Auditory processing disorder is a condition in which the central nervous system is unable to process sound properly. Although it can affect anyone, most cases start during childhood and affect up to 5% of all children. People with this condition often can’t make out where a sound is coming from or differentiate between similar sounds. They may find it difficult to understand speech and the order of sounds. This can cause learning difficulties in children. You can manage the condition with hearing exercises that train your brain to deal with sound better; by compensating for the hearing problem with visual and other aids; or by making changes to the environment like working in a quiet room.
Auditory processing disorder (APD) is a condition in which the central nervous system is unable to process sound properly. Anybody can get APD (also known as central auditory processing disorder), but most cases start in childhood. It’s estimated that about 5% of children are affected by APD to some degree.1
Although it is a hearing-related disorder, APD is not the same as hearing loss – in fact, it may not even register as hearing loss in an audiogram or other routine tests. The problem here is beyond the ear and is related to the brain circuitry. So how do you identify APD?
Someone with APD:
- has trouble identifying precisely where a sound is emerging from
- may be confused about the order of sounds
- may not be able to differentiate between similar sounds like “eighteen” and “eighty” or “crash” and “cash”
- may not be able to understand speech – especially if more than one person is talking, there’s noise in the background, the quality of sound is bad, or someone is talking very fast
- may not be able to remember verbal directions.2
- may mispronounce words or leave out syllables3
- may show signs of ” auditory fatigue.” That is, the daily effort required to hear may become too much for them and they may just stop trying to adjust. Or they may “act out” to distract from their problems with hearing.4
- may do badly at school. A child with APD might use contextual signals to replace what they’ve missed. For instance, in the sentence, “ The … rises in the east,” we can easily fill in the missing word. This is known as auditory closure ability. We all use it to some extent to understand what’s being said. Someone with APD, however, might have to rely on it constantly. Since they need to allocate a lot of their mental resources just to understand what’s being said, they’re often left with a reduced capacity for other school work.5
But do keep in mind that some of the symptoms of APD are also common to other conditions. For instance, people with attention deficit hyperactivity disorder (ADHD) and autism may also have trouble with understanding what’s being said or remembering it. However, in these cases, the symptoms can’t be traced to faulty processing of auditory stimuli in the central nervous system. Also, APD could occur along with other disorders like ADHD. Therefore, it’s important to confirm that the difficulties with understanding speech are actually due to APD. An audiologist (a specialist who deals with hearing, balance, and related problems) can conduct tests and give you an accurate diagnosis.
What Causes It?
The exact reasons for APD are yet unknown. But certain triggers have been identified.
- Children who’ve had recurring episodes of ear-related problems such as glue ear (where the middle ear retains fluid) at a young age may be susceptible. Even when the condition has been sorted out, it might have impacted how sound is processed by the brain.
- A genetic component may be at play as APD seems to run in families.
- APD has been linked to brain damage due to a tumor, stroke, head injury, or meningitis.
- Changes related to age and conditions like multiple sclerosis which affect the nervous system are also associated with APD.7
What Can You Do About It?
There’s no cure as such for APD but you can manage it by modifying the environment in which communication happens, using other skills to compensate, or making remedial changes that affect the defect itself.
- Some activities (auditory training) can teach your brain to deal with sound better. This includes exercises like paying attention to a particular sound in spite of background noise or singling out a sound and figuring out where it’s coming from. A professional can help you with this or you can do it by yourself. Computer programs and CDs that are tailored to APD can also help.8
- Giving children with APD notes before class, paying them extra attention in class or proactively teaching them new words, and using visual aids like graphs and pictures can help compensate for problems with hearing.
- Changes to the environment can also help – for instance, working in a quiet area without the distraction of a TV. A person with APD can also use a frequency modulation system. This has a transmitter and a receiver, magnifies the sound of the speaker, say a teacher, and sends it wirelessly to the receiver so what’s being said can be heard above background noise.9
With a little care and the appropriate interventions, APD is a condition that can be managed, so stay positive and don’t let it put a crimp in your step!
References [ + ]
|1, 2, 7, 8.||↑||Auditory processing disorder, National Health Service.|
|3.||↑||Auditory Processing Disorder, Learning Disabilities Association of America.|
|4, 5.||↑||What is CAPD? National Acoustic Laboratories.|
|6.||↑||Understanding Auditory Processing Disorders in Children, American-Speech-Language-Hearing Association.|
|9.||↑||General CAPD Management Strategies, National Acoustic Laboratories.|