Frequently Asked Questions
What is an auditory processing disorder (APD)?
Despite having normal hearing, people with auditory processing disorders (APD) have difficulty processing and interpreting auditory information. The ear detects and transmits sound to the brain normally, but when the orally presented information goes to the brain, the child or adult has problems interpreting or understanding it accurately and/or efficiently. It is estimated that 20% of the school age population has APD.
What are red flags for APD?
- Difficulty with reading, spelling, reading comprehension
- Difficulty remembering auditory information
- Difficulty organizing sounds in a proper sequence
- Problems successfully combining auditory and visual information
- Difficulty with localisation of sound
- Problems attending to different information presented to opposite ears
- A consistent delay in response to a question or instructions
- Difficulty understanding speech in background noise
How is APD diagnosed?
At Auditory Processing Services we use the Buffalo Model developed by Dr Jack Katz, Ph.D. for diagnosing and treating auditory processing issues. We assess clients (from age 3.5 years) on the degree to which they deviate from the norms on 3 listening tests. The tests measure a person's performance in 4 categories:
Decoding: the ability to process phonemes quickly and accurately
Tolerance-Fading Memory: The ability to understand speech while in competing noise and the necessary short-term memory capacity to do so.
Organisation: The ability to organise and store orally presented information in the brain.
Integration: The ability for the left and right hemispheres of the brain to communicate.
How is APD treated?
Most commercially available programs provide practice related to general auditory processing skills and compensation strategies. The Buffalo Model’s treatment, which has a long history of success, targets the specific areas of weakness identified in the APD testing. We identify the individual’s specific auditory processing problems (which relate to specific academic/occupational and personal communication difficulties) and train the auditory nervous system to process speech and other sounds more accurately, quickly and with less effort. We focus on the areas of deficit. Working one-to-one with auditory training therapy can develop the skills and strategies to resolve an individual's weaknesses.
More information on CAP
Central Auditory Processing (CAP) refers to how the brain processes auditory information. A person can have perfect hearing but still have difficulty understanding what is being said and the sounds they hear. Problems associated with CAP can affect both children and adults. These can include but are not limited to;
· Difficulty maintaining attention
· Difficulty following multiple or long instructions
· Difficulty understanding speech in background noise
· Difficulty hearing when speech is unclear or degraded (e.g., soft, rapid, or distorted speech, accented speech, speech in reverberant environments, phone conversations)
· Mishearing auditory information
· Slowness in processing and responding to auditory information
· Inconsistent or inappropriate responding to auditory information
· Frequent requests for repetition and/or rephrasing of information
· Saying 'what' or 'huh' often, asking for repeats
· Listening fatigue
· Difficulty or inability to interpret prosody cues that underline emotion, humour and shades of meaning in speech
· Difficulty maintaining attention
· Poor listening skills
· Tendency to be easily distracted
· Poor auditory memory
· Hyperacusis including reduced tolerance for and sensitivity to noise
· Difficulty localising the source of a signal and tracking sounds.
In turn, these difficulties are associated with speech and language delays in children including difficulties with phonological and phonemic awareness, academic difficulties including reading, spelling and/or learning problems, psychosocial difficulties and exhaustion after school from listening effort. This is not an exhaustive list nor are these behavioural characteristics exclusive to Auditory Processing Disorder (APD) (ASHA, 2005). The prevalence of APD in the community has been estimated to be between 3-5% (Chermak & Musiek, 2007), and higher in Pacific Island families (34%) in Aukland (Purdy et al., 2012) and adjudicated adolescents in a US juvenile detention centre (72%) (Moncrieff et al., 2014). I aim to help clients improve their central auditory processing skills and reduce the mental overload spent compensating for their difficulties. Early intervention is best and clients who receive treatment post APD evaluation have been seen to improve their academic achievement, participation, career opportunities and psychosocial development. A professional evaluation may result in additional services and resources becoming available through schools, employers, insurance, and government support networks.
Podcasts/Discussions
If you're interested in learning more about APD you can listen to this Podcast: Between Two Ears. You'll find it here: https://linktr.ee/betweentwoears
Nina Kraus discussion: (134) Better Hearing for Better Learning. Roundtable Discussion: Improving Auditory Assessment in Schools - YouTube
Published Research and Peer Reviewed Papers
Case Study: COVID-19 Brain Fog or Auditory Processing Disord... : The Hearing Journal (lww.com)
Auditory processing disorders: It's not just kids who have t... : The Hearing Journal (lww.com)
Characteristics of Auditory Processing Disorders: A Systematic Review
https://pubs.asha.org/doi/full/10.1044/2015_JSLHR-H-15-0118
The Buffalo CAPD Model: The Importance of Phonemes in Evaluation and Remediation (researchgate.net)
Training Programs for Improving Speech Perception in Noise: A Review - PMC (nih.gov)
Strategies and Interventions for Auditory Processing Disorders
Auditory Processing Training with Children Diagnosed with Auditory Processing Disorders: Therapy Based on the Buffalo Model
Denman, I., Banajee, M., & Hurley, A. (2015). Dichotic listening training in children with autism spectrum disorder: A single subject design. International journal of audiology, 54(12), 991–996. https://doi.org/10.3109/14992027.2015.1070308
Gopal, K. V., Schafer, E. C., Mathews, L., Nandy, R., Beaudoin, D., Schadt, L., Brown, A., Phillips, B., & Caldwell, J. (2020). Effects of Auditory Training on Electrophysiological Measures in
Individuals with Autism
Spectrum Disorder. Journal of the American Academy of Audiology, 31(2), 96–104. https://doi.org/10.3766/jaaa.18063
Incremental Therapy Approach for Children Identified with Auditory Processing Disorder
Helland, T., Morken, F., Bless, J. J., Valderhaug, H. V., Eiken, M., Helland, W. A., & Torkildsen, J. (2018). Auditive training effects from a dichotic listening app in children with dyslexia. Dyslexia (Chichester, England), 24(4), 336–356. https://doi.org/10.1002/dys.1600
Kozou, H., Azouz, H. G., Abdou, R. M., & Shaltout, A. (2018). Evaluation and remediation of central auditory processing disorders in children with autism spectrum disorders. International journal of pediatric otorhinolaryngology, 104, 36–42. https://doi.org/10.1016/j.ijporl.2017.10.039
Kraus N. (2012). Biological impact of music and software-based auditory training. Journal of communication disorders, 45(6), 403–410. https://doi.org/10.1016/j.jcomdis.2012.06.005
Leite, R. A., Wertzner, H. F., Gonçalves, I. C., Magliaro, F. C., & Matas, C. G. (2014). Auditory evoked potentials: predicting speech therapy outcomes in children with phonological disorders. Clinics (Sao Paulo, Brazil), 69(3), 212–218. https://doi.org/10.6061/clinics/2014(03)12
Lotfi, Y., Moosavi, A., Zamiri Abdollahi, F., & Bakhshi, E. (2019). Auditory Lateralization Training Effects on Binaural Interaction Component of Middle Latency Response in Children Suspected to Central Auditory Processing Disorder. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 71(1), 104–108. https://doi.org/10.1007/s12070-018-1263-1