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 also not a lack of intelligence or 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 cake when someone says rake
  • Has difficulty understanding what is said, especially in loud places, where multiple people are talking
  • 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, 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, 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, steps for doing laundry in laundry room).
  4. Break instructions into small incremental steps, allowing child to complete one 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 as 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 Assistive Technology for APD.
  9. Many of the same strategies used with ADHD are helpful for children with APD.

TIP: Quiet Communication

The most valuable tip for living with and teaching a child with APD, is to minimize noise when talking, studying, and instructing. Television, radio, computers, and talking in the same room produce background noises that make it impossible for the person with APD to hear individual words spoken. Voices sounds more like a distant rumble. Having a conversation in a noisy restaurant, shopping mall, theater, or other busy environment is fruitless, frustrating to both parties. Train yourself to be aware of this issue and provide a quiet place when you want your 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

Sensory Processing Disorder (SPD)

Often children with SPD are mistakenly viewed as behavior problems or misfits 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 characteristic of autism, ADHD, and gifted. Unfortunately, children are sometimes diagnosed and medicated for ADHD, when in fact they have SPD. Locate a neuropsychologist, medical doctor, or occupational therapist to determine if your child is struggling with sensory processing disorder. Star Institute; American Academy of Family Physicians

Characteristics Checklist

(over-stimulated or sensory avoiding)

  • Easily overwhelmed by people and places; avoids large groups; may appear to have social anxiety
  • Seeks out quiet spots in noisy, crowded environments; tends to walk away to be alone
  • Is easily startled by sudden noises; bells, sirens, horns, and vacuum cleaners can trigger crying & distress
  • Is bothered by bright lights, flashing lights, and florescent lights
  • Refuses to wear tight or itchy clothing; requires tags to be cut out; prefers soft, worn out garments
  • Avoids touching people or hugging them
  • Has a strong reaction to the texture or smell of certain foods; can’t eat many foods because of texture
  • Refuses to try new foods and has a very limited diet of preferred foods
  • Gets upset about small changes in routine or environment and avoids trying new things
  • May have a difficult time toilet training
  • Hard to calm down; may have melt-downs, temper tantrums
  • Has poor balance causing accidents

(under-stimulated or sensory seeking)

  • Constantly touches objects, feels of fabrics, puts objects to the face to feel of it or even in their 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 to talk
  • Often gets distracted or feels anxious
  • Is clumsy and uncoordinated; has accidents

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. Use 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, Teacher Pay Teachers.

TIP: Calming Place

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, 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