Auditory Processing Disorder
Auditory processing is a term used to describe what happens when your brain recognizes and interprets the sounds around you. Humans hear when energy that we recognize as sound travels through the ear and is changed into electrical information that can be interpreted by the brain. The "disorder" part of auditory processing disorder means that something is adversely affecting the processing or interpretation of the information.
APD (Auditory Processing Disorder) affects about 5% of school-aged children. These children can't process the information they hear in the same way as others because their ears and brain don't fully coordinate. Something adversely affects the way the brain recognizes and interprets sounds, most notably the sounds composing speech.
APD is an often misunderstood problem because many of the behaviors noted above can also appear in other conditions like learning disabilities, attention deficit hyperactivity disorder (ADHD), and even depression. Although APD is often confused with ADHD, it is possible to have both. It is also possible to have APD and specific language impairment or learning disabilities.
Children with APD often do not recognize subtle differences between sounds in words, even though the sounds themselves are loud and clear. For example, the request "Tell me how a chair and a couch are alike" may sound to a child with APD like "Tell me how a couch and a chair are alike." It can even be understood by the child as "Tell me how a cow and a hair are alike." These kinds of problems are more likely to occur when a person with APD is in a noisy environment or when he or she is listening to complex information.
Diagnosis can be difficult as most children with APD are thought to hear normally because they can usually detect pure tones that are delivered one by one in a very quiet environment (such as a sound-treated room). Those who can normally detect sounds and recognize speech in ideal listening conditions are not considered to have hearing difficulties.
However, the ability to detect the presence of sounds is only one part of the processing that occurs in the auditory system. So, most children with APD do not have a loss of hearing sensitivity, but have a hearing problem in the sense that they do not process auditory information normally. If the auditory deficits aren't identified and managed early, many children will have speech and language delays and academic problems.
It is important to understand that there is not one, sure-fire, cure-all method of treating APD. Notwithstanding anecdotal reports of "miracle cures" available in popular literature or on the internet, treatment of APD must be highly individualized and deficit-specific. No matter how successful a particular therapy approach may have been for another child, it does not mean that it will be effective for your child. Therefore, the key to appropriate treatment is accurate and careful diagnosis by an audiologist.
Treatment of APD generally focuses on three primary areas: changing the learning or communication environment, recruiting higher-order skills to help compensate for the disorder, and remediation of the auditory deficit itself. The primary purpose of environmental modifications is to improve access to auditorily presented information. Suggestions may include use of electronic devices that assist listening, teacher-oriented suggestions to improve delivery of information, and other methods of altering the learning environment so that the child with APD can focus his or her attention on the message.
Primary Sources: http://www.nidcd.nih.gov/health/voice/auditory.htm (National Institute on Deafness and other disorders, http://www.ncapd.org/php (National Coalition on Auditory Processing Disorders)
By MaryEllen Smith Tavares
