Auditory Processing Difficulties and Disorders (APD), and their treatment

People who have normal hearing actually hear far more than they perceive. Where hearing is a function of the ear, auditory processing - listening - is a function of the brain. Auditory processing describes the way the brain assigns significance and meaning to the sounds in the environment. Effective auditory processing involves a relatively high speed of information transfer. It also requires a good attention span, a well-functioning memory, and sensitivity to the many subtleties of sound. When parts of this complex system break down or don't operate efficiently, listening is compromised. All the ensuing problems are collectively known as Auditory Processing Disorders (APD).

Many children with APD have a family history of auditory difficulties or partial deafness. In addition, there are some developmental issues that have been shown to have a relationship to APD. These include a complicated birth, childhood ear infections or colds, glue ear, allergies, or a slow speech development. Some children have early experiences with sound that involve either a lack of auditory stimulation or a noisy environment. These children may have learnt to be discouraged by listening, while others block out aggressive sound if they are hypersensitive to certain frequencies. Clearly not all children who fall into the categories mentioned develop APD, but many children with the disorder have experienced at least one of these issues.

The Victorian Department of Education, Employment and Training defines auditory processing as the ability to 'hold, sequence and process' auditory information. Auditory processing is the system that transfers and decodes what we hear into what we understand. It is, in effect, the wiring between hearing and understanding. The ear and the brain communicate with each other, not unlike two people having a conversation on a mobile phone. If there is any kind of interference on the line, the reception of the given message will be compromised. The line may cut in and out, there may be a small time delay, or there may be a lot of background noise. Where one type of interference may cause distraction, another may cause frustration, misunderstanding or confusion.

This is precisely what happens with auditory processing. Depending on the type of processing dysfunction, different problems will emerge. Ideally, auditory processing should enable people to decode auditory signals as they are delivered, integrate auditory information with other environmental cues, organise this in a meaningful way, screen incoming auditory information to sort the relevant from the irrelevant, and lastly to associate sounds with written language.

It is impossible to isolate the components of this system or to consider that any sensory system only affects its specific domain. How we make use of auditory information is a complex and interdependent network of hearing, listening, and the brain's processing of information to produce appropriate responses. Without this ability, relationships, learning and development are all challenged.

Auditory processing disorder is often present from early childhood, leading to a number of difficulties as the child becomes older and messages become complex and are given more quickly. This may manifest as poor auditory comprehension, delayed language development, poor expressive and receptive language or high distractibility, though many other symptoms are also noticed. Auditory processing problems are a feature of many other disorders, including autism, dyslexia, learning disabilities, dyspraxia, Asperger's syndrome, developmental and speech delay, and attention deficit disorder with or without hyperactivity (ADD or ADHD).

Auditory Processing Disorder often leads to the deterioration of behaviour as a result of poor expressive and receptive communication. As children experience the discouragement of being misunderstood and the frustration of misunderstanding others, they become more disconnected from their environment and the people around them.

Learn about Auditory Processing Disorder and its treatment at our website www.auditoryprocessing.com.au.

THE EAR AND LISTENING

The ear is most commonly regarded as a hearing mechanism. In fact, the inner ear comprises two organs - the cochlea and the vestibule. The cochlea is responsible for perceiving and analysing all external sounds in the environment including language, while the vestibule operates as an integrative mechanism for all the sensory information received by the body as well as maintaining posture and balance. Given that the cochlea and vestibule share some anatomical components, it is no surprise that a person with poor auditory processing often does not only have trouble processing auditory information (cochlea), but also has poor motor skills and balance (vestibule). Although we most often credit it as purely a hearing device, the ear is actually at the core of basic functioning.

Some children are more attentive to bone conducted sounds. They primarily listen with their body instead of with their ears. These individuals have difficulties in dampening the sound intensity and to filter out irrelevant sounds. This may be one of the reasons why individuals are hyper sensitive to sound as they may have lost the ability to focus and tune out extraneous background noise. In this situation, every noise has the same amount of importance. Capturing a word may be difficult as ambient noise distracts from focusing. As a result, the child misses part of the conversation or instruction being given.

It is important to note that APD, while not curable, is treatable. Auditory Processing Disorder is frequently treated with a range of one-on-one interventions such as speech therapy or reading recovery. It can also be treated through sound stimulation combined with audio-vocal training. The Tomatis Method is the most highly regarded auditory training program.

TOMATIS LISTENING PROGRAM

Dr Alfred Tomatis, a French physician, developed the Tomatis Method of auditory training about fifty years ago. The Method is founded on the principle known as the Tomatis Effect: that the voice produces what the ear hears. If the ear does not perceive words or sounds accurately, it will not be possible to reproduce language effectively. The Tomatis Method involves listening to specially modified music through headphones that replicate the function of an ideal ear, and the music is manipulated in such a way that it stimulates the cochlea and vestibule. In this way, the Tomatis Method both strengthens the auditory system and improves the quality of sound perceived by the ear.

When completing the listening program, children and their mothers complete various language and motor tasks, and use microphones so that their voices are integrated into the listening process. The important thing to realise is that the Tomatis Method improves auditory processing with respect to language. The use of microphones with filtration of the voice trains the listener to receive and produce language signals more effectively.

The Tomatis Method has shown to improve substantially auditory processing difficulties, by ameliorating auditory sequential memory difficulties, the ability to distinguish speech against a variety of background noises and thus listening, as well as assisting in the acquisition of phonemic discrimination and phonological awareness.

Learn more about the Tomatis Listening Program.

FAST FORWORD PROGRAM

Fast ForWord comprises of a series of software programs training exercises, presented as a game that use levels of acoustically modified speech to re-train the auditory system. The exercises are designed to help children recognize word sounds first in isolation, then in groups of sounds, words and finally sentences. The exercise schedule is intense and consists of 100 minutes per day, five days per week, for four to eight weeks and is a home base program that requires professional and parent supervision.

Studies indicate that at risk students trained with Fast ForWord program make an average one to two year gains after four to eight weeks of training.

Learn more about the Fast Forword Program.

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