Auditory Processing Disorder

Auditory processing is the brain’s ability to accurately perceive speech in both quiet and noisy settings. The brain can detect and analyze small differences in pitch, loudness, and duration. Some children with normal hearing have difficulty with this ability, leading to problems with discriminating speech. This is a (central) auditory processing disorder or (C)APD. (C)APD can impact the listener’s ability to develop language, succeed academically, and/or communicate effectively.

• Trouble hearing background noise
• Difficulty figuring out where sound is coming from
• Seems distracted or inattentive in noisy environments
• Mishearing words or similar sounds
• Asking for repetition often
• Academic issues, including single word reading, reading by phonics, spelling
• Difficulty following multistep instructions provided orally
• Difficulty with auditory nonverbal information, such as detecting sarcasm and understanding jokes
• A lack of music appreciation, or child speaks without inflection

Auditory processing does not include:

• Comprehension of spoken language
• Higher-level language skills, such as inferencing or abstract thinking
• Organization, retrieval, or formulation of language
• Attention disorders

The cause of a child’s auditory processing disorder is often unknown, and research into risk factors for (C)APD is currently ongoing through Boston Children’s Auditory Processing Service. Evidence suggests the following can be associated with a higher risk for (C)APD, although not everyone with these conditions will have auditory issues:

• Chronic middle ear infections
• Concussions or head injuries
• Neurological issues and seizures
• Lyme disease
• Lead poisoning
• Genetic factors: (C)APD may run in families.
   

Audiologists are uniquely trained to administer specific diagnostic tests to diagnose (C)APD. These tests are designed to assess the maturity of the auditory neural pathways, from ear to brain, with performance compared to age based normative data. History information is collected and includes results of other/multidisciplinary assessment to assist with differential diagnosis. Testing includes assessment of hearing sensitivity.

Diagnosis should be individualized, with the nature of disorder based on patterns of performance. Performance may be monitored over time as the neural pathways mature.

• Environmental accommodations: Classroom modifications recommended to improve access to auditorily presented information. These physical accommodations are intended to reduce the adverse effects of noise and reverberation on the speech signal.
• Compensatory or listener strategies: recommendations designed to teach the child strategies to strengthen access to verbal information
• Hearing assistive technology: formerly known as FM systems, these devices are designed to improve the signal coming from the teacher and reduce the interference from background noise
• Direct treatment: computer assisted training programs

To begin the intake process and schedule an appointment, call 617-355-6042.