‘School can be a very boring place if the child suffers from Auditory Processing Disorders’
I was recently invited to have an interactive facebook chat session on AUDITORY PROCESSING DISORDER by a dynamic Indian telecare therapy portal, 1SpecialPlace. Posting the edited chat here for Audiology Planet audience. The names are anonymised for obvious reasons.
1SpecialPlace Hello everyone. I welcome Dr. Jay Jindal who is our esteemed guest today. Dr Jindal, we are thankful that you could take out time to join us today. We are eager to learn more on Auditory Processing Difficulties in children.
Jay Jindal May I extend my warm welcome to all of you who have joined this fantastically arranged 1SpecialPlace session on auditory processing disorders. My thanks to the organising team for inviting me to have a chat with you wonderful people.
My name is Dr Jay Jindal. I am an audiologist- hearing and balance care specialist for children and adults. The youngest person I have seen in my hearing was 7 days old and the oldest one-well, just over 105. So, I get to meet many interesting young and old persons in my job.
So, without further ado, please fire away all your burning questions.
1SpecialPlace Thanks again for taking out time for us. To start with, could you tell us what Auditory Processing Disorder really is?
Jay Jindal Auditory processing is basically ‘what we do with what we hear’. Ears serve the mere function of carrying sound to its master- the brain. Brain deciphers the meaning of the sounds or speech. Low and behold, our hearing is, more or less similar. However, our auditory processing or ‘listening abilities’ are different because no two brains are the same. Sometime these abilities are below average causing issues with understanding, and therefore, learning or remembering etc. This is termed as APD.
It makes sense because we can only learn or remember what is being said, if we understand it. Think of watching a foreign language film and trying to decipher the meaning. Most you can understand is by watching rather than by listening to what’s being said. And, what you can understand is limited to how visual the movie is. This is how a child with APD may feel at school in their class
So, simply speaking Auditory Processing Disorder (APD) is difficulty in understanding and/or remembering information coming from hearing organs, that is-our ears. It is characterised by poor perception of speech and non-speech sounds in the brain due to impaired neural function (how the hearing structures represents sounds for the brain to interpret meaning); whereas their ears and hearing may be working perfectly well.
1SpecialPlace That’s an elaborate and well explained take on APD
SK I thank 1SpecialPLace and Dr Jindal for this great support. My daughter 3.5 yrs has difficulty in listening. How do I improve that?
Jay Jindal Many thanks for your question. I think the first thing to do is to see a children’s hearing specialist (audiologist) to have a thorough check up of her hearing. Once they help you identify your daughter’s specific hearing issues, they should be able to offer the management.
Jay Jindal Also remember, ‘glue ear’ (mucous stuck behind the ear drum and not draining properly) is one of the most common childhood condition that 90% children below age of 4 will suffer at some point. It can cause hearing and listening problem
I will post some general things that can enhance listening in a moment
Jay Jindal To answer your question, the simplest way to enhance listening skills in children is to play lots of listening games with them-
● ‘Musical chairs or statues’ (vigilance)
● ‘Simon says’ (vigilance, auditory discrimination, following directions)
● ‘Marco Polo/ Blind Man’s Bluff’ (localization and tracking)
● ‘Same and different’ (auditory discrimination)
● Exposure to rhymes and songs (phonological awareness, auditory discrimination)
● Following directions (auditory memory and sequencing)
1SpecialPlace Great tips about listening games
1SpecialPlace Jay Jindal could you elaborate a bit on the subtle signs to identify APD in children?
Jay Jindal Ah! where do I start… So, my working assumption in my paediatric clinics is that- mum knows the best! If the mum says to me that the child has a hearing/listening problem- I start by believing in them. Basically these are children who are otherwise very bright but don’t show the same level of academic or learning in general life. You give them two sets of instructions- go to the room and get your socks. They will go to their room and forget what to do next. You will find them staring at the cupboard.
Jay Jindal They will be much more comfortable speaking to you in quiet one to one conversation. In school or in noisy get together- they will become a different person
Jay Jindal Some general things that have been said about APD:
1. Difficulty understanding speech in the presence of competing background noise or in reverberant acoustic environments
2. Difficulty hearing on the phone
3. Inconsistent or inappropriate responses to requests for information
4. Difficulty following rapid speech
5. Frequent requests for repetition and/or rephrasing of information
6. Difficulty following directions
7. Difficulty learning a foreign language or novel speech materials, especially technical language
8. Problems with the ability to localize the source of a signal
9. Difficulty or inability to detect the subtle changes in prosody that underlie humor and sarcasm
10. Difficulty maintaining attention
11. A tendency to be easily distracted
12. Poor singing, musical ability, and/or appreciation of music academic difficulties, including reading, spelling and/or learning problems
TT Wow! That’s a vast list of signs.
TT But could a child with APD also have other sensory processing difficulties?
Jay Jindal Indeed. There are various brain interactions (cognitive or higher order interactions as we call them in technical language) that may result in multitude of symptoms. In fact, most children I and my colleagues see, have APD with another condition that coexists with it (or the other way round) e.g. sensory difficulties, dyslexia, autistic spectrum disorder etc etc
Jay Jindal Just to give you an idea of the interactions that I mentioned
Here’s a clever infograph on executive functions: