Compensatory Strategies for Central Auditory Processing Disorder

Central Auditory Processing disorder teaching strategies

Teaching Strategies / March 19, 2020

Auditory Processing Disorder (APD) is a disability that affects how the brain processes spoken language and represents a major factor in the difficulties affecting people with communication disorders. People with APD have difficulty interpreting, storing and accessing auditory information despite normal hearing. In addition to hindering speech and language development, APD can affect other related areas of learning, particularly reading and writing.

People who have auditory processing deficits have difficulty interpreting the messages being sent to the brain. There is clearly a neurological basis to APD, but although those affected with APD may or may not have hearing loss, most do have normal intelligence.

Central Auditory Processing Disorder (CAPD) refers to a disorder in which there is damage to the Central Auditory Nervous System, such as lesions, tumors, etc; this condition is rather rare. What most of us see in the children with whom we work are a combination of deficits in one or more of the auditory processes that are essential in the development of normal communication skills.

What causes Auditory Processing Disorders?

APD may have a wide range of etiologies. One important factor is delayed auditory development; and this is often due to recurrent Otitis Media. Otitis Media is the most prevalent illness in children. We give a person antibiotics, which may get rid of bacteria, but doesn’t get rid of fluid – which means the child still has a 30 dB hearing loss during the time of fluid in the ears. In addition, Amoxecillin has been proven to be 83% ineffective. Unfortunately, when we increase antibiotics, it increases candida in the body, which has been known to leads to increased allergies and a disbalanced digestive system, which leads to a disbalanced brain. There are many natural remedies for Otitis Media, with less harmful effect.

Who suffers from Auditory Processing Disorders?

Auditory processing difficulties, or language formulation disorders, are commonly found in children with Autism Spectrum Disorders, Attention Deficit/Hyperactivity Disorder, Learning Disabilities, Dyslexia, and a wide range of Speech and Language disorders. In fact, recent research found that 75% of people with Learning Disabilities and Attention Deficit/Hyperactivity Disorder also have Auditory Processing Disorders. This is not to say that all learning or attention deficits are due to auditory problems. And of course, not all people with auditory processing problems have other diagnoses, such as Autism or Learning Disabilities, or Dyslexia. Many children and adults who have auditory processing disorders do not have other disabilities, and have never been identified or received a diagnosis. They are often the people about whom parents, teachers, or friends say, “I just can’t figure out what’s wrong!” Whenever we hear this from a parent or teacher, it is important to check out auditory processing abilities, the “invisible disability.”

What are the Auditory Skills necessary for Learning Language?

Auditory information processing involves all of these skills simultaneously. However, it is important to know what constitutes the ability to process auditory information, so that we can look at each area to determine if it is functioning properly.

  • Localization – to localize to the source of sound. This is the best indication of auditory development. If a child cannot determine from where the sound is coming, their whole world will be very confused.
  • Discrimination – to differentiate among sounds of different frequency, duration, or intensity
  • Auditory attention – to pay attention to auditory signals, especially speech, for an extended time
  • Auditory figure/ground – to identify a primary speaker from a background noise.

    Sound in Noise – Our acoustic environment is different everywhere. There is always some ambient noise present – especially for children. Therefore in the presence of noise, we usually raise our voice above the ambient noise level. However, sound depletes quickly as we move to the back of a room. We find that many children with APD (and certainly a child suffering from Otitis Media) can’t hear above the noise level.

    Ability to selectively listen (or Modulation difficulty). A child with poor attention may not necessarily have true Attention Deficit Disorder. Rather, that child may have APD with auditory figure/ground disturbances. In fact, this is the most common difficulty in people with auditory processing deficits

  • Phonologic awareness: Identifying sounds in words, the number of sounds in a word, and similarities among words; may show up in spelling, writing, and reading difficulties.
  • Auditory Discrimination – to discriminate among words and sounds that are acoustically similar
  • Auditory Closure – to understand the whole message when part is missing
  • Auditory Blending – to synthesize isolated phonemes embedded in words
  • Auditory Analysis – to identify phonemes or morphemes embedded in words
  • Auditory sequencing – to store and recall auditory stimuli of different length or number in exact order
  • Auditory Memory – storing, or retaining, pertinent auditory information; may affect ability to follow oral directions, participate in discussions, and spell.
  • Auditory Association – to identify a sound with its source
  • Decoding of Speech – In learning to understand speech, we have to be able to form a memory for sounds and words. These are called auditory templates. Enough of the template must be stimulated in order to recognize word, etc. If something occurs (like where you don’t get consistent input), those templates are not going to develop as strong engrams. If you can’t get the phonemes, you can’t get the words. This is the basic skill required in learning to read. So being able to read begins as soon as we begin to hear sounds/phonetic elements.

What is Temporal Processing – an Essential Auditory Processing Skill for Language and Reading?

Another essential skill in auditory processing is Temporal Processing – the rate at which we can process auditory information. A person must be able to process auditory information at a rapid pace in order to develop appropriate listening and language skills. Audiologists have recognized this in people with sensori-neural hearing loss for a long time, and have referred to this concept as the “temporal window”. We know that if a person’s “temporal window” is too large, that is, the time period required to process sound is too long; it becomes more difficult for them to understand speech. Any brief change in the speech signal then becomes difficult to perceive and the communication is distorted.

If someone is walking by a very small window, you will see him or her for just a brief period of time. In order to recognize them, you will have to be very quick in your skill. If you are not so quick, you will need a longer window; that is, you will need more time to figure out whom that person is that you saw.

You can see slow auditory processing in the child who is asked a question, and he sits there and looks at you and takes quite a while to respond, or maybe he says “What” or “Huh” and you repeat the question. Then finally he answers. He may not be saying “What” because he didn’t hear you, (and that makes you really mad because you know he heard it!). He may need you to repeat it again because he needs that extra time for the first statement to process in his mind before he can come out with an answer.