Auditory Processing Disorder (APD) is a condition in which the brain does not process sounds in the normal way. APD can affect people of all ages, but often starts in childhood.
Is your child easily distracted? Do they find noisy environments upsetting? Is reading, writing and spelling a problem? Do they find it hard to follow conversations? These may be symptoms of an APD also known as Central Auditory Processing Disorder (CAPD).
Initially, it may appear that the child has a hearing loss, but this is usually ruled out by a simple hearing test. A child with APD struggles to register and make sense of what they hear and will require longer to process sounds, words and sentences. When children are looking, listening and learning from what they see and hear, children with APD are struggling to concentrate, understand speech and discriminate sounds, all of which may lead to frustration and anxiety.
A child who has APD may:
- Be easily distracted
- Become upset by loud or sudden noises
- Dislike noisy environments
- Behave and perform better in quieter settings
- Have difficulty following directions, whether simple or complicated
- Encounter problems with reading, spelling, writing or speech and language
- Find abstract information difficult to interpret
- Struggle with verbal instructions
- Be disorganised and forgetful
- Have difficulty following conversations
- Take a long time to process information.
Many of these may also appear in other conditions such as Attention Deficit Hyperactivity Disorder (ADHD), learning difficulties and even depression. For this reason APD is often misdiagnosed. But trained professionals, such as speech and language therapists and audiologists who specialise in APD, can determine if your child has APD.
APD’s causes are not fully understood. It may be genetic or in some case relate to early hearing difficulty from glue ear; in other cases it is linked with brain trauma or a traumatic birth. Some of the characteristics of APD are:
- Acoustic challenges: the child is unable to pay attention because of noise in the background. Noisy, highly stimulating classrooms can be very frustrating.
- Auditory memory problems: a child has difficulty remembering information such as directions, lists or study materials. Memory problems can exist on short-term basis (‘I can’t repeat it now’) and/or on a long-term basis (‘I can’t remember it when I need it for later’).
- Auditory discrimination problems: a child will have difficulty hearing the difference between sounds or words that are similar (coat/boat or ch/sh). This problem can be associated with emerging dyslexia.
- Auditory attention problems: a child is unable to maintain focus and listen long enough to complete a task or requirement (eg listening to a lesson in school). Health, motivation and attitude can also affect attention.
- Auditory planning and co-ordination problems: these relate to higher-level listening tasks. A child affected in this way will find it difficult to draw inferences from conversations, understand riddles or comprehend verbal problems.
Schools should be reminded that APD has a significant effect on a child’s learning and behaviour.
Professionals can help improve the school environment for a child with APD in a number of ways:
- A speech and language therapist can help with drawing up strategies.
- School staff should keep in regular contact with the parents regarding their child’s progress.
- The teacher should adapt the classroom environment, with the help of a professional’s advice on furnishings, stimulating décor, listening devices etc.
- Sitting towards the front of the classroom facing away from the windows will help concentration and minimise distraction.
- Ear defenders for use during private study, to eradicate outside noise.
How parents can help
- Reduce background noise.
- Make sure your child is looking at you when you are speaking.
- Use simple, expressive sentences.
- Allow for longer time to process what is said.
- Speak at a normal rate and at appropriate volume.
- Reinforce directions by highlighting key words.
- Check your child understands the directions and is not just repeating your words.
- Practise auditory memory skills, by using rehearsal (the child repeating back the information), using lists (1, 2, 3), visual cues (e.g. gestures), and mnemonics.
- For directions that are to be completed at a later time, writing notes, wearing a watch and maintaining and predictable routine in the household also help.
- Help your child to be organised.
- Provide your child with a quiet study place and sensory ear defenders, if necessary.
- A visual timetable to support auditory information about the child's day.
- Help your child understand that they can be actively involved in giving themselves the best chances, such as moving to a quieter place when listening is necessary and applyingn the strategies taught in speech and language therapy.