A Battle Between the Brain and Sound

Auditory Processing Disorder: an auditory deficit that affects the way in which the central nervous system uses auditory information, influencing a person’s ability to attend, understand, and remember information (American Speech Language-Hearing Association)

So what does this mean and who does this affect?

In simpler terms, this describes an interference between the brain when it recognizes and interprets the surrounding sounds. A common challenge experienced by those who have auditory processing disorder (APD) is recognizing subtle differences between sounds, even if those sounds are loud and clear. For example, the request, “Tell me how the chair and a couch are alike” may be interpreted as “Tell me how the couch and the chair are alike” or as, “Tell me how the cow and the hair are alike.”

Out of the school-age population, APD affects between five and seven percent of students and is commonly misdiagnosed as a learning disability. In cases where APD is suspected, children are often evaluated by an audiologist and speech-language pathologist in order to measure hearing acuity along with possible auditory perception problems in regards to receptive and expressive language. This commonly affects students in large group settings (e.g., the classroom), where then there is background noise (e.g., the playground), and when given a series of directions. These are all very common encounters throughout the school day.

Luckily, there are treatment approaches as APD presents multiple challenges in regards to a child’s learning environment. One training approach focuses on auditory discrimination (e.g., deciphering between “peas” and “bees”), localizing sound, sequencing sounds, or identifying target sounds in noisy backgrounds. Because it is important to train these skills in regards to more complex language environments, another approach teachers functional language skills (e.g., vocabulary, grammar, conversation skills) and uses strategies (e.g., visual aids and repeating directions) to assist this language processing.

My first experience with APD was about a year and a half ago when I was shadowing a speech-language pathologist in a private practice setting. One of the intervention sessions that I observed was with a high school student who had APD. She would practice sound discrimination, word discrimination, and picking phrases out of environments where there were multiple voices or distractions. She mentioned that she struggled the most in highly populated environments like school hallways, the lunchroom, and on the bus, and consequently, the speech-language pathologist worked to train her processing by playing faint conversations in the background as they worked to identify target sounds. I was intrigued by this intervention technique and how it was specifically targeted towards the environments that she struggled most in.

According to the American Speech Language-Hearing Association, there are accommodations within the classroom that can create a more positive and effective learning environment for the student. These can include: selecting a seat away from auditory and visual distractions, reducing unnecessary visual and auditory stimuli in the classroom (e.g., posters, bulletin boards, noisy pencil sharpeners), looking into technology devices that can transmit sound directly from the teacher to the student, and being aware of the clarity of speech and directions within the classroom.

By creating an awareness of APD and targeting strategies to assist those diagnosed with this processing disorder, students can maximize intervention opportunities and perform to their best ability within the classroom. In terms of literacy, this commonly affects spelling and reading, while these challenges can be compensated with adaptive strategies. It is important to diagnose these problems early on in order to maximize intervention and auditory training.

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