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APD and ADD: What's the Difference?
Identifying Auditory Processing Disorders
Most hearing disorders are discovered late in childhood, not at birth.
Date: 5/1/2009

Parents of school-age children often talk about their kid’s friends and teachers, ever-changing fads and extracurricular activities like sports and music. Sometimes challenges faced in the classroom, perhaps health concerns, but rarely the two together. After all, when was the last time you heard anyone talk about an auditory processing disorder? It’s likely not recently; probably never.

Auditory processing is what happens when the brain both recognizes and interprets sounds. Disorders in auditory processing prevent people from correctly processing – or interpreting – these sounds. This leads to problems with comprehension.

While difficulties with auditory processing may be associated with conditions such as attention deficit disorder, developmental delays, dyslexia or autism, they may not always be linked. A child with an auditory processing disorder may have normal hearing and intelligence.

“Children with auditory processing disorders may have trouble hearing all the sounds in a spoken word or they may not be deciphering and hearing sounds that are similar,” says Lorraine Sgarlato-Inducci, Au.D., audiologist at RWJ Hamilton.

“You may tell your child ‘Go upstairs; make sure you brush your teeth; and get into your pajamas,’" explains Inducci. “The child then goes upstairs and brushes his teeth but then you go upstairs and find he hasn’t changed into his pajamas. When things like this happen repeatedly you may become very frustrated, feeling like the child is not listening to you.

What you may not realize is that the child is having difficulty processing what you said and is not intentionally disobeying you.” In conversation, the child with an auditory processing disorder is trying to follow but his rate of speech is not the same as the person talking. He is a slower processor, struggling to take it in while the person speaking is further ahead.

What to Look for

  • Difficulty remembering information presented orally.
  • Problems executing multiple step directions.
  • Poor listening skills.
  • Needs more time to process information.
  • Low academic performance.
  • Behavior problems.
  • Challenges with language, reading, spelling.

Diagnosing the Disorder

“If you suspect a problem, discuss this with your pediatrician,” Inducci advises parents. Most likely, the doctor will conduct a hearing screening. “If your concerns are not satisfied, seek an audiologist who can conduct a hearing test and auditory processing evaluation.”

Children should be seven years of age or older but can be screened as young as five.

At school, a child with an auditory processing disorder may become frustrated, stop paying attention and fall behind. When a teacher recognizes a deficiency or suspects a learning disability, the student is referred for a child study team evaluation at the school, which often leads to hearing, speech and language evaluations as well as an assessment by a mental health professional.

Rehabilitation after Diagnosis

Once the specific diagnosis is made, the audiologist develops a treatment plan which may include a multidisciplinary approach to rehabilitation. When the brain doesn’t distinguish the difference between an “s” and a “z”, speech/auditory therapy can help. Reading therapy becomes important, for example, when that child cannot link those sounds to their symbols (letters). Occupational therapy can help strengthen visual and fine-motor skills.

“When a parent attacks this problem aggressively, you see great results,” says Inducci. “I have seen children with severe disorders completely rehabilitated.” 

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