Could Your Child Have Auditory Processing Disorder?

Does your child struggle to block out background noise, follow conversations or pronounce words correctly? Is she hypersensitive to sound? She may have an auditory processing disorder in addition to (or mistaken for) ADHD.

Henry is fidgety and distractible during classroom activities, according to his second grade teacher. During gym class, he’s hypersensitive. He gets cranky and lashes out at classmates who “are yelling at me and telling me what to do.” His mother has noticed similar behaviours at home. When he’s doing homework, she says, “He uses every little sound as an excuse to delay getting down to work.” Even the dishwasher distracts him, despite the fact that the kitchen is on the other side of the house. “He just can’t sit still.”

This sounds like a classic attention deficit disorder (ADD ADHD) profile, right? Well, yes and no. Henry does have ADHD, but an audiologist has also diagnosed him with something called auditory processing disorder(APD).

Do you hear what they hear? While APD isn’t as well documented as ADHD, it is becoming increasingly common. Roughly 7 percent of children have some type of auditory processing difficulty. Does Your Child Avoid the Jungle Gym? Or Cringe at Loud Noises? It Could be SPD. But what is it exactly? At its most general, APD is a glitch in the brain’s ability to filter and process sounds and words. An APD child doesn’t have difficulty hearing, in fact, in most cases, her hearing is good. Rather, her brain perceives the sounds incorrectly, affecting the child’s ability to distinguish between similar sounds (da and ga, for example). Some children with APD also have trouble screening out background noise, so they pick up bits of surrounding sounds. The echo in a gymnasium or the hum of the air conditioner in the classroom interferes with the conversation at hand. It’s like listening to the radio with interference from other stations garbling the reception.

A child with the disorder typically tries so hard to understand what’s being said that she forgets parts of the conversation or doesn’t pick up on the nuances or subtleties of the words. Combine APD with ADHD, and a child’s abilities to listen and remember are severely compromised.

Just as APD can affect a child’s ability to focus, so an attention deficit can affect auditory processing. Symptoms of the two disorders often overlap. Studies suggest that 50 percent of those diagnosed with ADHD may also have APD. Experts continue to disagree whether APD is a manifestation of ADHD, or if they are separate disorders.

“Children with ADHD may be poor listeners and have difficulty understanding or remembering verbal information,” explains Teri James Bellis, author of When the Brain Can’t Hear, but “it is the attention deficit that is impeding their ability to access or to use the auditory information that is coming in,” not the processing of it in the brain.

“Not all language problems are due to APD, and not all cases of APD lead to language and learning problems,” cautions Bellis. APD isn’t diagnosed by checking off a laundry list of symptoms.

The only way to diagnose the condition is with a battery of tests, performed by an audiologist who monitors the child’s hearing. A child listens to words and sentences as background noise is slowly increased and to instructions spoken at faster speeds, to determine if the ability to listen decreases. When a child reaches school age, however, Tepfer advises that APD may begin to compromise academic success. “At that age, I would recommend evaluation for APD,” she says, “because now, it’s not only the language but also his performance in the classroom. To manage the disorder, the student may need remediations other than speech and language therapy. A full evaluation will help you know what those are.”

APD can be treated from childhood through adolescence, when the auditory pathways stop developing and even later, although experts agree that the earlier the diagnosis and treatment, the better. As with ADHD, a combination of professional, school, and home therapies is most effective.

Treatment includes a wide variety of exercises that target specific auditory deficits. Here are some common approaches:

  • To overcome sound discrimination problem, a professional trains the child’s brain to differentiate sounds — first in a quiet environment, then with increasingly louder background noise.
  • To sharpen auditory memory, an audiologist uses sequencing routines — having the child repeat a series of numbers and directions — to exercise the listening “muscles.”
  • To manage language-processing problems, a therapist will train and encourage a child to ask a teacher, adult, or peer to repeat or rephrase an instruction or comment. The therapist and child might also work on developing a customized note-taking system that enables him to capture the information being taught in the classroom.

The following tips will increase your child’s ability to listen when he or she is at home:

  • Don’t try to have a significant conversation when your child is in another room, watching television, or listening to music – or when an appliance is running.
  • Before you start a conversation, be sure your child is ready to listen (finished with what she was doing). Also, face her directly and make sure she’s looking at you.
  • Speak slowly and use simple, short sentences; pause between ideas.
  • Encourage your child to ask you to repeat something that he doesn’t understand.