Your child is eating a meal with you. This is the child who cuddles up with you for a fun show on TV. The same child who wants one more push on the swings.
Learning has not been easy for this child. At each parent-teacher conference from 3 years old until now you have had to hear about trouble attending during lessons. While the child might not act impulsively or “wild,” they seem to have trouble focusing in- especially when someone is speaking to them.
At times, they have trouble understanding the differences in sounds and letters. At other times, they cannot follow a verbal direction. When there is visual information, it is learned and remembered. When there is visual information paired with spoken information, their success increases more.
One of the child’s teachers has said to you that they have an “auditory processing disorder”.
Now, what does that mean?
In the field of speech/language pathology, there are some “controversial” diagnoses that are used when describing children. Apraxia is one and Auditory Processing is another.
Not every child who has trouble listening or understanding language has an Auditory Processing Disorder.
In over 10 years in the field I would go so far as to say, I don’t know if I have ever evaluated, worked with, or met a child who has a true Auditory Processing Disorder. Yet, I hear that word used to describe children multiple times a year.
For a parent or teacher, what are some ideas that we can use to shape this conversation about Auditory Processing?
There is a convergence between language comprehension, attention, and Auditory Processing; Auditory Processing Disorders can only be diagnosed by an audiologist. Testing that is used to determine these diagnoses examine a student’s ability to hear in backgroundnoise, listen for small differences in speech sounds, and understand spoken words/sentences when competing words and sentences are presented(i.e.; hear a different sentence in each ear and isolate the information from one ear).
Takeaway: Be wary of situations in which a child shows attentional difficulties or challenges in understanding language. It does not mean an Auditory Processing Disorder. If you are unsure, bring your child to an Audiologist who specializes in these diagnoses.
Be especially mindful of concerns with attention– While ADD/ADHD are more well-known diagnoses, I have seen a number of times when children are said to have Auditory Processing Disorder, but the attentional concerns really stand out. This is especially true when children are in primary grades. From a diagnostic perspective, it probably does not make much sense to diagnose either ADD/ADHD or Auditory Processing Disorder until children mature (and I don’t mean when they are in their teens). An audiologist I know won’t test for Auditory Processing Disorder until a child is 7 years old. While a “wait and see” approach might not be recommended in some cases, we also don’t want to set up false positives.
Takeaway: Stay aware of the child’s challenges with attention. While it might be difficult to do, look at times of the day when they are more attentive or less attentive. Are there activities where they are more attentive or less attentive? These are important observations to make because they might provide needed information.
Look for these hallmarks of a true Auditory Processing Disorder– Difficulty with listening when there is noise; while all of us might say it is hard to listen in noise, for children with a Auditory Processing Disorder it could be near impossible. Furthermore, an adult can compensate for challenges when listening in noise (i.e. ask for repetition, move to a quieter area). For these children, those compensatory skills might not be present yet.
Challenges with following directions; This is a matter of degree. We all miss directions at some point- it could be due to the directions being unclear or that we don’t understand them. Children with an Auditory Processing Disorder might seem to be confused often, or have significant trouble following directions.
Difficulty with the phonics aspect of reading; Understanding the connection between sounds and words is a key aspect of most reading instruction these days. Those minute differences between sounds make it really hard for a child with Auditory Processing Disorder to both hear/understand the sounds and make the leap to the way those sounds are represented in letters and words.
Challenges with speech sound production; While this is not the most common hallmark, it has been observed in some children with Auditory Processing Disorder. Similar to the phonics area, children have difficulty with hearing the differences in sounds that they might produce (ex: did they add the “s” to the end of a word?)
Takeaway: These hallmarks are often seen in children with Auditory Processing Disorders. They are not ALL needed to make a diagnosis and there might be other areas that show up in testing. Once again, pay attention to times in which you see challenges in these areas. Pay attention to circumstances that might affect success in these areas.
One isolated weakness does not make a child have an Auditory Processing Disorder.
Diagnoses are challenging to make for professionals and even harder for parents/caregivers to work through. As an experienced professional, I like to talk about observable behaviors before I ever call those behaviors a name such as “Auditory Processing Disorder.” Be wary of any teacher or therapist who throws diagnostic names around without observations to back them up. Understand that this diagnosis needs to be made by an Audiologist and that there are mitigating factors which can affect a true read.