children with hearing loss find it difficult to ignore the background noise, so they are distracted by the sounds around them. Echoes in the hallway or the noise of the air conditioner easily distract them from a conversation or a lesson. It's like listening to a radio with interference.
The child with this disorder tries so hard to understand what is being said that he forgets parts of the conversation or does not remember the nuances and context of the conversation.
This can cause problems at school, at home, and simply in the daily life of the child, where the ability to listen, remember and respond is required.
Types of HCI
Dr. Jack Katz, M.D., a pioneer in the field of auditory processing disorder, says that HCM encompasses three distinct disorders that can occur together or on their own.
1. Problems with differentiating sounds. When children learn to speak, they reproduce the sounds they hear. A person with NSW may slur, using close-sounding sounds instead of correct ones (“pegal” instead of “running”), although their peers have already stopped doing this. Usually, people who do not distinguish sounds well, speak indistinctly, often speak quickly, as if chewing on the endings of words. This can also affect reading with writing.
2. Problems with auditory memory. This disorder makes it difficult for a child to remember numbers and facts, which also affects his reading and speaking skills.
Usually, children with auditory memory problems cannot remember their address and phone number for a long time, and they also have difficulty remembering basic mathematical concepts. The same goes for spoken instructions.
3. Problems with speech processing. This part of the NSW is the most problematic. It affects the child's ability to understand what is required of him, as well as his communication skills. A child with this disorder has difficulty taking oral tests and gets confused when reading and telling stories with a long plot and many characters. He often refrains from talking as it takes him a long time to understand what is being said and formulate a response.
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NSV and ADHD
Some studies show that up to 50% of people with ADHD also suffer from NSV. Other studies claim that in 60% of cases, auditory impairment is paired with some other disorder - typically ADHD, sensory integration disorder, visual processing disorder, and executive dysfunction.
In other words, the symptoms of NSV and ADHD often overlap. Just as a problem with distinguishing and processing sounds can affect a child's ability to focus, the symptoms of ADHD can also affect NSV. Some experts even believe that NSV is a manifestation of ADHD, although most still consider them separate disorders.
In general, people with ADHD exhibit inattention and inability to focus and/or hyperactivity and impulsivity regardless of the environment. Children with NSW, however, tend to lose focus and become distracted predominantly in noisy environments, and usually do not experience these problems in quiet environments. Many children with NSW are extremely sensitive to sounds. In fact, some may feel pain when they hear certain sounds, such as a blender, the sound of a motor, or police sirens.
“Children with ADHD can be poor listeners and have difficulty understanding and remembering spoken information,” explains Teri James Bellis, author of Teri James Bellis When the Brain Can't Hear , “but it’s attentional deficits, not processing problems, that keep them from absorbing information aurally.
”
These NSV symptoms are similar to those of ADHD (according to the National Institute of Deafness and Other Communication Disorders, USA):
⚠️ It hardly holds attention and remembers information received by ear
⚠️ Complexes comprehensive instructions
⚠️ Bad listening skills
⚠️ It takes more time to process information
⚠️ Problems with behavior
⚠️ Problems with reading, text comprehension, spelling and vocabulary.
Children with hearing processing disorders may be misdiagnosed with ADHD, and vice versa. If NSV occurs in an adult, they may be perceived as a passive-aggressive, oppositional person who hides emotions or likes to argue, instead of being perceived as an attention-deficit or auditory disorder.
Causes of HF
The cause of HF is not known. Experts argue whether the cause of the disorder is heredity or environment, or both. Although the human auditory system is fully developed at birth, the auditory pathways continue to develop until age 12.
Because of this, early environmental factors—such as poor prenatal nutrition, a mother's dependence on alcohol or cigarettes, poor nutrition during childhood, and chronic ear infections—can negatively impact hearing. Preterm birth, Lyme disease and other brain infections, internal head trauma, and exposure to heavy metals (such as lead and mercury) may also play a role. The good news is that, as the auditory pathways continue to develop into adulthood, EAR is successfully corrected during childhood.
Diagnosis of HSI
Remember that “not all speech problems are due to HF, and not all HF is associated with speech and learning problems,” says Bellis.
The only way to diagnose a disorder is to get tested by specialists. “Symptoms that usually show up in 3-4 year olds are sensitivity to sounds and difficulty in distinguishing sounds, which can be understood from their speech,” explains Wendy Tepfer, a speech therapist from New York.
When a child reaches school age, EARs interfere with their studies, Toepfer says.
“I recommend checking at this age, because now the signal that something is wrong is no longer only a speech problem, but also academic performance. To cope with the disorder, the student may need treatment that is more in-depth than speech therapy. Get a thorough examination from a specialist to draw up a treatment plan.”
Most people with NSV are diagnosed between the ages of 8 and 12, but therapy can help both children and adults.
Because of EAR, David couldn't speak until he was 20!
The hard work of a loving mother, who is ready to fight for her son to the end, and new neurological technologies can work a real miracle!
Now you don't have to wait twenty years to say the first word!
Treatment options for HCV
HCV can be treated at any age, even when the auditory pathways are no longer developing, but experts still say it's better to get diagnosed and corrected early.
Treatment includes many different exercises aimed at hearing impairments. The therapy includes exercises in computer programs such as FAST FORWORD and Earobics, as well as individual sessions with a speech therapist. Here are some methods commonly used by specialists:
📌 To deal with the problem of distinguishing sounds, the specialist will train your child's brain to distinguish sounds first in a quiet environment, then with increasingly loud background noise.
📌 To sharpen auditory memory, the otolaryngologist will use repetitive exercises—for example, asking the child to repeat a series of numbers or directions—to train the “auditory muscles.”
📌 To deal with speech processing problems, the therapist will instill in the child the habit of asking teachers, adults, and peers to repeat or paraphrase what has been said. The therapist can also develop a note-taking system with the child to help them learn to isolate and record key information learned in class.
Help in the classroom
Here's what you can do to help your child with HSD in the classroom:
✔️ Improve acoustics - By closing windows and doors, and laying down a sound absorbing mat, you can help your child with HSD “hear” the teacher.
✔️ Seat your child in the front desk, away from students who may distract him during class, this will also help him hear the teacher better.
✔️ Ask the teacher to look at your child more often and speak more slowly, and use simple sentences when he gives a task so that the child can more easily process the information he hears. It will also help if the teacher writes the assignment on the board.
Help at home
Here's how you can help your child with EAR at home:
device.
✔️ Before talking to the child, make sure that he is ready to listen (finished doing what he did before). Also, make eye contact with him.
✔️ Speak slowly and use simple short sentences; Pause for a moment to finish the thought so he can digest it.
✔️ Teach your child to ask him to repeat what he said if he did not understand something.
✔️ Develop auditory processing areas of the brain, fast and sustainable results can be achieved by applying the FAST FORWORD computer technique that works online. In FAST FORWORD, you can study at any convenient time, in any convenient place, you only need a computer or iPad, any headphones and Internet access.
Source
Find out more about how the FAST FORWORD method helps in correcting HR and sign up for trial online classes! Don't delay helping your child with hearing loss!
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What is important to know about raising a child with a hearing impairment
When my son was in first grade, his teacher complained to me that he was constantly distracted during class. She said he didn't listen to her. For her, it was an act of disobedience.
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I explained that my son had an auditory perception disorder (ACD).
He usually behaves very well, but the classroom environment was too chaotic and noisy for him. With all that noise in the background, my son just couldn't understand what she was saying to him, no matter how hard he tried.
For people who do not have HSI, it is very difficult to understand the difficulties that a person with this disorder faces on a daily basis. Even my husband, who tries to understand him, often fails to "see" the world from our son's perspective.
I have learned a lot as a parent of a child with EAR. And since I have an EAR myself, I think I'm the right person to talk about this disorder. Here are some aspects of the disorder that I would like others to understand about me, my son, and EAR.
1. It's not disobedience
In HCI, the brain often doesn't process the words the person hears correctly. So when my son doesn't answer right away or doesn't understand what you're saying, he doesn't do it because he's being rude or ignoring you.
He just doesn't understand what you are saying.
My son wants to understand you more than anything else. But people like me and my son sometimes avoid communication because they are afraid of being rude. Unfortunately, such is life for a person with NSW.
2. The name "Auditory Perception Impairment" can be confusing. My son's hearing is actually very good. And that might just be part of the problem. For example, my husband's electric shaver makes a piercing, annoying sound when it's charging. At least that's what my son and I think. Besides us, no one in the family pays attention to this sound, which bothers us so much.
This may seem paradoxical. A person with EAR hears sounds that no one else notices, but cannot "hear" what someone is saying. This is because EAR is a disturbance in the brain's PROCESSING of incoming sound information, and not a hearing problem.
3. Extraneous sounds make it difficult to understand
When I talk to my child, my voice is mixed with a thousand extraneous sounds.
It could be the sound of air blowing from the air conditioner. Or the sound of footsteps from the corridor. Or the buzzing of an overhead fluorescent lamp. That's why I try not to start a difficult conversation with my son in a noisy or chaotic environment.
If you have something important to share but it's noisy, send a message. Better yet, if you need to have a normal conversation with him, find a quiet place to do so. Talking directly to him and making eye contact also help.
4. Advising "to be more attentive" or "try to listen" does not help
Some people confuse NSV with ADHD, but these disorders are different. after all, it's hard to concentrate when you can't understand what's being said around you.0005
But telling my son to “focus” and “listen” won't help when his brain is trying to make sense of the sounds. It's like telling you to "listen" to speaking in a foreign language that you barely speak.
Hearing loss - EAR?
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5.
Paraphrasing is better than repetition
When my son asks “what?” in response to something that I said, I want to repeat what I said, a little louder. But in fact, he needs me to repeat what I said a little differently. This is because some phrases and sentences can be harder to process. The sounds may be too similar. Word order can be too complex.
Paraphrasing—rather than repeating the same words louder—can really help. When I dealt with my own EAR, I used to ask again, “Could you please say it again, but in other words?”.
6. It is important for the child to feel comfortable enough to ask you as many times as necessary.
I understand that and so does my son. That's why it's so hard for him to ask.
But if he knows you don't mind repeating and paraphrasing what you've said a few times, he'll be more comfortable asking for it. It's great when people are willing to do it for him - and for me. We appreciate it more than you can imagine.
7. We understand that you may get annoyed when we try to understand you
Even though I have EAR, I sometimes get upset with my son. I'm losing my patience. Therefore, I understand that this can also strain other people.
My son's first teacher never got around to understanding his problems. In the end, we were lucky that she was quickly replaced. Our new teacher is wonderful. And the only difference between it and the previous one is the willingness to try to understand the difficulties that a child with a hearing impairment faces.
8. Impairment of Hearing Perception can be corrected without leaving your comfortable home
The discovery of brain plasticity and modern neurological techniques developed on the basis of this discovery make it possible to successfully and in a short time to correct NE. One of the most effective and easy-to-use methods for correcting HF is the FAST FORWORD online computer method, which has been successfully used around the world for more than 20 years and has already helped more than 3 million students.
