How to help a child with auditory processing

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 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

Helping Children with Hearing Impairment: A Guide for Parents and Professionals

IN.

Koroleva, Inna Vasilievna. Help for children with hearing impairment: A guide for parents and specialists / IV Koroleva. - St. Petersburg: KARO, 2016. - 304 p. : ill. — (Special Pedagogy). ISBN 978-5-9925-1130-7.

This book should become a reference book for all professionals who deal with children with hearing impairments - doctors of various profiles (otolaryngologists, audiologists, pediatricians, neurologists), deaf teachers, speech therapists, psychologists, and of course, for parents of such children. The future of a child with hearing impairment depends on these people, so they should know what great opportunities there are today to help him, know what and how to do. And it is extremely important to understand that the timeliness of this assistance is a key factor in the effective rehabilitation of a hearing-impaired child. In the past, doctors often determined that a child was hard of hearing when he was already 2-3 years old. Now this pathology can be detected already in the hospital, which means it is very early to help the baby! As with any illness, the sooner help is given, the more effective it is. Now we know that it is not scary that the child does not hear, it is scary that sounds and speech do not enter his brain. Hearing speech is necessary in order to perceive information, speak, communicate with people around, learn in order to develop thinking. Speech is also important for raising a child: it helps him learn to understand what is good and what is bad, what is possible and what is not. Therefore, even a slight hearing loss in a baby leads to a delay and disruption of his speech and intellectual development. But today, thanks to hearing aids, cochlear and brainstem implants, even deaf children can hear sounds and speech, which means they have the opportunity to develop normally.

The very early age of detection of hearing impairment and the fact that up to three years the child spends most of his time in the family, communicating with loved ones, determines the change in methods of helping children with hearing impairment. If, under traditional approaches, the deaf teacher worked only with the child, then the modern approach is family-centered, in which the deaf teacher provides support to the family and the child as a family member.

Early detection of hearing impairment in a child requires teachers of the deaf to have skills in corrective and developmental work with very young children. Parents, having learned that their child is hard of hearing, experience a state of shock and want answers to many questions: “Why is the child hard of hearing? Can it be cured? How to help a child? How to communicate with him? Can you teach him to speak? Where will he study? Therefore, psychological support for parents is an essential component of the modern approach to rehabilitation. It includes building parental confidence in communicating with their child, the ability to independently make informed decisions related to their child, as well as the skills to develop the child's ability to listen, understand speech and speak with hearing aids and cochlear implants, especially in everyday situations. and during joint games.

The book was written on the basis of many years of experience working with parents and specialists in one of the leading European centers for cochlear implantation - St. Petersburg Research Institute of Ear, Throat, Nose and Speech. This experience shows that parents need answers to a variety of questions: about diagnostic methods, rehabilitation, hearing aids, special and inclusive education for children with hearing impairments, psychological and social problems faced by parents of children. The book also contains important practical advice: how to teach a child to hear in hearing aids, to speak, to communicate with others, how to properly educate him, and much more.

The book is also useful for the training of future deaf teachers, speech therapists, correctional psychologists, as it allows students to form a holistic view of the system of assistance to children with hearing impairment.

The book tells about modern possibilities of helping children with hearing impairment. Medical, technical, psycho-pedagogical methods of rehabilitation of children with hearing impairment are described. The causes and methods of diagnosing hearing impairments in children are considered. Information is presented on hearing aids, cochlear and brainstem implants, features of hearing aids for children, methods of teaching hard of hearing and deaf children, social and psychological issues of their rehabilitation. The auditory method of speech development in children with hearing impairment is described. It involves early diagnosis and hearing aid, early corrective and developmental classes, psychological support for parents and their involvement in the process of development of a child with hearing impairment. Particular attention is paid to teaching parents the ability to develop different skills in a child during daily activities and games, to create conditions for the spontaneous development of speech. The book contains many practical recommendations for the development of hearing, speech, language, thinking, communication skills in a child with hearing impairment, as well as advice on their upbringing. The book is intended for parents of children with hearing impairments and specialists involved in the rehabilitation of children with hearing impairments — teachers of the deaf, speech therapists, speech pathologists, psychologists, audiologists, otorhinolaryngologists, pediatricians, and neurologists.

Foreword
Recommendations for parents and specialists
Recommendations for parents
Recommendations for deaf teachers, speech therapists, psychologists
Recommendations for doctors
Chapter 1. Why the child does not hear well
- How the ear is arranged and what is the auditory system
- How a person hears
- Types of hearing impairment
- Causes of hearing loss in children
- Treatment of children with hearing impairment
- Help for Hearing Impaired Children
Chapter 2 Diagnosing Hearing Loss in Children
- What is important to know about sounds
- How a child perceives sounds in different conditions
- Audiogram or "hearing passport" of a child
- Degrees of hearing loss
- What is the diagnosis of hearing impairment in a child?
- Objective methods of hearing assessment
- Auditory evoked potential audiometry
- Impedance measurement
- Otoacoustic emission
- Computed and magnetic resonance imaging
- Subjective methods of hearing assessment
- Playing tone audiometry
- How to prepare your child for a hearing test
- Hearing test with sounding toys and speech
- Parent survey
- Hearing screening tests for children
- Peculiarities of behavior and speech development of children with slight hearing loss
Chapter 3 Hearing aids and FM systems
- How children with hearing impairments hear sounds and speech
- What is a hearing aid - the most important thing about it
- What is an earmould
- When a child needs a hearing aid
- What is hearing aid and how do children fit hearing aids
- How a child hears with hearing aids
- How to put on and take off your hearing aid
- How to teach your child to wear hearing aids
- If the child removes the hearing aid
- How to check the correct fit and fit of a hearing aid
- How to care for your hearing aid
- Hearing Aid Nutrition
- Hearing aid care
- Cleaning the earmould and tube
- Binaural and monaural hearing aids
- What are FM systems?
Chapter 4 Cochlear and Brain Implantation
- What is a cochlear implant and how is it different from a hearing aid
- Does my child need a cochlear implant
- Which ear is best for surgery on a child
- How cochlear implantation is performed
- How a child recovers from surgery
- When a child begins to hear, understand speech and speak after a cochlear implant
- What is hearing and speech rehabilitation for children with cochlear implants
- Precautions for children with cochlear implants
- What is brainstem hearing implantation
Chapter 5 Teaching Hearing Impaired Children
- How Hearing Impaired People Communicate
- Teaching methods for hearing impaired children
- Oral methods
- Gesture methods
- Auditory methods
- Family Centered Approach
- Where children with hearing impairments study
Chapter 6. How to help a deaf child learn to listen and speak, or General rules for teaching a child with a hearing impairment
- What is needed for a child to learn to understand speech and speak
- General Rules for the Education and Development of a Hearing Impaired Child
Chapter 7. Developing the ability to communicate
- Preverbal means of communication of a child, or how children with normal hearing communicate until they learn to speak
- What does a child who is not understood feel
- Learning to communicate with the eyes and more...
- How to use gestures to communicate with your child
- Using drawings when communicating with a child. Draw the daily routine
Chapter 8: Learning to listen and understand speech
- Why it is important for a child to learn to hear well
- Before hearing aid
- After hearing aid
- How to help your child learn to hear faster with a hearing aid
- Why is it so important to teach a child to hear environmental sounds
- How a child learns to understand speech
- What is phonemic hearing and how to develop it in a child with hearing impairment
- Activity or play?
- Listening to music - developing hearing and much more
- Milestones in the development of hearing and speech in a child with a hearing aid or cochlear implant
Chapter 9. Learning to speak
- What a child must know to speak
- How pronunciation skills develop in children with normal and impaired hearing
- We develop voice and sound pronunciation
- How to evoke voice and speech sounds in a baby
- Imitation of visible articulation and auditory perception of speech
- Support for tactile sensations
- Imitation of animal voices, environmental sounds and… interjections
- Speech rituals
- Singing
- Finger games and more
- Moving and making sounds
- Articulation gymnastics and massage
- Using Read
- Fingerprinting
- Conjugated speech
- Helping your child pronounce words correctly
- Language system again...
- First words and phrases
- Development of grammatically correct speech
- The rate of development of oral speech in a child with hearing impairment
Chapter 10. Develop motor skills, attention, thinking, memory
Help me do it myself!
How to develop motor skills, visual perception, smell, touch in a child at home
How to develop thinking in a child at home
Teaching a child to compare and sort objects by size, color and shape
Teaching a child to distinguish and group objects and pictures according to purpose or accessories
Ordinary items that can be used to teach a young child

Chapter 11. Psychological and social problems

Psychological support for parents and families
Problem child: advice to parents

Advice 1. Dealing with hyperactivity
Advice 2. Teaching order and discipline
Advice 3. Dealing with bad behavior (aggressiveness, stubbornness, tantrums)
Advice 4. Avoid punishing the baby
About your attitude towards the child
Qualities of mother (parents) ) positively influencing the development of the child
Social issues
Disability
Parents of all countries, unite, or Associations of Parents of Hearing Impaired Children
Appendix 1. Glossary of basic terms and concepts
Appendix 2. Gestures of the deaf to help communicate with a deaf baby topic "Summer, flowers" for children with hearing impairment in kindergarten
Appendix 4. Plan of classes for children with hearing impairment from birth to 5 years
Lessons for children of the first year of life.
Classes with children of the second year of life.
Activities with children 2-5 years old
Appendix 5. What a child should do at different ages
Motor, auditory, communication, language and speech skills of a child aged 1 to 5 years
Useful books
Contents
Abbreviations used in the book :
CI - cochlear implant
CA - hearing aid
CMSI - brainstem hearing implant

Why test a child's hearing?

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Hearing impairment - 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, cutting 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 a disturbance in the brain's ability to distinguish and process sound 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”).

This is how NRW can manifest itself:

So what?"

👉 Ignore 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 in speech development

👉 Divine behavior

👉 poorly developed social skills

👉 Difficulties in learning to read

👉 Spelling problems

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.

Is your hearing impaired?

Find out how to help your child with HSI quickly!

DISCOVER

HF and ADHD

Some studies show that up to 50% of people with ADHD also suffer from HF. 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 keeps attention and remembers the information received by ear

⚠️ It hardly performs comprehensive instructions

⚠️ Bad listening skills

⚠️ It takes more time to process information

⚠️ Problems with the behavior of

⚠️ 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.

Diagnosing NSW

Remember that “not all speech problems are due to HF, and not all HF leads to speech and learning problems,” says Bellis.

The only way to diagnose the 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 HRS

HRS can be treated at any age, even when the auditory pathways are no longer developing, but experts still say it's best 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 to 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.