Auditory Processing Disorder

Some children with normal hearing may appear to not hear what is being said to them because their brains may be unable to appropriately change the incoming sounds into meaningful information. This condition is known as auditory processing disorder (APD).

When sound enters the ear canal, the eardrum moves and the bones within the ear vibrate. This vibration causes the sound to amplify 27 times greater than when it first entered the ear canal. The amplified sound causes fluid to wave in the cochlea, making small hair cells in the cochlea move. The movement of these cells sends electrical impulses to the brain, which translates the sound into meaningful information.

In children with APD, something interferes with the translation part of this process. They might have difficulty distinguishing subtle differences between sounds, even though they are actually hearing the sounds clearly. If you ask, “How are a couch and a chair alike?” the child with APD might interpret the question as, “How are a cow and a hair alike?” Obviously, the two questions would elicit very different answers.

Symptoms

APD often presents itself more strongly when the child is in a noisy environment or is listening to complex information. Other symptoms of APD include:

• Difficulty paying attention to and recalling information presented orally
• Trouble following multi-step directions
• Poor listening skills
• Needs more time to process information
• Low academic performance
• Behavior problems
• Difficulty with reading, comprehension, spelling, vocabulary and language usage

Diagnosis and Treatment

APD can be difficult to diagnose, and generally diagnosis is made after a child reaches at least 5 years of age. Hearing loss and attention deficit disorder must be ruled out. An ENT and an audiologist, who specializes in the diagnosis and treatment of hearing issues, work together to diagnose APD.

Treatment can include environmental modifications, such as the use of earphones to reduce background noise, different seating in the classroom and the use of written instructions in addition to verbal commands. Children with APD can also be taught learning strategies that help them increase their language base and auditory memory.