How to detect a selective attention difficulty related to APD
…if you focus on the underlying skills needed to process speech when it’s spoken in a noisy environment, you’re on the right track.
What parents sometimes call selective hearing, is oftentimes selective attention. It’s a lapse in dichotic listening skills, the ability to accurately identify what’s heard when different sounds hit each ear at the same time.
For many children, this is a challenging skill to master. And therefore, there are lapses. Not picking up parent instructions, while listening to music. Keeping up with what his friends are saying, when there are things going on in the playground. It’s about being able to discern which is the background noise and tune that out to focus on what needs to be heard.
Getting a listening test
If you suspect an issue, called a binaural integration deficit or auditory divided attention, there are tests available. It all falls under the auditory processing disorder (APD) label. It’s about processing, ‘what we do with what we hear.’ The broad set of skills that come into play to do auditory processing successfully include attention, memory, cognition, hearing and more. It creates difficulties with language, learning, and reading.
A peripheral hearing exam is worth doing, but a (Central) Auditory Processing evaluation such as a dichotic listening test is a better bet. The American Academy of Audiology recommends a range of tests including the Digits Test.
Dichotic listening tests allow insights into the central auditory nervous system function. They also identify specific processes that may be deficient, say researchers Annette Hurley and Cassandra Billiet from the School of Allied Health Professions at the Louisiana State University Health Sciences Center.
A dichotic listening test with about 40 items – consonant vowel syllables – allows for more precision in the diagnosis. The test presents the listener with different stimuli in each ear at the same time. They then have to repeat what they’ve heard. Ideally, they’ll be a retest over time for the results to be valid.
So, what are the option if a dichotic listening test suggests an issue?
Neuroscience is a key to catching up
Advances in neuroscience have shown intensive training as an intervention works. The key here is the role of auditory plasticity to produce behavioral change, according to the American Academy of Audiology Clinical Practice Guidelines.
Such an intervention focuses on the underlying skills needed to process speech when it’s spoken in a noisy environment. Neuroscience-backed software such as Fast ForWord training does just that. There is more than 30-years-plus of research to back this type of approach. The program incorporates cognitive research, linguistics, and natural learning science as well.
How Fast ForWord Helps Selective Attention
Gemm Learning offers the Fast ForWord program at home to children, teens and adults. The idea is to isolate and strengthen the key underpinning skills called learning MAPS. That stands for Memory, Attention, Processing (for auditory discrimination) and Sequencing.
Inside Fast ForWord there are exercises that develop selective attention, helping students tune out distractions – both visual and auditory. This helps develop the listening skills needed to function well in a classroom and a noisy playground.
One of the most consistent research outcomes from Fast ForWord is improvements in the ability to discriminate speech in noise. This surprises some people because there are no specific exercises that focus on background noise. And so, why the significant improvements? Because Fast ForWord training is improving the underlying skills needed to process speech in noise.
Examples of Listening Help
- Fast ForWord trains the brain to hear each of the phonemes more clearly — for some children there have been “fuzzy” representations of similar sounding phonemes which are now more clear — so it is easier for the brain to recognize it.
- The brain has been trained to process the phonemes more rapidly – it doesn’t have to spend as much time trying to determine what each phoneme is
- The brain can remember more sounds/words in a row because it is processing more rapidly
- It is now easier for the brain to attend – and thus pick up the important message and filter out what is/isn’t important.
- There is improved ability to sustain attention for listening
Overall, the brain is more efficient at listening and understanding.
This type of training is a natural fit as well for adults who have suffered a cerebral vascular accident (also known as a stroke in layperson’s language), as Hurley’s and Billiet’s research has found. However, auditory training/therapy isn’t usually part of their rehabilitation programs.
 Hurley, A & Billiet. (undated). Dichotic Interaural Intensity Difference (DIID) Training: Auditory Remediation after CVA. School of Allied Health Professions, Louisiana State University Health Sciences Center – New Orleans LA.