Auditory processing disorder (APD) is a disorder in the auditory system that disrupts the way a person’s brain understands audio input, that is, what they are hearing. Even though APD causes difficulty with tasks related to hearing, APD is not a form of hearing loss. People who have this condition can hear, but their brains struggle to process the sound input they are receiving.
The condition can occur in children and adults alike.
Symptoms of APD
The symptoms of auditory processing disorder can be different from one person to another. The symptoms are often connected with other speech and language disorders, including autism spectrum disorder (ASD). A child who has APD will likely have a combination of many symptoms.
The most typical symptoms of auditory processing disorder are:
- Significant difficulty in understanding speech and the spoken word, especially in settings where there is a lot of background noise.
- Difficulty following verbal instructions that have a lot of steps.
- Easy distraction by unexpected or loud sounds.
- Difficulty paying attention when a lot of listening is required, such as classroom lectures.
- Difficulty remembering or summarizing information that was presented verbally. It is easier for APD patients to remember and summarize information presented visually.
- Difficulty reading, spelling, or writing.
- Difficulty understanding figurative language in humor or idioms.
Auditory Processing Disorder & Autism
People who have autism and who have auditory processing disorder can physically hear, but their difficulty is in perceiving what they hear. APD is commonly found in children who have some form of neurodiversity.
While it is not fully understood why this is, some researchers believe that the hippocampus (the region of the brain that decodes auditory information) might be undeveloped among people who have autism. Another theory is that children with autism process the sounds they hear slower than children who do not have autism. Yet another theory suggests that children with autism are slower in shifting their attention from one sound to the other, which causes them to miss words and verbal cues.
Treating Auditory Processing Disorder
How can auditory processing disorder be treated? On a basic level, young children can be taught to ask clarification questions or to request that instructions be repeated.
On a deeper level, speech therapy is used to help assist with language and reading comprehension in neurodiverse children. This comes into play because people with APD struggle to differentiate similar sounds, whether in speech or in hearing. “Bed” becomes “dead,” or “cat” becomes “hat,” and so on.
A therapist trained in APD can help a patient improve their ability to distinguish between similar-sounding words so that the patient can both hear and say the correct word in the appropriate context. The work entails exercises that focus on specific auditory problems. Computer programs and apps can assist with this in conjunction with one-on-one sessions with a trained speech language therapist/pathologist.
Auditory Discrimination & Processing
When a speech language therapist works with children, there are some common techniques they can use:
- Training the child’s brain to differentiate (or discriminate) between sounds. They will first do this in a quiet environment and then in settings with increasingly loud background noises.
- Sharpening auditory memory by using sequencing routines. These are not dissimilar to “Simon” games, wherein the therapist will work with the child to exercise their brain in listening by using a series of numbers and instructions (sequencing routines) and gradually increasing the length and complexity of the items on the list.
- Dealing with problems related to language processing. A child might be too shy or too distressed to draw attention to themselves if they have APD. The therapist will encourage and support the child on how to ask an adult (a teacher, parent, or caregiver) or a peer to repeat or rephrase a comment, a request, or an instruction.
This step could also cover coming up with a unique system for taking notes, that helps the child best capture the information being disseminated in the classroom, and minimizes the amount of information lost due to their APD.
Lifestyle Changes & Attention Prompts
Certain lifestyle changes can also be made to help a child with APD. This is crucial since auditory processing is dependent on environment and surroundings, and the therapy for APD is similarly influenced.
In school, for example, teachers can improve their classroom acoustics. Simple changes like adding bookshelves, drapes, and carpets can absorb background sounds, so a child with APD can find it easier to focus on the noise inside the classroom itself.
Teachers can also seat children with APD near the front of the class and away from sources of background noise (open doors, fans or air conditioning units, or even electric pencil sharpeners).
Attention prompts, such as touches on the shoulder, can help a child who is more prone to distraction because of their APD.
For the benefit of the child, communication should be streamlined. This can entail making intentional eye contact with the child and inserting pauses into didactic lecturing. This gives the child more time to process the information they are receiving. Misunderstood material could be rephrased, and teachers should ask follow-up questions (“Can you tell me what I asked you to do?” or “What are you going to do now?”) to determine to what degree the child has been able to follow the lesson.
Use visual aids such as pictures or basic written outlines.
Children with auditory processing disorder have to work harder than children without APD to pay attention, and they may need more frequent breaks to consolidate information and give their brains a rest.
Some teachers use microphones and a headset to help the child focus on the teacher’s voice better.
Helping at Home
How can parents help their children with autism who have auditory processing disorder? Adults need to do what they can to boost and maintain their child’s attention. Use games that focus on listening and repetition, such as Simple Simon or something similar. Even a fully-developed story, like a movie, can be useful. For example, while watching something, encourage your child to make a gesture of some kind (such as raising their hand) when they see a recurring character, which will train them to keep their attention on the story.
It is also important to anticipate the fundamental concepts in upcoming homework, such as new words. Parents should take an active role in guiding their child through vocabulary development. New words and sounds will be exceptionally difficult to a child with auditory processing disorder.
Routines & Being Patient
Maintaining routines is especially important for a child who has autism and APD, especially in environments where there may be a lot of movement and activity. Providing structure and order will help your child with their focus. Making lists and flow charts can be very useful when there is the possibility that verbal instructions can be misinterpreted or not understood at all.
At home, even simple lifestyle changes can go a long way in helping a child who struggles with APD. Turning off a TV or a music player when speaking, for example, will remove distracting noises that can hinder conversation comprehension. Gestures and gentle touches on the arm can help a child shift their focus from what they were doing to what you want them to pay attention to (such as listening to you).
Some of these changes might not come easily to people who have never dealt with APD or autism before. It is vital that parents put themselves in the right frame of mind before talking with their affected children. Relaxation and mindfulness techniques might help prepare for carefully guided and structured conversations, especially when most adults might not even consider how much information is lost in the normal course of communication.
References
The Diagnosis and Management of Auditory Processing Disorder. (July 2011). Language, Speech, and Hearing Services in Schools.
Central Auditory Processing Disorders in Individuals with Autism Spectrum Disorders. (June 2018). Balkan Medical Journal.
Auditory Encoding Abnormalities In Children With Autism Spectrum Disorder Suggest Delayed Development Of Auditory Cortex. (December 2015). Molecular Autism.
Central Auditory Processing Disorder. American Speech-Language-Hearing Association.
Interventions to Improve Communications in Autism. (October 2008). Child and Adolescent Psychiatric Clinics of North America.
Auditory Discrimination Learning: Role of Working Memory. (January 2016). PLoS One.
A Randomized Control Trial of Interventions In School-aged Children With Auditory Processing Disorders. (April 2012). International Journal of Audiology.
Auditory Training for Central Auditory Processing Disorder. (November 2015). Seminars in Hearing.
Auditory Processing Disorder. (July 2001). The Hearing Journal.