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What is APD?
Auditory Processing Disorder (APD), also commonly referred to as Central Auditory Processing Disorder (CAPD), is the inability to attend to, discriminate among or between, recognize, or understand auditory information. APD is a sensory processing deficit that commonly impacts listening, spoken language, comprehension, and learning. APD is associated with some sort of dysfunction within the central auditory nervous system.
Characteristics of APD
Two to three percent of the population of children are believed to have Auditory Processing Deficit with twice as many boys as girls being affected. Most children with APD have normal intelligence and normal hearing sensitivity, however they appear hearing impaired.
Children with APD exhibit several of these symptoms:
- Difficulty learning to read
- Poor reading and spelling skills
- Difficulties with phonics and speech sound discrimination
- Hear words incorrectly
- Difficulty telling sounds apart
- Saying “Huh or What”, “ I didn’t hear you”, or “I didn’t understand what you meant"
- Problems following directions, especially when complex
- Distracted by background noise
- Poor organization of verbal material
- Respond inconsistently or inappropriately to auditory information
- Difficulty attending to oral messages
- Oral and written expression problems
- Remembering what is heard
- Unable to learn songs or nursery rhymes and poor music and singing skills
- Unable to concentrate, or stay on task, and are easily distracted
- Delay in responding when participating in oral communication
- Often have a history of ear infections or were born prematurely
- Listening for extended periods
- Unable to locate sounds
The ASHA (American Speech-Language-Hearing Association) defined Auditory Processing Disorder (APD) in 1996 as a disorder with problems in one of the following six areas:
- Sound localization and lateralization (knowing where a sound source is located)
- Auditory discrimination (usually with reference to speech, but the ability to tell that one sound is different from another)
- Auditory pattern recognition (musical rhythms are one example of an auditory pattern)
- Temporal aspects of audition (auditory processing relies on making fine discriminations of timing changes in auditory input, especially differences in timing between the way input comes through one ear as opposed to the other)
- Auditory performance decrements with competing acoustic signals (listening in noise)
- Auditory performance decrements with degraded acoustic signals (listening to sounds that are muffled, missing information or for some reason not clear.)
APD, also referred to as central auditory processing disorder (CAPD), is diagnosed by an audiologist who has received specialized training in the evaluation of central auditory function. My goals for each individual are accomplished by an accurate diagnosis coupled with a treatment/therapy regime targeted to remediate the identified auditory processing deficits. A battery of normed tests is essential to assess the six areas of potential processing deficits, yielding a profile that outlines auditory strengths and weaknesses.
Northwest Auditory Processing Clinic selects a test battery that best meets the individual’s specific needs, based on clinical and professional experience, and most importantly, the unique needs of each client. An evaluation at Northwest Auditory Processing Clinic will include at least one test from each of these categories:
- Dichotic Tests - Dichotic tests present a different auditory stimulus to each ear simultaneously.
- Monaural Low-Redundancy Speech (MLRS) Tests - MLRS tests assess auditory closure, the listener’s ability to fill in and recognize an acoustic signal when parts of the signal are missing or by changing frequency, temporal or intensity characteristics.
- Temporal Processing Tests - Temporal processing tests measure the listener’s ability to recognize the order or pattern of nonverbal auditory signals.
- Binaural Interaction Tests - Binaural interaction tests assess “binaural fusion,” the listener’s ability to take incomplete information presented to each ear and fuse the information into an understandable signal.
Screening for APD
There are AP screening tests; however, auditory processing disorders cannot be identified from a screening test. The purpose of a screening is to determine if the child demonstrates age appropriate skills by passing the screening or whether results indicate the need for a diagnostic AP evaluation.
There are several commonly utilized screening tests which may be useful in suggesting the need for APD evaluation, but should be viewed cautiously as these tests do not address all four areas that encompass APD.
- Screening Test for Central Auditory Processing Disorders in Children (Scan-C)
- Screening Test for Central Auditory Processing Disorders in Adolescents and Adults (SCAN-A)
- Dichotic Digits Tests (DDT)
- Selective Auditory Attention Test (SAAT)
- Pediatric Speech Intelligibility Test (PSI)
- Test of Auditory Perceptual Skills (TAPS)
Treating Auditory Processing Disorders
Northwest Auditory Processing Clinic designs individualized treatment plans to address the specific areas of deficit identified in the APD evaluation. The successful management in the educational setting focuses on remediating the disorder, changing the environment, and improving the client’s listening and learning skills. Input to IEP goals and objectives, classroom accommodations, including strategies for the teacher, use of assistive devices and FM systems, are offered.
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