Auditory Processing Disorder (APD)

Definition

Auditory Processing Disorder, also known as Central Auditory Processing Disorder, is a condition that causes difficulty in distinguishing subtle differences in sounds. This is not a hearing problem as a hearing exam may prove your child has perfect hearing. It is neither a lack of intelligence, nor a specific learning disability but may lead to learning difficulties.

APD  may occur after premature birth, chronic ear infections, meningitis, lead poisoning, or a head injury and is also found to run in families. The brain simply does not process (hear) the sounds in the usual way. Experts do not agree that APD exists alone, thus it is not included in the Individuals with Disabilities Education Act (IDEA, 2004) or the Diagnostic Statistical Manual-5th edition (DSM-5, 2014) as a separate disorder. An audiologist can help you determine if your child has Auditory Processing Disorder. 

Characteristics Checklist

  1. Phonological Awareness
  • Unable to recognize or isolate the individual sounds in a word
  • Unable to recognize similarities between words (as in rhyming words)
  • Unable to identify the number of sounds in a word

2. Auditory Discrimination

  • Unable to distinguish individual phonemes, especially at the beginning of a word such as hearing the word cake when someone says rake.
  • Has difficulty understanding what is said, especially in loud places, where multiple people are talking like restaurants and sporting events.
  • Has difficulty following a conversation, therefore will be slow to respond (which looks like a language disorder).

3. Auditory Memory

  • Doesn’t follow multi-step instructions; hears the first & last step, but misses the middle steps (which looks like ADHD).
  • Has difficulty remembering a story that is read aloud such as in a lecture, a sermon, or even a joke.

4. Auditory Sequencing

  • Has difficulty retelling the order of events from a story read aloud.
  • Has difficulty remembering order of items in a list.
  • Has difficulty recalling the order of sounds in a word.
  • Drops the ends of words and mixes up letters (which looks like dyslexia).

5. Auditory Blending

  • Struggles when putting sounds/phonemes in order in a word (which looks like dyslexia).

Source: LD Online, APD symptoms

Strategies

  1. Speech therapy is one of the best treatments for APD because therapists work one-on-one with students to practice hearing sounds, reading lips, and interpreting the nuances of language.
  2. Maintain eye contact when speaking with your child and giving instructions, naturally, without forcing eye contact.
  3. Give instructions in writing as much as possible (i.e. post lists of chores on refrigerator).
  4. Break instructions into small steps; allow child to complete a task before giving instructions for the next.
  5. Provide a quiet place to study, as well as have conversations.
  6. Be aware that meaning will get lost or confused in verbal exchanges, so patience is critical; you will need to repeat, re-explain, and slow down when talking with your child.
  7. Understood.org provides other ideas for classrooms accommodations.
  8. Use assistive technology for APD.
  9. Many of the same strategies used with children with ADHD or Dyslexia are helpful for children with APD.

TIP: Quiet Communication

The most valuable tip I can share for living with and teaching a child with APD, is to minimize noise when talking, studying, and instructing. Television, radio, computers, and other people talking in the same room produce background noises that make it impossible for the person with APD to hear individual words that are spoken. Voices actually sounds more like a distant rumble. Also, carrying on a conversation in a noisy restaurant, shopping mall, theater, or other busy environments is fruitless and furthermore, frustrating to both parties. Train yourself to be aware of this issue and provide a quiet place when you want the words to count. Get rid of or minimize excess noise while homeschooling. If outside noises are problematic, allow your child to use a white noise machine, or a noise cancelling device such as a headset while reading and studying independently.

Resources

National Coalition for Auditory Processing Disorders, What is APD

Understood, What is APD

LD OnlineAPD & VPD

OT Toolbox for teaching auditory processing skills (website created by occupational therapists), APD tools

Sensory Processing Disorder (SPD)

Often children with SPD are mistakenly viewed as behavior problems due to lack of information and understanding from family, friends, and teachers. The more parents learn about this disorder, the better equipped they are to accommodate, advocate for, and facilitate their child’s assimilation into a sensory overloaded environment.

Definition

Sensory Processing Disorder (formerly sensory integration disorder or sensory dysfunction) is a neurological condition in which the brain does not respond properly to stimuli from the senses. People with SPD have difficulty managing their sensory input and either become over-stimulated by the environment or under-stimulated causing problems with daily life activities.

There is no official diagnosis listed in IDEA or DSM-5 for this disorder because most experts do not consider this a stand alone disorder. However, many of the symptoms are listed as characteristics of autism, ADHD, and gifted. Unfortunately, children are sometimes diagnosed and medicated for ADHD, when in fact they have SPD. Locating a neuropsychologist, medical doctor, or occupational therapist to determine if your child is struggling with sensory processing disorder can prevent this from happening.

Source:

Star Institute, Facts about SPD

American Academy of Family Physicians, Family Doctor, SPD.

 

Characteristics Checklist

(over-stimulated- sensory avoiding)

  • Overwhelmed by people & places; avoids large groups; appears to have social anxiety
  • Seeks out quiet spots in noisy, crowded environments; walks away to be alone
  • Startled by sudden noises; bells, sirens, horns, or vacuums can trigger crying & distress
  • Is bothered by bright lights, flashing lights, and florescent lights
  • Refuses to wear tight, itchy clothing; requires tags be cut out; prefers soft garments
  • Avoids touching people or hugging; bumping into someone may trigger a meltdown
  • Has a strong reaction to the texture or smell of certain foods
  • Refuses to try new foods and has a very limited diet of preferred foods
  • Gets upset about small changes in routine or environment; avoids new things or places
  • May have a difficult time toilet training
  • Hard to calm down; may have melt-downs, temper tantrums
  • Has poor balance causing accidents

(under-stimulated- sensory seeking)

  • Constantly feels of fabrics and objects; puts objects to the face to feel or even in the mouth
  • Plays roughly and takes physical risks
  • Has a high tolerance for pain; may not cry often
  • Often squirms, fidgets, and chews on things
  • Is constantly on the move, seemingly high level of energy
  • Invades other people’s personal space; stands to close when talking
  • Often gets distracted or feels anxious
  • Is clumsy and uncoordinated; has accidents

Sources:

Understood, Signs and Symptoms

STAR Institute, Checklist of Traits

Strategies

  1. Children with SPD need occupational therapy with a sensory integration approach that is individually developed according to his/her sensory needs.  The purpose of the therapy is to help them respond to stimuli in a more typical, appropriate manner. Listed below are some of the most common sensory therapies:
  2. The use of appropriate assistive technology can be extremely helpful: noise cancelling headsets, white noise machines, weighted blankets, sensory-friendly fidget toys, modified lighting, and glare reducing sun glasses.
  3. Introduce new foods slowly; keep foods separated on plate and only introduce one new food at a time.
  4. Create a personalized quiet space where he/she can go to calm down and reset.
  5. Set up an art station that suits your child’s preferences and encourage art.
  6. Carefully plan outings to prepare for over-stimulating environments. Use of social stories may be beneficial for some children before attending an event to prevent an inappropriate emotional response. Find helpful strategies on Teacher Pay Teachers.

TIP: Calming Place

I’ve seen many creative parents develop unique calming places that meet the needs of their child and restore peace to their home. In one family, the parents converted a small closet into an indoor sensory room that contained a lava lamp, a bean bag, a small fan, some fidget toys and plenty of books. Another parent discovered that her son preferred to squeeze himself between the couch cushions when he was emotionally stressed to provide needed pressure for soothing his anxiety. A third family built a reading platform (similar to a small tree house) equipped with plenty of large pillows, favorite stuffed animals, and picture books to provide privacy when their child needed to be alone. Be sure to talk with your child to determine what is calming, observe before and after meltdowns, and be creative in providing a personal calming place.

Resources

Profectum, provides education for parents, resources, webcasts Parent Tool Box

National Autism Resources, offers Tools, Products & Resources

The OT Toolbox is the best practical website for providing the ‘how to’ in teaching your child with SPD using the Tool Box

Understood provides explanation of various Treatments.

Skill 4 Life provides services, classes, a blog and website and app information.