APD (Auditory Processing Disorder), sometimes called CAPD (Central Auditory Processing Disorder), is an auditory perception problem in which sounds and words cannot be accurately recognized or distinguished from one another. Because childhood development and appropriate functioning depend upon a child’s ability to use and understand language, APD can case multiple problems. Some of the characteristics of children with APD are listed below. Professionals who evaluate children for APD will typically look for such signs of the disorder (Johnstone, August 2008).
The diagnosis of APD requires that other conditions be ruled out. Information from parents, teachers and other caregivers is significant in helping professionals determine if a child has APD. Behaviors and conversation in the classroom, during school work and other typical activities can highlight APD related problems. Because such problems are caused by misunderstanding auditory information, diseases and disorders that affect hearing and language are typically considered. During the evaluation process, it is common for referrals to be made to audiologists (hearing specialists), otolaryngologists (neck and head specialists) or speech and language pathologists to help with diagnosis.
Other Conditions that Frequently Occur with Auditory Processing Disorder
There is evidence that APD often occurs along with other specific speech and language impairments and dyslexia (Dlouha, n.d.). Additionally, some research indicates that APD may also be present in some children who have ADHD, behavioral problems and autism (Moore, 2006). Many children with APD do have behavioral and emotional problems in reaction to prolonged, often chaotic interactions with others as well as from their frustrated attempts to perform tasks well and to behave appropriately. Some will experience motor co-ordination problems that interfere with the completion of daily activities and age-appropriate development.
The Impact of Auditory Processing Disorder upon Children and Their Families
Children with APD can require much support and assistance from their families daily. This can be very stressful for both the child and family members. Reading, writing and spelling are affected by this disorder and consequently, educational milestones are missed or partially completed. School and school work can become routine sources of stress and conflict. Additionally, difficulties with communication create social interactions that can be confusing, conflictual and misinterpreted. These often lead to isolation, feelings of rejection, frequent discipline and conflict. Consequently, children with Auditory Processing Disorder are at high risk for anxiety, depression, low self-esteem and multiple developmental problems. Their difficulties in understanding information and directions can cause them to appear defiant, oppositional or of a lower cognitive ability. Resulting social stigmatization can reinforce the child’s belief that he or she is ‘bad’ or not bright. This multitude of related issues frequently requires family members to become educated in ways to support and assist these children. Modifications in communication strategies, as well as in environmental conditions, are often necessary. These enhance the child’s ability to process auditory information and to reclaim developmental lags, but require families to learn and implement new strategies for assisting the child. Often an array of professionals are required to address multiple, associated problems. Families may find themselves in an intensive, often demanding regime of treatment that utilizes several modalities and professionals.
Treatment Options
Evaluation and treatment for APD is highly individualized for each child. Multiple appointments with professionals of different specialties are typical particularly during evaluation; however, it is also typical for treatment itself to involve more than one professional and more than one approach. Children will be exposed to a variety of settings, procedures and equipment during the evaluation and possibly within the course of treatment. An audiologist, for example, will typically administer several tests that require a sound-controlled room, electronic equipment and headsets. The child’s active participation is required in pushing buttons or signaling what is heard in some way. Other exams also require the child’s active interaction such as responding to spoken language or identifying a variety of sounds from different locations. Physical examinations of the ears, neck and head are typical. Some children benefit from the use of auditory trainers that are devices worn to reduce distracting sound. Acoustic changes within the classroom and home may be necessary to improve the child’s auditory processing. These changes can also involve the use of devices or other techniques to increase environmental sound control. Additionally, some children are given speech and language exercises to rehearse and many may work with therapists to retrain auditory processing and memory through structured exercises done in the therapist’s office. Auditory integration training is another mode of treatment in which children see a trained specialist who uses exercises to retrain the auditory system and decrease hearing distortion.
Dlouha, N. V. (n.d.). Central auditory processing disorder (CAPD) in children with specific language impairment. International Journal of Pediatric Otorhinolaryngology, 71:6 , 903-907.
Johnstone, P. M. (August 2008). Toward Evidence-Based Practice in the Auditory Processing Disorder Clinic. Perspectives on Audiology 4 , 9-14.
Moore, D. (2006). Auditory Processing Disorders: Acquisition and Treatment. ASHA Annual Convention Session 0432. Nottingham UK: http://www.docstoc.com/docs/522539/Auditory-Processing-Disorders-Acquisition--Treatment.
Autism Spectrum Disorders (ASD)