Yolanda has taught college Psychology and Ethics, and has a doctorate of philosophy in counselor education and supervision.
Mary is attending the parent-teacher conference at her daughter Jill's school. Jill is eight years old and in the second grade. Jill's teacher tells Mary that Jill has trouble following multi-step directions and often appears to not be paying attention when given instructions. Jill often asks for clarification several times throughout the day, i.e. Jill says 'what?' at least six times during each class period. Directions have to be written down for Jill because she has trouble when they are given verbally. Jill forgets things that are said to her very quickly. She has trouble discriminating between sounds, i.e. she often confuses the 'st' sound with 'sc'. Jill also has problems carrying conversations with other students, i.e. she tends to overtalk and rarely allows other students to get a word in.
After further discussion with Jill's teacher and the school counselor, Mary decides to take Jill to see a child psychologist to be assessed for mental conditions, including learning disability and attention deficit hyperactivity disorder (ADHD). The child psychologist notes that while there are impairments in several different areas, she does not believe that Jill's limitations are due to a mental condition. The child psychologist refers Jill to an audiologist, who diagnoses Jill with auditory processing disorder (APD).
Definition and Symptoms
Auditory processing disorder (APD), also referred to as central auditory processing disorder, is a neurological condition that affects the way in which the brain processes spoken language. APD interferes with the ability to receive, recall, comprehend, and apply auditory information even though hearing ability is normal. APD impairs the ability to listen, hinders speech and language development, and can influence learning ability. Despite these impairments, most individuals with APD possess normal intelligence. It is estimated that between five and seven percent of children have APD. Girls are twice as likely to be diagnosed with APD as boys.
Jill displayed several of the symptoms of APD. She had difficult following instructions, understanding verbal information, remembering verbal information, and listening. Jill had problems with mishearing information. She had trouble remembering and following multi-step verbal directions. Jill's ability to converse with her classmates was impaired. Jill also had language difficulties, i.e. she had trouble distinguishing between sounds.
Children with APD might have trouble with spelling, reading, and verbal math problems. Vocabulary may also be limited. Academic performance may suffer as a result. It might take children with APD longer to process verbal information. They may have short attention spans. Children with APD can easily be distracted by noises and work best in quiet environments. It is often difficult for children with APD to organize their thoughts. They may also have trouble with motor abilities and find it difficult to sit still.
Many of the symptoms of APD are also symptoms of other childhood conditions, such as learning disabilities and ADHD, which has resulted in misdiagnosis and misunderstandings regarding APD. Furthermore, not everyone who has a language or learning impairment has APD. Similarly, not everyone who has APD will have a learning or language impairment. It is also important to note that APD is not the result of autism, intellectual disability, or similar higher-order deficits.
Treatment for APD is not a one-size-fits-all approach. Rather, treatment is highly individualized and depends on which areas are impaired. What works for one child might not necessarily work for the next. This is why working with an audiologist to not only make sure that the child is accurately diagnosed, but to also make sure that the child receives the best treatment for him or her is so important. There are three main focuses of APD treatment: modifying the environment in which the child learns and communicates, helping the child to develop the skills necessary to compensate for APD, and correcting the auditory impairment.
More research needs to be done on the treatment of APD. Several treatment approaches that have shown promise and are currently being studied are auditory trainers, environmental modifications, language-building skills, and auditory memory enhancement.
Auditory trainers are useful in that they decrease background noise while allowing the child to focus more on the person speaking.
Making modifications to the environment, such as placing the child closer to the speaker, reducing the distractions in a classroom, and providing students with written and verbal instructions can reduce learning problems and improve the child's ability to pay attention and follow directions.
Children can be taught language-building skills in an effort to increase their vocabulary and language skills.
Auditory memory enhancement techniques, which aim to improve children's ability to recall, store, and use verbal information, can also be used to reduce impairments associated with APD.
Auditory processing disorder is a neurological impairment in which the brain's ability to process verbal information is significantly impaired. Symptoms of auditory processing disorder include trouble following directions, being easily distracted by noise, problems with carrying conversations, trouble discriminating sounds, language difficulties, and trouble processing verbal information. Treatment of APD is highly individualized and can include auditory trainers, environmental modifications, language-building skills, and auditory memory enhancement.
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