Remedial Teaching with a Difference

Auditory Processing Disorders

What is Auditory Processing?

Auditory processing describes what happens when your brain recognises and interprets the sounds around you. Humans hear, when energy that we recognise as sound, travels through the ear and is changed into electrical information that can be interpreted by the brain.

Auditory Processing involves a complex set of skills that are essential for listening and communication comprehension:

  • Sensation – identify sound existence
  • Localisation – find the source of the sound in location to the listener
  • Auditory attention –focus on the speaker for an age appropriate amount of time
  • Auditory figure-ground – distinguish the main speaker from background noises
  • Auditory discrimination – recognises patterns and differentiates words and sounds that are similar in sound.
    E.g. fat/cat or death/deaf
  • Auditory closure – understanding the whole word or a message when part of it is missing. This skill is often used in loud settings where only partial information is heard
  • Auditory synthesis – blend individual sounds (phonemes) into words. e.g. m of mat
  • Auditory analysis – identifying phonemes (e.g., /d/ in dog), morphemes (prefixes, e.g., /re-/ in repeat and suffixes, e.g., /-s/ in hats), and other grammatical information
  • Auditory association – attach meaning to sounds
  • Auditory memory – remember oral information. Involves short- and long-term memory

What is Auditory Processing Disorder?

When a child has difficulty with processing information, it usually means that something is adversely affecting the processing or interpretation of information. Children with auditory processing difficulty typically have normal hearing and intelligence but they have trouble processing information they hear.

APD is an often misunderstood problem because many of the behaviours can appear in other conditions like learning disabilities, attention deficit hyperactivity disorder (ADHD), and even depression. Although APD is often confused with ADHD, it is possible to have both. It is also possible to have APD and specific language impairment or learning disabilities.

This is a complex problem affecting about 5% of school-aged children. These children are unable to process the information they hear in the same way as others because their ears and brain don't fully coordinate. Something adversely affects the way the brain recognises and interprets sounds, most notably the sounds composing speech.

Children with Auditory Processing Disorder (APD) often do not recognise subtle differences between sounds in words, even when the sounds are loud and clear enough to be heard. These kinds of problems usually occur in background noise, which is a natural listening environment. So, children with APD have the basic difficulty of understanding any speech signal presented under less than optimal conditions.

Detecting APD

Children with APD are thought to hear normally because they can usually detect pure tones that are delivered one by one in a very quiet environment (such as a sound-treated room). Those who can normally detect sounds and recognise speech in ideal listening conditions are not considered to have hearing difficulties.

However, the ability to detect the presence of sounds is only one part of the processing that occurs in the auditory system. So, most children with APD do not have a loss of hearing sensitivity, but have a hearing problem in the sense that they do not process auditory information normally. If the auditory deficits aren't identified and managed early, many of these children will have speech and language delays and academic problems. Symptoms of APD can range from mild to severe and can take many different forms.

Typical Characteristics in
Pre-School Children

  • May demonstrate delayed speech and language abilities or articulation errors that are not consistent with age
  • Have difficulty following instructions at home or at school that other children of the same age can follow easily
  • Have an easier time following daily routines like putting your bag away on arrival at Kindy, than following new, verbally presented instructions
  • Ask for repetitions frequently
  • Demonstrate signs of frustration or confusion which can manifest as either refusing to participate at all to staring blankly when confronted with new instructions or activities
  • Have difficulty understanding instructions in a noisy environment
  • Have difficulty learning nursery rhymes or simple songs
  • Demonstrating no interest in having a book read to him/her or ignoring the text completely
  • Demonstrates social communication difficulties, such as hurt feelings or frequent misunderstandings, more than other children
  • Avoid talking to other children or adults
  • Be highly distractible, especially in noisy situations
  • Fails to exhibit steady progression in the production and/or comprehension of more complex language and new vocabulary
  • Fails to respond to or show curiosity about new sounds or demonstrates no attention or interest when spoken to.
Typical Characteristics in
Primary School Aged Children

  • Behaves as if hearing loss is present, despite normal hearing tests, especially in noisy environments
  • Demonstrates greater difficulty with verbal that nonverbal tasks
  • Demonstrates significant fluctuation in ability levels across tests of speech, language or cognitive processes, with weaknesses in those areas considered to be more auditory in nature
  • Exhibits a delay in the content, use or form of language
  • Exhibits articulation errors that persist longer thatn they should
  • Easily distractible
  • Refuse to participate in classroom discussions or otherwise offers inappropriate or off-topic contributions
  • Difficulty following multistep instructions
  • Poor reading and spelling skills
  • History of chronic ear infections
  • Poor music or singing skills
  • Poor problem solving skills
  • Poor social communication skills or difficulty making and keeping friends
  • Relies heavily on memorization when learning new information
  • Needs a high degree of external organization in the classroom to begin and complete required tasks
  • Expresses frustration with certain tasks

Many children display some of these behaviors at some time, however, a child with APD will display these behaviors more consistently and more frequently as compared with other children of the same age.

What can we do to help?

Auditory processing disorders can affect development of speech, language and communication as well as reading and spelling, resulting in dyslexia and/or problems with talking and understanding. Johansen Individualised Auditory Stimulation (JIAS) can help to improve these difficulties.

Here are some practical ideas to help in the classroom or at home. The most effective way, however, is to treat the cause.

  • Reduce the background noises by using soft furnishings on hard surfaces such as curtains, throws, pillows, carper squares. Soft furnishings absorb noises
  • Sit away from noise sources, (e.g. doors, windows, pipes)
  • Use ear plugs during individual work time or test taking
  • Provide quiet isolated work areas
  • Give directions in small steps
  • When speaking use simple, expressive sentences. Speak slower and a little louder
  • Sit close to teacher (preferential sitting)
  • Face the child and maintain eye contact while speaking
  • Provide breaks to prevent frustration or becoming overwhelmed
  • Give additional time to process the oral directions and questions
  • Re-phrase and reinforce verbal instruction
  • Demonstrate or model the lesson or assignment
  • Have the child repeat the questions or directions aloud for comprehension
  • Use a computer or overhead to provide visual clues
  • Provide written notes and assignments for the child to refer back to, instead of relying on memory
  • Use manipulatives during lessons
  • Use graphic organizers that include pictures
  • Use outlines and study guides to keep the child on task and organised
  • Use color-coded organisation ideas: color code each subject. Everything pertaining to that subject is one color – readings, assignments, notes, etc

References: Kids Health from Nemours (2007), Florida Department of Education (2001) Technical Assistance Paper: Auditory Processing Disorder. Bellis, Terri James (2002): When the brain can’t hear. Unraveling the mystery of Auditory Processing Disorder.

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