Auditory Processing Disorder in Children

What is APD, what causes APD, how it impacts learning

Central auditory processing disorder (CAPD or APD) is a disconnect between how an individual hears sound and how sound is processed. In most cases, there is no hearing loss or neurological disease involved.

APD is not a condition or affliction. It describes symptoms – namely difficulty processing on sound.

Auditory processing skills typically mature around 7 years of age*, at which time a child can listen at natural language speed and pick out the sounds inside words (phonemic awareness) for reading. However, auditory processing can take a few more years to fully develop in many children, holding back their reading and learning, but not sufficiently delayed to come in below the sound sequencing and sound discrimination thresholds in testing required for an auditory processing disorder diagnosis.

* Some countries do not start reading instruction until 7 years of age, as only then will most children have fully matured auditory processing skills.

Most reading difficulties are language-processing related

A study by NIH (1985-1995) found that 88% of struggling readers have weak phonemic awareness, caused by under-developed auditory or language processing.  Approximately 25%+ of children read below grade level – the commonality of weak phonemic awareness here suggests a prevalence of under-developed language processing skills holding back reading and learning.

This is not surprising. Processing at natural language speed is not easy, it requires processing at up to 40 sounds per second. While auditory processing skills do keep developing over time – exercised by listening – often that maturing is delayed, impacting a child’s learning growth.

Fully diagnosed auditory processing disorder affects 2-7% of the population. Because of the avoidance behaviors associated with reading and learning difficulties, many APD children are diagnosed with something else, either ADHD, developmental dyslexia or another learning disability.  And many others have difficulty processing sounds that hold them back but below testing thresholds or not tested at all.

How APD Undermines Learning

Auditory processing disorder undermines language mastery – the gateway to all learning. It’s the most important cognitive skill you may have never heard of! Children whose language processing skills do not develop as expected are at risk for difficulties in:

• Learning — listening accuracy and comprehension
• Reading — fluency and comprehension
• Social interaction
• Thinking — internal dialog uses language

Delays in auditory processing also impede development of working memory (related to IQ), attention skills and higher level thinking and learning. Furthermore, reading comprehension is almost always a challenge. If reading is not automatic, decoding distracts from comprehension.

Hypersensitive auditory processing disorder, a hypersensitivity to background noise, is another factor that impacts learning. A child’s intolerance to usual noises creates disrupts the learning routine in a way that over time adds up.

Fast ForWord for Auditory Processing

This is where Fast ForWord software has come into prominence, helping auditory processing disorder in children and in adults. The software presents a range of quick-fire, adaptive exercises to accelerate the maturing of processing skills. These exercises are the equivalent of hearing millions of words in just a few months.

What Causes Auditory Processing Disorder?

Auditory processing skills develop naturally through daily language interaction and stimulation — listening and talking. And so the primary auditory processing disorder causes have their roots in the amount of language your child is able to hear accurately in early life.

In most cases, there is sufficient stimulation around a child to develop fully formed language processing skills by the age of 6 or 7. At this age most children can comprehend spoken language at natural language speed and they can pick out phonemes, the sounds inside words, for reading. The most crucial time in this development of these crucial and complex skills in the central auditory nervous system is the first three years of life.

A famous study, the “Early Catastrophe” by Hart and Risley, found children in professional homes hear 30 million more words than their peers in lower income homes over their first three years of life, the so-called “30 million word gap.”  This extra language experience translates into a faster start in learning and reading.

Interruptions in Listening Can Cause APD

Another possible cause is an interruption in language stimulation due to an unusual number of childhood viruses, recurring ear infections, degenerative disorders, glue ear and other hearing glitches. This early childhood form of auditory processing disorder is developmental APD.

Children who are not born hearing the sounds of English are also at risk for language processing disorder (LPD), difficulties processing the sounds of English.  This is particularly challenging for internationally-adopted children. English is phonetic, whereas for instance, Mandarin is tonal. A Chinese-born child who moves to America will need to start mapping the language all over again.  She is at risk for LPD because her 3-year language development window is shortened.

Other Sources of APD

Acquired APD on the other hand refers to auditory processing disorder causes from an outside event. This might include head trauma, chemotherapy or a disease, such as viral meningitis. Acquired APD is less common, but similarly caused by a general lack of cognitive skill functioning that impacts language processing.

About 40% of learning disabilities are hereditary. Auditory processing disorder fits into this pattern, it runs in families.

Finally, we should note that the most common cause of auditory processing disorder in children is “none of the above”.  It’s a tough skill to master, requiring incredibly fast processing and many children simply require more time and stimulation than their surrounding environment provides.

A Child’s Day With Auditory Processing Disorder

Auditory processing disorder in children can be very challenging. When we are young, our day job is school. Our primary focus is getting an education. With auditory processing disorder, a child’s school day may be more challenging, frustrating and sometimes humiliating than anyone realizes.

• He may be missing much of what the teacher is saying in class, particularly in noisy classrooms.
• Homework can be frustrating and stressful.  This stems from not understanding the assignment, an inability to follow the lesson in class and/or reading problems.
• Social conversations with peers are challenging, particularly in noisy playgrounds.
• Sometimes she faces humiliation, having to answer in class before she understands the question.
• Reading out loud in class or to a parent is often another daily struggle.

These daily frustrations erode confidence and self-esteem.  Furthermore, they create a negative connection to reading and learning that over time will be hard to reverse.  Consequently, many children with APD do eventually grow out of their processing delays, but they never do become enthusiastic readers.

How To Identify APD and What To Do Next

As you might expect, being aware of central auditory processing disorder causes and therefore recognizing auditory processing disorder in children early on is important. ASHA, the American Speech-Language Hearing Association, recommends formal testing through an audiologist. This testing normally occurs in a sound room. Different volume levels and sound combinations test temporal aspects of auditory discrimination (sequencing), auditory pattern recognition and the ability to process degraded or distorted sound.

However, since auditory processing impacts a range of behaviors, there are tell-tale signs of APD you can observe using a symptoms checklist with signs of auditory processing disorder in children listed by age.

If you decide on formal testing, you will receive advice on managing auditory processing disorder for your child at home and at school.  However, that is about all you will get. There is no medicine or magic pill for APD.  It is a delay in cognitive skill growth. And just like other physical or cognitive skills, the only way to improve auditory processing skills is with exercise.