Why an Auditory Processing Disorder Diagnosis Can Be Good News
May 11, 2015 by Geoff Nixon
Because APD causes rather than coexists with other issues, the way forward is simpler than you might think.
Parents often panic when they receive their child’s clinical evaluation. More often than not the list of difficulties is scary long: weak working memory, executive attention concerns, hints of dyslexia, dysgraphia, etc., etc.
However, evaluations identify difficulties, not necessarily problems. This is particularly relevant to an auditory processing disorder diagnosis where there are often many symptoms or difficulties, but only one problem, the underlying APD. It’s not unlike an evaluation for a broken ankle — it comes back as having difficulty walking, running, jumping, twisting, etc., but really there’s only one problem, the broken ankle.
In a general cognitive screening, different parts of the evaluation target different skills with skills tested one at a time — working memory, impulsivity, focus, sequencing, vocabulary, reading, etc.
Similarly, parents tend to attribute certain behaviors in their children to delays in one skill or another with the idea that each skill deficit represents a separate problem. It doesn’t help that cognitive evaluations almost always highlight many different issues — maybe if they don’t find anything, clients won’t think they got their money’s worth? — and so these various weaknesses or symptoms are presented in a sometimes scary long list.
The mistake many parents make is that the think of each weakness as a different problem to solve. In the case of auditory processing disorder these apparently very different symptoms are almost always related, and it is the diagnosis of auditory processing disorder that is the common theme.
Auditory Processing Delays Have Common Themes
A study done in the Lancashire Children’s Hospital in the UK investigated the role of attention, cognition, memory, processing speed, speech, and non-speech auditory processing in children with an auditory processing disorder diagnosis. In their in-depth evaluation of 110 children, in all cases, there were multiple conditions. For instance auditory processing disorder and working memory issues or auditory processing disorder and executive attention.
In fact, at least one of these two cognitive skill delays — working memory and attention — was almost always present where there is suspected auditory processing disorder.
Given the common co-existence (or co-morbidity in clinic-speak) of an auditory processing disorder diagnosis and other skill delays, there has to be more to the story and recurring coincidences in child after child.
While these deficits or symptoms may be presented in parallel — separate symptoms, separate problems — in reality, one causes the other. Auditory processing disorder causes delays in development of other cognitive skills.
Auditory processing is the skill that determines how well you listen at an early age — the primary source of all early learning — and how well you read later on. The English language uses phonemes, tiny syllables, that require lightning fast language processing to be heard accurately. Auditory processing delays are actually quite widespread and far and away the most common source of language, learning and reading problems.
Because of its crucial role in language processing, it is not surprising that it can cause a wide range of other reading and learning (which requires listening and reading) difficulties. More often than not, auditory processing disorder remains undetected or undiagnosed in children with reading or learning difficulties.
How Auditory Processing Disorder Causes Other Difficulties
Auditory Processing and Working Memory
Listening with auditory processing disorder has been likened to listening to sound through water. The words are muddy at best and impossible to understand at worst.
This means children with an auditory processing disorder diagnosis do not practice building working memory — the transient holding and manipulating of information — because they don’t capture clear information to hold or manipulate. Without practice, working memory skills do not develop as they should. Hence the common occurrence of auditory processing disorder with working memory problems.
In fact, this co-occurrence is so common that Fast ForWord, our auditory processing disorder treatment, assumes a related weakness in working memory and exercises it from the outset.
Auditory Processing and Attention
Listening with an auditory processing disorder diagnosis is a chore, it’s exhausting. These children are working so hard on listening, they don’t get to experience what it’s like to sit in class and focus comfortably. They don’t learn how to shut out distractions, how to avoid being impulsive or how to attend for long periods because they are totally preoccupied with trying to listen.
As with working memory, attention difficulties are not only common in children with auditory processing disorder, they are almost expected because APD undermines a child’s opportunity to practice paying attention.
As with working memory, our Fast ForWord program which first and foremost is an auditory processing software, exercises focus skills at the same time as it builds auditory processing skills.
Auditory Processing and Reading
Reading is a language skill. If a child is unable to break a word down into its component sounds, that word will be difficult to recognize on a page. This is phonemic awareness, the most essential of foundational reading skills. Delays in phonemic awareness almost always exist where there is an auditory processing disorder diagnosis.
Auditory Processing and Language
Children with an auditory processing disorder diagnosis tend to have smaller vocabularies than other children. This is because they are not able to hear words clearly enough to use them in their own conversation or if they are used they are mispronounced or misused. Grammar and language syntax are often delayed also with an auditory processing disorder. Observing rules of language requires the ability to recognize differences in spoken language according to different tenses and sentence structures, etc. This requires listening to be automatic, freeing up thinking capacity for this level of observation.
Fix one difficulty to help all
Parents are often over-whelmed when they receive a cognitive evaluation of their child. The list of difficulties is long and the task of improving them all seems over-whelming.
Our message is that, while your laundry list of symptoms may name several problems, the chances are there is only one, an auditory processing disorder diagnosis.
This can be thought of as good news for two reasons:
- Auditory processing is a skill that can be changed, rewired, improved
- The other symptoms on the list are most likely caused by APD.
Once you improve auditory processing, many of these other symptoms will resolve themselves. APD is a glitch in learning development. Resolve that glitch and normal cognitive, language and learning development will resume.
And yes, auditory processing is a cognitive skill that most certainly can be exercised and improved. It’s what we do at Gemm Learning. Our client endorsements show that gains in auditory processing are possible and can have far reaching positive effects for students of all ages.