Auditory Processing Disorder in Children: What

Does it Mean8
By: National Institute on Deafness and Other Communication Disorders (2;;1)

9n this article

• What is auditory processing?

• What causes auditory processing difficulty?
• What are the symptoms?
• How is it diagnosed?
• What treatments are available?
• Current research
• Where can I learn more?

What is auditory processing8

Auditory processing is the 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 (APD) means that something is adversely affecting the processing or interpretation of
information.

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.

APD goes by many other names. Sometimes it is referred to as central auditory processing disorder
(CAPD). Other common names are auditory perception problem, auditory comprehension deficit, central
auditory dysfunction, central deafness, and so-called "word deafness."

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What causes auditory processing difficulty8

We are not sure. Human communication relies on taking in complicated perceptual information from the
outside world through the senses, such as hearing, and interpreting that information in a meaningful way.
Human communication also requires certain mental abilities, such as attention and memory. Scientists
still do not understand exactly how all of these processes work and interact or how they malfunction in
cases of communication disorders. Even though your child seems to "hear normally," he or she may have
difficulty using those sounds for speech and language.
The cause of APD is often unknown. In children, auditory processing difficulty may be associated with
conditions such as dyslexia, attention deficit disorder, autism, autism spectrum disorder, specific language
impairment, pervasive development disorder, or developmental delay. Sometimes this term has been mis-
applied to children who have no hearing or language disorder but have challenges learning.

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What are the symptoms8

Children with auditory processing difficulty typically have normal heating and intelligence. However,
they have also been observed to:

• Have trouble paying attention to and remembering information presented orally

• Have problems carrying out multistep directions
• Have poor listening skills
• Need more time to process information
• Have low academic performance
• Have behavior problems
• Have language difficulty (e.g., they confuse syllable sequences and have problems developing
vocabulary and understanding language)
• Have difficulty with reading, comprehension, spelling, and vocabulary

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=o> is it diagnosed8
You, a teacher, or a day care provider may be the first person to notice symptoms of auditory processing
difficulty in your child. So talking to your child's teacher about school or preschool performance is a good
idea. Many health professionals can also diagnose APD in your child. There may need to be ongoing
observation with the professionals involved.

Much of what will be done by these professionals will be to rule out other problems. A pediatrician or
family doctor can help rule out possible diseases that can cause some of these same symptoms. He or she
will also measure growth and development. If there is a disease or disorder related to hearing, you may be
referred to an otolaryngologist, a physician who specializes in diseases and disorders of the head and
neck.

To determine whether your child has a hearing function problem, an audiologic evaluation is necessary.
An audiologist will give tests that can determine the softest sounds and words a person can hear and other
tests to see how well people can recognize sounds in words and sentences. For example, for one task, the
audiologist might have your child listen to different numbers or words in the right and the left ear at the
same time. Another common audiologic task involves giving the child two sentences, one louder than the
other, at the same time. The audiologist is trying to identify processing problems.

A speech-language pathologist can find out how well a person understands and uses language. A mental
health professional can give you information about cognitive and behavioral challenges that may
contribute to problems in some cases, or he or she may have suggestions that will be helpful. Because the
audiologist can help with the functional problems of hearing and processing and the speech-language
pathologist is focused on language, they may work as a team with your child. All of these professionals
seek to provide the best outcome for each child.
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What treatments are available8

Several strategies are available to help children with auditory processing difficulty.

• Auditory trainers are electronic devices that allow a person to focus attention on a speaker and
reduce the interference of background noise. They are often used in classrooms, where the teacher
wears a microphone to transmit sound and the child wears a headset to receive the sound. Children
who wear hearing aids can use them in addition to the auditory trainer.
• Environmental modifications such as classroom acoustics, placement, and seating may help. An
audiologist may suggest ways to improve the listening environment, and he or she will be able to
monitor any changes in hearing status.
• Language-building exercises can increase the ability to learn new words and increase a child's
language base.
• Auditory memory enhancement, a procedure that reduces detailed information to a more basic
representation, may help. Also, informal auditory training techniques can be used by teachers and
therapists to address specific difficulties.
• Auditory integration training is sometimes promoted by practitioners as a way to retrain the
auditory system and decrease hearing distortion.

It is important to know that much research is still needed to understand auditory processing problems,
related disorders, and the best interventions for each child or adult. All the strategies undertaken will need
to be suited to the needs of the individual child, and their effectiveness will need to be continually
evaluated.

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Current research
In recent years, scientists have developed new ways to study the human brain through imaging. Imaging
is a powerful tool that allows the monitoring of brain activity without any surgery. Imaging studies are
already giving scientists new insights into auditory processing. Some of these studies are directed at
understanding auditory processing disorders. One of the values of imaging is that it provides an objective,
measurable view of a process. Many of the symptoms described as related to APD are described
differently by different people. Imaging will help identify the source of these symptoms. Other scientists
are studying the central auditory nervous system. Cognitive neuroscientists are helping to describe how
the processes that mediate sound recognition and comprehension work in both normal and disordered
systems. Research into the rehabilitation of child language disorders continues. In the future, both basic
and clinical research will help us better understand the nature of auditory processing disorders.

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Where can 9 learn more8

If you have questions, contact us at the NIDCD Information Clearinghouse
1 Communication Avenue
Bethesda, MD 2;Z[2-345_
Toll Free: (Z;;) 241-1;44
TTY: (Z;;) 241-1;55
E-mail: nidcdinfo`nidcd.nih.gov
Internet: www.nidcd.nih.gov

Contact the following group for information related to audiology and audiology professionals and
services.

American Academy of Audiology

Z3;; Greensboro Drive, Suite b5;
McLean, cA 221;2
coice: (b;3) b[;-Z4__
Toll-free: (Z;;) AAA-233_
TTY: (b;3) b[;-Z4__
Internet: www.audiology.org

Or, for information related to audiology and speech-language pathology professionals and services,
contact

American Speech-Language-Hearing Association

1;Z;1 Rockville Pike
Rockville, MD 2;Z52
coice: (3;1) Z[b-32b[
Toll-free: (Z;;) _3Z-Z255
Hours: Z:3; a.m.-5 p.m., eastern time
TTY: (3;1) Z[b-;15b
Fax: (3;1) Z[b-b355
E-mail: actioncenter`asha.org
Internet: www.asha.org

For more information, contact the NIDCD Information Clearinghouse.

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National Institute on Deafness and Other Communication Disorders, NIH Pub. No. ;1-4[4[ March 2;;1

http://www.ldonline.org/article/Z;5_?themeeprint

f2;;_ WETA. All Rights Reserved.