Do you have concerns about your child's ability to process information? Do you ever feel like you are talking, and they aren't really "listening" to what you are saying? Many parents have heard of Auditory Processing Disorder, but the symptoms can be hard to pin down - especially when autism, ADHD, or a language disorder are involved. To help clarify this complex diagnosis, we have gone to an expert in the field of hearing - Dr. Lindsay Cockburn, a pediatric audiologist in Los Angeles, California. Thank you Lindsay for sharing your expertise about auditory processing disorder! We are so happy to feature your knowledge on the blog today.
Hearing is perceiving that sound is present. Listening is an active process that involves paying attention to what is heard. Auditory Processing is making sense of what you are listening to. Auditory Processing involves the brain using prior knowledge, experiences, and language skills to give sounds and speech meaning. It is a complex process where the brain deciphers what sounds are more important, so you can focus on the person you’re talking to and understand what they are saying better than the people talking to each other behind you.
Auditory Processing Disorder (APD) is a range of hearing and listening difficulties that are not due to hearing loss or cognitive impairments. A person with auditory processing disorder has normal hearing, but difficulty understanding speech, especially in the presence of background noise. APD can be diagnosed by an audiologist, ideally as part of an interdisciplinary team of specialists. The audiologist completes a battery of tests aimed at exhausting the auditory centers of the brain looking for specific challenges. Based on test results, they can then give recommendations for school accommodations, communication strategies, and assistive listening devices that can help the child function better in their everyday life.
The most common signs of APD are:
The first step in an APD evaluation is a standard hearing evaluation by an audiologist. A “hearing test” done at school or a doctor’s office is only a screening, so it’s important to have a complete diagnostic hearing evaluation done.
Once the audiologist has established that hearing is normal, they can recommend APD testing. Many audiologists (even pediatric audiologists) do not perform APD testing so it’s common to be referred to an additional clinic or to the school district’s educational audiology team for an APD evaluation. A hearing test can be completed on a child at any age, but an APD evaluation requires sustained attention and the ability to repeat back words and sentences clearly so most audiologists will not perform evaluations on kids younger than 5-7 years old.
Although psychologists, speech-language pathologists, and occupational therapists may have screening measures for auditory processing abilities, it’s important to remember that an APD evaluation is a set of complex calibrated listening tests that must occur in a soundproof booth. Psychologists, speech language pathologists, and OTs are important members of the interdisciplinary team and can provide important insight that can help with diagnosing APD.
The first step that can be done, which will benefit anyone, is using good communication strategies. As a parent, model these strategies by:
Autism, ADHD, and Auditory Processing Disorder have some overlapping signs and symptoms. People with autism process sound differently, which can result in not responding to their name or being sensitive to loud sounds. They also have communication difficulties because they process speech and language differently than neurotypical peers. Listening and auditory processing both require attention and focus. When a person with ADHD is thinking about something else, their brain can struggle to switch back into active listening mode so they often miss the first part of what someone said or sometimes the entire message. This is where working as an interdisciplinary team comes in handy - so that all of the experts can come together and make sure they are treating the correct disorder.
Many of the communication strategies and school accommodations for APD can also help people with Autism and ADHD. People with Autism and ADHD often receive speech therapy at schools and speech language pathologists can work with classroom teachers to incorporate these strategies to help with listening skills.
Lindsay Cockburn is a pediatric audiologist in Los Angeles, CA. She started her pediatric audiology blog Listen With Lindsay to make information about hearing, technology, and education more accessible to everyone. You can follow her on Instagram @ListenWithLindsay for more tips.
Thank you Lindsay! We are so grateful for your expertise in this area, and for this incredible explanation of this complex issue. We often receive questions about ADHD, autism, and auditory processing disorder, and now we know exactly where to send people for more information!
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