What is Auditory Processing?
Auditory Processing is what we do, with what we hear.
What are some signs of Auditory Processing disorder?
If your child displays some of the following listening behaviours, consider an auditory processing assessment.
- Difficulty hearing or understanding in background noise
- Misunderstands, especially with rapid or muffled speech
- Difficulty following oral instructions
- Difficulty in discriminating and identifying speech sounds
- Inconsistent responses to auditory information, or poor listening skills
- Asks for things to be repeated, says ‘huh?’ often
- History of learning or academic difficulties
- Short attention span, easily distracted, or daydreams
- Is inattentive and/or disorganized. (Scale of Auditory Behaviours)
Could this be an Auditory Processing Disorder? Or is it something else?
To find out, many parents take their children for an Auditory Processing Assessment.
Auditory processing refers to “what we do with what we hear” (Tomlin 2017). Auditory Processing is the link between the detection of sound and the extraction of meaning from the signal (Bamiou et al. 2006). It is the efficiency and effectiveness with which the central nervous system (CNS) utilizes auditory information (AAA 2010). Deficits in auditory processing can range from acoustic to phonemic to linguistic in nature, or a combination of these levels of auditory processing.
My training and experience in both Audiology and Speech Pathology have shown me just how complex and fascinating auditory processing is. The test battery that I have developed is tailored to suit the age and individual needs of the client. My goal is to find out if and how Auditory Processing weaknesses affect the daily life of a client, and my management plans are practical. I understand that families need to keep a balance and that there is always a 'big picture'.
Auditory Processing Cases
In many cases Auditory Processing weaknesses exist alongside, or masquerade as, other cognitive, mental health or processing challenges such as Attention Deficit Disorder, Anxiety Disorder, Depression, Language Disorder, Learning Disability, Working Memory weakness or Processing Speed weakness.
At the end of an Auditory Processing assessment parents will understand their child's auditory processing profile, with its strengths and weaknesses. The assessment is designed to find out if the auditory weaknesses are 'bottom-up' (difficulty interpreting degraded speech, poor temporal processing, or weakness in dichotic listening), or if the problems are 'top-down' (involving higher level processes such as language processing, phonological awareness or auditory memory).
In many cases weaknesses can occur at both levels of processing. Finding this out is crucial to planning appropriate intervention and/or making referrals to other professionals such as psychologists and pediatricians or making suggestions for Individual Education Plans. Sometimes children have already seen other professionals who have referred the child for an Auditory Processing Assessment.
What to expect from an auditory processing assessment?
The assessment is divided into parts as follows: I send intake forms and a teacher questionnaire that is completed and sent back to me ahead of a 30-minute initial videoconferencing appointment during which I go over the intake forms with a parent and give them an idea of what the student can expect at the in-person appointment.
The in-person visit includes hearing and processing tests (approximately 2.5 hours). My office capacity is three people which means the student and one parent (if necessary) can attend.
Once an analysis of the results is complete, a parent feedback session via video-conferencing is arranged (approximately 45-60 minutes). Feedback is an important part of the assessment. The fee includes the initial visit, test time, feedback and report.
Many extended health plans will reimburse clients for some of the cost of an Auditory Processing assessment.
Considerations for Children
While it is difficult to comprehensively diagnose Auditory Processing Disorder before the age of about 6-7 years, testing early for potential weakness allows a student to benefit from early intervention.
For example, if the basis of a child's auditory weakness is phonological or language-based in nature, early intervention in these areas is crucial. If the weakness is more bottom-up in nature, then making environmental modifications can be a huge help until such time as a child is ready to benefit from some form of auditory training approach.
Considerations for Adults
Gradual Auditory Processing weakening is a normal part of aging. However, some adults experience Auditory Processing deficits that are more severe than those expected with age, and which have a negative impact on communication.
One of the challenges facing Audiologists however, in testing adults is that in many cases, due to the natural aging process, peripheral hearing loss also exists. While it is possible to use a modified test battery for Auditory Processing in the presence of peripheral hearing loss, diagnosis must be more cautious, and treatment recommendations more guarded.
Treatment Options for Auditory Processing Disorders
There is no one-size-fits-all treatment for children or adults with Auditory Processing weaknesses. Instead, each case is considered individually, and depending on the Auditory Processing profile and depending on the real-world impact of these weaknesses in conjunction with any coexisting deficits, any of the following treatment options can be considered:
- Individual therapy with Phonological Awareness training.
- Language redundancy training.
- Intensive computer based listening training.
- Recommendations for environmental modifications at school or at home.
- Recommendations for Individual Education Plans at school.
Parents should not expect a 'quick fix', nonetheless, positive change can be expected when a combination of appropriate treatments is implemented.
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