What is Auditory Processing Disorder (APD)?
Auditory Processing is a term used to describe how the brain recognises and interprets the sounds that we hear. “What we do with what we hear” (Katz et al, 1992). This assessment is performed on children who have normal hearing thresholds, but cannot process sound information accurately. These children experience significant learning difficulties because they are unable to make sense of what they are hearing.
|Auditory Processing is a complex system and is responsible for processes such as:
A thorough diagnostic assessment is available for children aged 7 years + as well as adults who have auditory processing difficulties.
- sound localisation (determining where a sound comes from)
- pitch recognition and discrimination
- auditory closure (understanding degraded signals)
- auditory discrimination
- sound memory
|A parent or teacher may suspect APD if a child has:
- difficulty following instructions
- understanding speech in the presence of background noise
- a short attention span
- a lower reading ability
- difficulty learning in background noise or in group environments
- poorer verbal abilities
- low self-esteem
- is easily distracted
An auditory processing assessment takes 90 minutes and involves the following:
The audiologist will ask questions regarding the child’s learning and hearing skills.
Reports obtained from other professionals such as the speech pathologist, educational psychologist, behavioural optometrist or school reports should be brought along to the appointment.
A behavioural assessment is performed to determine hearing sensitivity to tones. Pure tone thresholds indicate the softest sounds that can be heard. This information is plotted on a graph showing the softest sound level that was heard as a function of the frequency (pitch).
Auditory Memory Tests
This test assesses your child’s ability to recall numbers and sentence material in sequence.
Auditory Processing Tests
Dichotic Digits Test & Competing Sentences Test: assesses the child’s ability to listen to information presented simultaneously to both ears.
Frequency Pitch Pattern Test: assesses the child’s ability to detect subtle differences in sound.
Low Pass Filtered Word Test: assesses the child’s ability to “fill in the gaps” when part of the signal is filtered out.
Masked Level Difference Test: assesses the child’s ability to process different but complementary information in both ears
Random Gap Detection Test: assesses the child’s ability to detect two tones presented at different intervals.
Management involves a team approach and can be separated into three areas:
- Environmental Modifications: such as preferential seating or use of a FM system.
- Direct Intervention: these are techniques/exercises designed to improve auditory discrimination and integration skills. An intervention program such as Fast ForWord involves a speech and language pathologist
- Compensatory Strategies: these are strategies that can be useful in enabling the child to cope in daily listening activities.
“A multidisciplinary approach which takes into account the individual child’s auditory, language, learning and associated characteristics is critical to appropriate interpretation and management” (Ferre, 1994)
Fast ForWord is an intensive computer based program specifically designed for those children with central auditory processing difficulties. It was developed by Scientific Learning in the USA on the basis of nearly 30 years of neuroscientific research. The Fast ForWord program is run by a qualified Speech Pathologist.
The program is designed to be undertaken on an intensive basis over a 6 to 8 week period under the supervision of a qualified speech pathologist; it particularly targets children who have difficulty distinguishing between similar sounds (eg. ‘s’ and ‘sh’).
The program slows down the speech sounds, thereby allowing the child to recognise the subtle differences between similar contrasts. As the child’s skill level improves, the program increases the speed of speech sounds; this allows the child to receive extensive practice in the context of normal communication.
Fast ForWord also targets children with fundamental learning deficits in the areas of memory, attention, and sequencing.
Through intensive structured exercises adapted to the child’s individual learning profile, the average gain is 1 to 2 years.
Personal FM Systems
|The iSense Micro is a personal FM system, used to increase the signal-to-noise ratio, thus improving acoustic access to information)
This unit was invented in Switzerland and fits discreetly to the child's ear. iSense Micro transmits the speaker's voice (eg. the teacher) directly to the child's ears, therefore significantly reduces the distractions associated with background noise and distance from the speaker. Please ask the clinic for a demo of this unit.