Can anyone clue me in on auditory processing disorders?

Hasil72

DIS Veteran
Joined
Apr 21, 2006
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I'm hoping someone can help me out with this situation. DD is 5 and has failed her hearing test at every annual check-up at the pediatrician. Last year they referred us to an audiologist at a local children's hospital (CHOP) because of the failures and the fact that I pointed out to them that she has had multiple infections in the left ear. Additionally, I was concerned that she requires the TV or radio louder than most to hear it clearly and that when we are driving in the car where she is seated behind me, sometimes it takes several repetitions before she grasps certain words. For example, they were working on a local road recently and DD asked what they were doing. I told her they were PAVING the road. She asked (more than once), They're SHAVING the road??? Once I turned to face her and repeated it, she finally got it. Regardless, CHOP docs said that all is well.

Another check-up, another failed hearing test. Pediatrician wants us to go back to CHOP. I asked about it being an auditory processing disorder. They told me that they can't test for that until she's around 7. My DS's case manager confirmed that most school districts won't test for that until the end of first grade. Why is that?

The only reason I ask is because she is a young 5 with a September birthday (just makes the cutoff) so we have her in a Kindergarten program through her daycare and are trying to decide if she should start first grade at our local public school next school year. She's not struggling but appears to be behind the others. I'm wondering if she is frustrated by not hearing clearly or what the teacher is saying in it's entirety hence, not grasping all the concepts.

Anyone have any personal experience with auditory processing that can tell me what to look for? How to proceed?

Thanks for any input.
 
Yahoo has a group on auditory processing disorders. They have some audiologists on it as well. It's a fairly active group. You'll get a lot of information there.

Yes, it's true that they don't normally test for it until around 7. It's a tricky thing to be able to Dx, apparently.
 
http://www.nidcd.nih.gov/health/voice/auditory.asp

You will need to know if the problem is in the ears themselves or in the brain. In school they thought I had hearing problems but I passed tests. The problem was that the tests were of beeps not vowels and words. It does see she has APD to some extent. Do not delay getting her into school as you need the kid in the system as soon as possible.

Read up on APD everything you can that is conventional and unconventional. Even with out an official label the kid can be helped at home by you through information at various sites. My mother is undiagnosed HSD/SID/SPD so I studied everything I can about neurovariations and sensitivity issues.

It may not be official but what if you were living in the boondocks of China as missionaries and had no help except what is online. In that case you would be writing friends who would be in the libraries researching for you and you would read up on the subject all without fancy clinicians and doctors.

Big hugs and chocolates
Laurie:hug:
 

http://www.nidcd.nih.gov/health/voice/auditory.asp

You will need to know if the problem is in the ears themselves or in the brain. In school they thought I had hearing problems but I passed tests. The problem was that the tests were of beeps not vowels and words. It does see she has APD to some extent. Do not delay getting her into school as you need the kid in the system as soon as possible.

Read up on APD everything you can that is conventional and unconventional. Even with out an official label the kid can be helped at home by you through information at various sites. My mother is undiagnosed HSD/SID/SPD so I studied everything I can about neurovariations and sensitivity issues.

It may not be official but what if you were living in the boondocks of China as missionaries and had no help except what is online. In that case you would be writing friends who would be in the libraries researching for you and you would read up on the subject all without fancy clinicians and doctors.

Big hugs and chocolates
Laurie:hug:

Thanks Laurie!

That's my point. Sure if you lock her in a sound proof booth with headphones she's going to hear you but what about when she's in a room four times that size with 20 other students, a loud HVAC system, etc. and the teacher is talking from the other side of the room? I had her evaluated by our child study team way back when (I think she was 3) only because she had early intervention for motor skills delays and DS is on the spectrum so I had no idea what to expect from a NT child i.e. what was NT age appropriate.

Without a doubt she will be ADHD dx'd at some point in time. They said that she was age appropriate but I at least have her on the radar for when she does go to "the big school" with DS. We would have sent her there for K but it's only 2 hours a day and she would have to switch daycare facilities and have 4 different sets of people handling her through the day (1-early am, 1-mid-day, 1@K Plus bus drivers, and 1-late day). That would be enough to make me meltdown. So we kept her where she has been since I had to go back to work FT.

I'll continue searching the web just like I did w/DS. Lucky for me, the Dir. of Curriculum in our district used to be the Principal at DS's school and she has provided me with a ton of materials to help encourage DD and help her get ready for 1st grade.
 
As has been said auditory processing is very different from “hearing” although obviously the 2 are closely linked.

A good audiologist can generally identify any hearing deficits relatively quickly in verbal children.

Auditory processing is about how the brain “uses and processed” this auditory information.

When there are variations or deficits in both areas the difficulties can increase greatly.

Often the auditory processing issues are related to executive function differentials, and in the case of individuals with significant autism spectrum indications an independent diagnosis of auditory processing is not considered “appropriate”.

In the case of the “misunderstanding” paving, this may come from a hearing deficit, an differential in ability to put the word in context (since often we do not here complete word and phrases, but fill in the blanks by context), or EF processing differential (typically linear vs non linear especially the impact it has on short term memory), and often some combination of all three.

It is important to include a broader family medical history (especially your DS) when working with clinicians (especially the clinicians who do the auditory processing evaluation) on this issue, so they can explore all the possibilities.

There should be no problem with a highly trained clinician to be able to do a useful evaluation at your daughter’s age, although often they want to repeat it at 7 or 8

bookwormde
 
DStep-son13 has an auditory processing disorder. He was diagnosed around your daughter's age (in Kindergarten) at Children's Hospital in Boston. His speech was very delayed. As a baby, he did not babble: no da,da,da ba,ba,ba etc... When he finally did speak, he was only able to utter one syllable, never 2. (ju for juice, da for daddy, tee for kitty etc...) He was about 3 1/2 before he could say more than 1 syllable for a word. Eventually, his speech caught up but he continued to say a number of words wrong (ex. lellow for yellow) well into elementary school. He received speech services from 2 years old until 5th grade. Learning to read was VERY difficult for him.

He did not have any trouble hearing the radio or T.V. and did not need them louder than anyone else. However, it was very difficult for him to distinguish sounds in places with bad acoustics. For example, he plays hockey and when he was younger it was often perceived that he wasn't listening to the coaches when he in fact couldn't process the language in that environment. The cafeteria and gymnasium were overwhelming as well.

Another area of great difficulty is mult-step directions. Because his mind is working to process the first direction, he misses others. Once he learned to talk, having him repeat back the directions one at a time helped with this.

He is now in 7th grade and has learned how to cope with his disabilities. (He also has mild ADHD) He no longer receives any type of special ed services and is doing well.

Good luck in your quest to help your daughter. You know her best. Would you believe that when DS's mom brought him to EI at 2 for a speech eval, they initially told her he wasn't talking becasue she wasn't a good parent and wasn't talking to him enough! Ugh!
 
We are sort of in a similar situation. DS5 is currently in kindergarten and I suspect he has APD. I have spoken to his pediatrician and she agrees that I should approach the school and ask that they evaluate him. We meet with his teacher on Monday and hope to meet with the principal later this week. I want the school to evaluate him before year's end so that we have a plan for 1st grade. He is doing fine so far but is very sensitive/emotional and gets easily frustrated. He doesn't seem to listen well and I can picture the teacher giving a set of instructions and he will do the first thing and then not know what else to do.

For a list of audiologists who diagnose APD in NJ, check this out:

http://www.ncapd.org/php/index.php?menuoption=NJ
 
My daughter has an APD--she passed every hearing test--she could actually hear MORE than most people. She could hear the noise that automatic doors make! The doctors got so sick of me telling them something was wrong...they'd do a hearing test and say she was fine. She also has mild CP, so they'd blow off what I was telling them....just a paranoid mother.:rotfl2:

I knew something wasn't right--if you told her to go take out the trash then go eat a cookie, and then she could go to her friend's house...... She'd just take out the trash---she was getting the first part of what was said, but not the rest. Finally when she was in sixth grade, she was visiting a pediatric internist for some other problems and he asked if there was anything else. I told him he would think I was crazy just like all the other doctors, but there was. I explained what was happening. He said those words every mother wants to hear, "You're not crazy, I think I know what is wrong.":thumbsup2 It turns out that he had APD and when she got the right type of testing, the problem was identified. BTW she is 41 and has 2 college degrees, so don't give up!
 
There should be no problem with a highly trained clinician to be able to do a useful evaluation at your daughter’s age, although often they want to repeat it at 7 or 8

bookwormde

Can you please tell me (as someone trained in hearing, language and speech disorders) what testing is available for preschoolers with APD???

I have not found a single assessment, despite weeks of searching, researching and asking every professional I know. I am very interested what this "evaluation" entails. Additionally, there is no treatment protocol until the age of 5 at the earliest that I know of.

Please tell me where I can send this parent! I can't show a significant weakness through standardized language testing (16th percentile... low but not low enough) so the child won't continue receiving speech and language services.
 
Thanks all of you. Yet again bookwormde, you have provided great insight.

I'm torn between the two because on one hand, I believe that there is some hearing loss in the one ear from repeated infections and perforation of the ear drum yet when the audiologist puts her in the box, she tests fine. So if she has trouble hearing in the classroom and spends her time trying to distinguish the correct sound, do we chalk it up to hearing loss or processing? Obviously a question I will pose again to the audiologist.

Do you think I should go back to Children's Hosital of Philadelphia (CHOP) or seek a different audiologist for a new evaluation.

Thank you again for the links!
 












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