What is auditory processing?
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.
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."
What causes auditory processing difficulty?
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 developmental disorder, or developmental delay.
Sometimes this term has been misapplied to children who have no hearing or
language disorder but have challenges in learning.
What are the symptoms of possible auditory processing difficulty?
Children with auditory processing difficulty typically have normal hearing
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
How is suspected auditory processing difficulty diagnosed in
children?
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 a 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 the processing problem.
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.
What current research is being conducted?
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. 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 continuously evaluated. The standard for determining if a
treatment is effective is that a patient can reasonably expect to benefit
from it.
What treatments are available for auditory processing difficulty?
Much research is still needed to understand APD problems, related
disorders, and the best intervention for each child or adult. Several
strategies are available to help children with auditory processing
difficulties. Some of these are commercially available, but have not been
fully studied. Any strategy selected should be used under the guidance of a
team of professionals, and the effectiveness of the strategy needs to be
evaluated. Researchers are currently studying a variety of approaches to
treatment. Several strategies you may hear about include:
- 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.
- Exercises to improve language-building skills 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 may be promoted by practitioners as a way
to retrain the auditory system and decrease hearing distortion. However,
current research has not proven the benefits of this treatment.
Where can I learn more about auditory processing?
For information related to audiology and audiology professionals and
services, contact:
American Academy of Audiology (AAA)
11730 Plaza America Drive, Suite 300
Reston, VA 20190
Voice: (703) 790-8466
Toll-free Voice: (800) 222-2336
TTY: (703) 790-8466
Fax: (703) 790-8631
E-mail: info@audiology.org
Internet: www.audiology.org
American Speech-Language-Hearing Association (ASHA)
10801 Rockville Pike
Rockville, MD 20852
Voice: (301) 897-5700
Toll-free Voice: (800) 638-8255
TTY: (301) 897-0157
Fax: (301) 571-0457
E-mail: actioncenter@asha.org
Internet: www.asha.org
NIH Pub. No. 01-4949
For more information, contact the NIDCD Information Clearinghouse.
View Full Article
Reprinted with the permission of the National Institute of Mental Health. © 2008 NIMH.
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