Sensory Integration Education

Auditory Processing Disorder is when the brain has difficulties understanding and interpreting sounds, including speech. It is not a hearing problem, but rather a difficulty in processing auditory sensory input. 

Auditory Processing Disorder (APD) can co-occur with attention, language and learning difficulties, such as dyslexia and ADHD. ADPs may be related to family history or acquired through trauma, illness or ageing: the cause is often unclear. 

Auditory Processing Difficulties Are Not the Same as Hearing Loss

A person with auditory processing difficulties may be able to hear sounds, but they may struggle to make sense of what they are hearing. They may have particular difficulties in picking out speech in a noisy environment or discerning the difference between similar-sounding words, for example. These symptoms of auditory processing difficulties can be mistaken for hearing loss or lack of focus. Because the problem is with making sense of sounds rather than physically being able to hear sounds, a normal (audiometry) hearing test cannot pick up auditory processing difficulties.

What Are the Signs of Auditory Processing Difficulties?

APD impacts on everyday life mainly through a reduced ability to listen, and therefore respond appropriately to speech and other sounds, according to the British Society of Audiology. There are different types of APD and symptoms and difficulties will vary from person to person. 

Some of the most common signs to look out for are:

Difficulty in noisy environments: A person with auditory processing difficulties may find it challenging to understand speech in noisy environments, such as in a classroom or at a restaurant.

Difficulty following verbal instructions: A person with an APD may struggle to understand verbal instructions, particularly when there are multiple steps involved.

Difficulties with focus and attention: People with auditory processing difficulties may have difficulty paying attention in class or during conversations with others.

Misunderstanding and recalling what is said: An individual with an ADP may misunderstand what is being said, often asking for repetition or clarification. They may also find it hard to recall and summarise verbally-delivered information.

Delayed speech and language development: Auditory processing difficulties can be linked to delays in speech and language development, particularly in children who are struggling to understand spoken words.

Researcher Valeria Isaac, MSc, OTR, said in a SensorNet magazine article:

“There is definitely more to auditory processing than just speech and language. A child can have normal hearing and speech development, and still might present with difficulties in auditory functions, which could impact cognitive performance, like attention and the ability to adapt and function within noisy environments.”

How Can I Support Someone With Auditory Processing Disorder?

It’s important to seek a referral to an audiologist if you think that you or your child has difficulties with hearing or understanding speech. An audiologist will be able to perform hearing tests to rule out hearing loss. If hearing is typical, then a referral to a specialist audiologist or speech and language therapist trained in ADP would be the next step. With the right strategies and appropriate professional support, people with an APD can enjoy full participation in life. 

Here are some ideas for supporting people with auditory processing difficulties:

• Speak clearly and face the person when talking to them. 
• Try not to cover your mouth when talking. 
• Avoid having more than one person talking at once.
• Use shorter sentences. Keep verbal instructions simple, with only a few steps.
• Speak at a measured pace: not too quickly or too slowly.
• Use visual aids, such as pictures, diagrams, or written instructions, to help the person understand what you are saying. Use closed captions on videos.
• Welcome questions and requests to repeat information for clarification.
• Reduce background noise when possible, for example, by turning off the television or radio or choosing a room with carpets and soft furnishings that absorb incidental noises.

SI Practitioners supporting clients with sensory discrimination difficulties would want to consider if ADP might be a factor too. When supporting clients with ADP, SI Practitioners would want to consider how they can reduce the language demand during assessment and sessions. 

References

_{Isaac, V. (2019). Innovation in Identification: Auditory Modulation and Efferent Pathways by Valeria Isaac, MSc, OTR. SensorNet 55.}

_{NHS. (2020). Auditory processing disorder (APD). NHS Website. https://www.nhs.uk/conditions/auditory-processing-disorder/}

_{Moore, D. R., Campbell, N.G. (2018). Position Statement and Practice}

_{Guidance: Auditory Processing Disorder (APD). British Society of Audiology.}