Auditory Processing Disorder Assessments for the School-Aged

What is Auditory Processing Disorder (APD)?

Auditory Processing Disorder (APD) is a neurological problem. In essence, APD refers to difficulty processing what we hear.

There are three types or categories of APD :

• 1 Developmental APD
  Cases presenting in childhood with listening difficulties, but with normal audiograms and no other known aetiology (causes) or potential risk factors other than a family history of developmental communication and related disorders. These individuals may retain APD into adulthood.
  
  
• 2 Acquired APD
  Cases associated with a known medical or environmental event (e.g. brain lesion, trauma, illness, noise or ageing).
  
  
• 3 Secondary APD
  Cases where APD occurs in the presence, or as a result of either transient (e.g. glue ear) or permanent peripheral hearing impairment.

What are the presenting difficulties of children with APD?

Children referred for APD assessment typically have a normal audiogram but present with characteristics that may include:

• Difficulty hearing spoken language in the background of other sounds, including speech (the most common presenting complaint).
• Difficulty hearing in reverberant acoustic environments, or when speech is rapidly presented or degraded in some way.
• Mishearing speech and similar sounding words (‘shoulder’ versus ‘soldier’).
• Responding inconsistently or inappropriately to spoken language and auditory information.
• Taking longer to process spoken language and auditory information.
• Frequent requests for repetition.
• Difficulty hearing on the phone.
• Poor attention to and/or memory of spoken language and instructions.
  
  

There may also be reports of impaired speech, language, phonological awareness, literacy, attention and academic performance.

In some cases, children are referred when they do not progress as expected after receiving other types of support, such as speech and language therapy or dyslexia/learning support.

What are the treatments/intervention for APD?

Auditory processing disorder is a neurological problem that cannot be treated by medication. Since auditory processing difficulties vary based on surroundings and development, its therapies vary by setting and age as well.

Current intervention strategies can be divided into 4 main areas:

• 1. Architectural considerations and acoustic environmental modifications.
• 2. Technology (sound field systems, assistive listening devices/remote microphone technology, and noise-cancelling headphones).
• 3. Auditory training programmes, computer software and apps.
• 4. Compensatory strategies.

At Kinsale Hearing:

The complete Auditory Processing Disorder (APD) assessment comprises two parts: The full audiological assessment and the Auditory Processing Disorder (APD) test batteries. The overall testing is 2-3 hours, depending on the age of the patient. Considering the length of the assessment time, the assessment can be divided into two separate appointments. If the weakness(es) in auditory experience is identified, auditory therapy/training and assistive listening devices (e.g. FM system, soundfield system, etc) can be advised.

Auditory Processing Disorder (APD) can often, but not always, co-occur with other diagnoses (e.g. dyslexia, dyspraxia, ASD, language disorder etc). It is vital that APD is distinguished from other diagnoses that can also impact auditory memory and attention (e.g. ADHD, working memory difficulties). If children have learning difficulties or low IQ, it is likely that they present with overall processing difficulties. Therefore, prior to the diagnosis of APD, any available diagnostic reports (e.g. Speech and Language Therapist, Educational Psychologist, etc) should be provided to an audiologist, to ensure an accurate diagnosis of APD.