Auditory processing refers to the brain’s ability to interpret and make sense of the sounds we hear. It involves recognizing, distinguishing, and understanding speech and environmental sounds, even in challenging listening environments. While our ears detect sound, it is the brain that processes and organizes this information, allowing us to follow conversations, detect differences in similar sounds, and filter out background noise.
A simple way to think about auditory processing is through Erber’s Hierarchy:
This disorder affects approximately 20% of school-aged children and 43% of children struggling in school as well as adults of all ages. It can be mistaken of occur alongside ADHD, dyslexia, and other disorders. It is common for younger and middle-aged adults to notice symptoms of APD in specific listening situations such as the college classroom, work, and social environments, and realize later in life the struggles they had growing up.
What Is Auditory Processing Disorder (APD)?
Auditory Processing Disorder (APD) is a condition in which the brain has difficulty processing and interpreting auditory information, even when hearing ability is normal. Individuals with APD may struggle to follow conversations in noisy settings, misinterpret spoken instructions, or have trouble distinguishing between similar-sounding words. This can impact communication, learning, and daily interactions. APD is often diagnosed through specialized testing by an audiologist and can be managed with targeted therapies and strategies to improve listening and comprehension skills.
it is estimated that there are over 300 million English speakers with APD and it often goes undiagnosed or misdiagnosed. It has over 50% comorbidity with dyslexia.
Signs of Auditory Processing Disorder
Sometimes, individuals can exhibit classic signs of hearing loss: they do not hear well or may only understand a portion of what is being said. They may experience learning difficulties, particularly in environments with lots of background noise or distractions. When multiple people are talking, they lose focus and can’t follow the conversation.
Other difficulties individuals with APD experience:
- Understanding speech in noise
- Learning to spell, reading comprehension, and/or writing
- Remembering auditory information
- Organization of numbers (such as remember multiple digits)
- Knowing where sound is coming from (localization)
- Following or understanding complex instructions
- Understanding accents
- Consistent delay in responses
Symptoms of APD in children
If you believe that a child may have APD, there are few questions to consider:
- Is the child easily distracted?
- Are noisy environments distracting or upsetting?
- Does the child’s behavior improve in quieter settings?
- Does the child have trouble following directions, whether simple or complicated?
- Does the child have reading, spelling, or writing difficulties?
- Is the child disorganized or forgetful?
- Are conversations difficult for the child to follow?
How Is APD Diagnosed?
To get an understanding of what difficulties you are noticing (or you are noticing in your child), questionnaires will be completed to help us understand the struggles. Then, a hearing test is completed to determine the health of the peripheral hearing and middle ear functions.
Following these steps, auditory processing testing is completed utilizing a variety of measurements to determine how well the individual performs in the presence of noise, integrates sounds from the left and right ears, and discriminates and identifies different speech sounds. Not only is quantitative information assessed but qualitative information (delays in responses, quick responses, need for repetition, etc.) is taken into account when determining a diagnosis. When making a formal diagnosis, the individual must fall two standard deviations outside norms of same aged peers for two tests, or three standard deviations outside norms of same aged peers for one test. Additional measurements may be completed based on the outcome to learn more to aid in treatment considerations.
Can Auditory Processing Disorder Be Treated?
Yes!
Utilizing specific diagnostic measures, we are able to determine areas of weaknesses to focus on and work on enhancing those abilities. One system, The Buffalo Model, breaks down test measures into four categories:
- Decoding – ability to quickly and accurately recognize speech
- Tolerance-Fading Memory (TFM) – understanding or tolerating speech in background noise, and short-term memory
- Organization – maintain proper sequence and order
- Integration – combining information across processing centers (left and right hemispheres) to bring information together
Dr. Katelyn Ooms, our APD Audiologist works with each patient (and their family when appropriate) to create a personalized plan of care to focus on difficulties and to strengthen areas of concern. The plan includes Phonemic Training, Speech in Noise Training, Phonemic Synthesis Therapy/ Phonemic Analysis, and Short Term Auditory Memory (STAM). Additional options are considered for specific needs.
A recent study looked into the outcomes of therapy utilizing the Buffalo Model of auditory therapy with school-aged kids diagnosed with APD. The findings show significant improvement on 12 of the 17 measures with 2 additional measures trending towards significant improvement. In addition, parents typically reported noticeable improvements in listening, auditory processing, learning, academic performance, and social communication interactions.
What Should I Expect from Auditory Processing Disorder Therapy?
It is recommended to have a 45–60-minute therapy session once a week for 10-14 sessions. This allows time for us to work on and build on the breakdown points. The lessons start off easier and increase in difficulty with each lesson. At the end of the therapy, we will re-test to compare about the first measurements to assessment improvement. Some individuals may require a second round of therapy for even more improvement.
Additional Questions:
What age can be tested and treated? Our office completed diagnostic testing for ages 7+.
Is telehealth an option? Coming soon! We are working towards offering both testing and treatment online.
How do I schedule? First, we need diagnostic testing completed (a hearing evaluation). This appointment will be between 45-60 minutes. Then, we will schedule APD testing that will typically be 60 minutes+ depending on the age of the patient. If you have any additional questions or want to schedule an appointment for APD testing call 864-442-5555!
Call Elevate Audiology at (864) 442-5555 for more information or to schedule an appointment.