Auditory Processing Disorder in Children

Auditory Processing Disorder (APD) is defined as a hearing problem that affects how one processes and understands sounds due to an interruption in the brain when it tries to process these sounds, especially speech. There’s no known cause of it–doctors suspect genetics, traumatic brain injuries, and frequent ear infections may play a role–and it affects about 5 percent of children in school. Some children may have APD their entire lives, while others may grow out of it. Either way, it’s important for your child to get APD treatment as early as possible so they have a lower risk of developing learning and listening problems. Haley Caruso, a clinical audiologist at Woman’s Hospital, explains APD and what to do if your child has it.

What are some signs of APD?
Children that have APD hear sounds the exact same way we do. The problem is that APD causes the brain to have difficulty distinguishing between sounds in words, especially in noisy environments. The brain and ears of those with APD don’t coordinate very well, so they struggle with comprehending what they hear. “There are many different types of Auditory Processing Disorder, which means there are many different types of symptoms,” says Dr. Caruso. “The student may have difficulty understanding speech or following conversations. They may misunderstand messages, need things repeated often, have inconsistent or inappropriate responses, have problems localizing sounds, or get distracted easily.”

How does it affect students?
“Children with APD can struggle with subjects such as math, reading, and English,” says Dr. Caruso. More specifically, concepts like spelling, phonics, and verbal word problems are harder for students with APD to grasp. Combined with all the signs listed above, these students can find school environments particularly challenging. From classroom discussions, to the noisy lunchroom, playground, and gymnasium, your child may find it difficult to hear their surroundings properly and, as a result, lose their concentration and fall behind on their studies. This is why it’s important to diagnose APD as early as possible.

How is APD diagnosed?
“In order to be diagnosed with APD, you need normal hearing, a normal IQ, and to be at least seven years old,” says Dr. Caruso. “Once you’re seven years old, your brain is developed enough to be able to do these processing tests. All tests are scored based on age range, which is typically between 7 and 14, though adults can have it, too.

“These processing tests involve a trained audiologist who will play a sequence of tests and sounds in a sound booth. The patient listens to instructions and responds accordingly. I pinpoint specific areas like binaural integration separation, binaural interaction, auditory closure, temporal patterning, and temporal processing.”

How is APD treated?
There is no known cure for APD, but there are several strategies that can help someone with APD develop better listening skills. Most children’s auditory systems are fully developed by the time they are 14, which means it is possible they will eventually develop their listening, learning, and communication skills on their own. Otherwise, there is speech language therapy, online training activities, hearing aids with FM systems (also known as a remote microphone system, which emphasizes a speaker’s voice over background noise), and other individualized therapies depending on what areas in which the student with APD is struggling. 

What should I do if I suspect my child has APD?
If your child is experiencing APD-like difficulties, they will have to undergo a series of tests to pinpoint their disorder. “APD can mimic other disorders like ADD, ADHD, and dyslexia, so it can’t be diagnosed on symptoms,” Dr. Caruso says. “APD can mimic signs of hearing loss as well, so we always check a child’s hearing before testing for APD.”

Once your child has a diagnosis, it’s important to coordinate with their school so they can receive interventions specific to their needs. APD isn’t technically considered a learning disability in schools (as opposed to those that are more “severe”), but you can still reach out to their teacher and ask for special accommodations. For example, your child with APD may need to sit closer to the front of the classroom so they can hear their teacher, or they may need to record their lessons so they can review the lessons later. Most importantly, your child needs reassurance that they are just as smart and successful as the other students around them; they just need a little extra help in and out of the classroom.

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