Auditory processing disorder in children: what does it mean? (Voice, Speech, and Language).* What is auditory, processing? * What causes auditory, processing difficulty? * What are the symptoms? * How is it diagnosed? * What treatments are available? * Current research * Where can I learn more? What is auditory processing? Auditory processing is the term used to describe what happens when your brain recognizes and interprets the sounds around you. Humans hear when energy that we recognize as sound travels through the ear and is changed into electrical information that can be interpreted by the brain. The "disorder" part of auditory processing disorder Auditory Processing Disorder (APD) (previously known as "Central Auditory Processing Disorder" (CAPD) is a disorder in how auditory information is processed in the brain. It is not a sensory (inner ear) hearing impairment; individuals with APD usually have normal peripheral hearing (APD APD atrial premature depolarization (see atrial premature complex, under complex ); pamidronate. ) means that something is adversely affecting the processing or interpretation of information. Children with APD often do not recognize subtle differences between sounds in words, even though the sounds themselves are loud and clear. For example, the request "Tell me how a chair and a couch are alike" may sound to a child with APD like "Tell me how a couch and a chair are alike." It can even be understood by the child as "Tell me how a cow and a hair are alike." These kinds of problems are more likely to occur when a person with APD is in a noisy environment or when he or she is listening to complex information. APD goes by many other names. Sometimes it is referred to as central auditory processing disorder central auditory processing disorder Audiology The inability to differentiate, recognize, or understand sounds in a person with normal hearing and intelligence (CAPD CAPD Continuous/chronic ambulatory peritoneal dialysis. See Dialysis, Peritoneal dialysis. ). Other common names are auditory perception auditory perception Neurology The ability to identify, interpret, and attach meaning to sound problem, auditory comprehension deficit, central auditory dysfunction, central deafness central deafness n. The loss or impairment of hearing caused by disease or a defect in the auditory system of the brain. , and so-called "word deafness word deafness n. Aphasia in which the meaning of ordinary spoken words becomes incomprehensible. ." What causes auditory processing difficulty? We are not sure. Human communication relies on taking in complicated perceptual information from the outside world through the senses, such as hearing, and interpreting that information in a meaningful way. Human communication also requires certain mental abilities, such as attention and memory. Scientists still do not understand exactly how all of these processes work and interact or how they malfunction in cases of communication disorders. Even though your child seems to "hear normally," he or she may have difficulty using those sounds for speech and language. The cause of APD is often unknown. In children, auditory processing difficulty may be associated with conditions such as dyslexia dyslexia (dĭslĕk`sēə), in psychology, a developmental disability in reading or spelling, generally becoming evident in early schooling. To a dyslexic, letters and words may appear reversed, e.g. , attention deficit disorder attention deficit (hyperactivity) disorder (ADD or ADHD) formerly hyperactivity Behavioral syndrome in children, whose major symptoms are inattention and distractibility, restlessness, inability to sit still, and difficulty concentrating on one thing for any , autism autism (ô`tĭzəm), developmental disability resulting from a neurological disorder that affects the normal functioning of the brain. It is characterized by the abnormal development of communication skills, social skills, and reasoning. , autism spectrum disorder, specific language impairment Specific language impairment (SLI) is a developmental language disorder that can affect both expressive and receptive language. SLI is a relatively "pure" language impairment, meaning that is not related to or caused by other developmental disorders, hearing loss or acquired brain , pervasive development disorder, or developmental delay developmental delay n. A chronological delay in the appearance of normal developmental milestones achieved during infancy and early childhood, caused by organic, psychological, or environmental factors. . Sometimes this term has been mis-applied to children who have no hearing or language disorder language disorder Speech pathology Any defect in verbal communication and the ability to use or understand the symbol system for interpersonal communication. See Dyslexia. but have challenges learning. What are the symptoms? Children with auditory processing difficulty typically have normal heating and intelligence. However, they have also been observed to * Have trouble paying attention to and remembering information presented orally * Have problems carrying out multistep directions * Have poor listening skills * Need more time to process information * Have low academic performance * Have behavior problems Have language difficulty (e.g., they confuse syllable sequences and have problems developing vocabulary and understanding language) * Have difficulty with reading, comprehension, spelling, and vocabulary How is it diagnosed? You, a teacher, or a day care provider may be the first person to notice symptoms of auditory processing difficulty in your child. So talking to your child's teacher about school or preschool performance is a good idea. Many health professionals can also diagnose APD in your child. There may need to be ongoing observation with the professionals involved. Much of what will be done by these professionals will be to rule out other problems. A pediatrician or family doctor can help rule out possible diseases that can cause some of these same symptoms. He or she will also measure growth and development. If there is a disease or disorder related to hearing, you may be referred to an otolaryngologist, a physician who specializes in diseases and disorders of the head and neck. To determine whether your child has a hearing function problem, an audiologic evaluation is necessary. An audiologist Audiologist A person with a degree and/or certification in the areas of identification and measurement of hearing impairments and rehabilitation of those with hearing problems. will give tests that can determine the softest sounds and words a person can hear and other tests to see how well people can recognize sounds in words and sentences. For example, for one task, the audiologist might have your child listen to different numbers or words in the right and the left ear at the same time. Another common audiologic task involves giving the child two sentences, one louder than the other, at the same time. The audiologist is trying to identify processing problems. A speech-language pathologist can find out how well a person understands and uses language. A mental health professional can give you information about cognitive and behavioral challenges that may contribute to problems in some cases, or he or she may have suggestions that will be helpful. Because the audiologist can help with the functional problems of hearing and processing and the speech-language pathologist is focused on language, they may work as a team with your child. All of these professionals seek to provide the best outcome for each child. What treatments are available? Several strategies are available to help children with auditory processing difficulty. * Auditory trainers are electronic devices that allow a person to focus attention on a speaker and reduce the interference of background noise. They are often used in classrooms, where the teacher wears a microphone to transmit sound and the child wears a headset to receive the sound. Children who wear hearing aids Hearing Aids Definition A hearing aid is a device that can amplify sound waves in order to help a deaf or hard-of-hearing person hear sounds more clearly. can use them in addition to the auditory trainer. * Environmental modifications such as classroom acoustics, placement, and seating may help. An audiologist may suggest ways to improve the listening environment, and he or she will be able to monitor any changes in hearing status. * Language-building exercises can increase the ability to learn new words and increase a child's language base. * Auditory memory auditory memory The ability to remember words and sounds. See Memory. enhancement, a procedure that reduces detailed information to a more basic representation, may help. Also, informal auditory training techniques can be used by teachers and therapists to address specific difficulties. * Auditory integration training Auditory Integration Training Definition Auditory integration training, or AIT, is one specific type of music/auditory therapy based upon the work of French otolaryngologists Dr. Alfred Tomatis and Dr. Guy Berard. is sometimes promoted by practitioners as a way to retrain re·train tr. & intr.v. re·trained, re·train·ing, re·trains To train or undergo training again. re·train the auditory system and decrease hearing distortion. It is important to know that much research is still needed to understand auditory processing problems, related disorders, and the best interventions for each child or adult. All the strategies undertaken will need to be suited to the needs of the individual child, and their effectiveness will need to be continually evaluated. Current research In recent years, scientists have developed new ways to study the human brain through imaging. Imaging is a powerful tool that allows the monitoring of brain activity without any surgery. Imaging studies are already giving scientists new insights into auditory processing. Some of these studies are directed at understanding auditory processing disorders. One of the values of imaging is that it provides an objective, measurable view of a process. Many of the symptoms described as related to APD are described differently by different people. Imaging will help identify the source of these symptoms. Other scientists are studying the central auditory nervous system. Cognitive neuroscientists are helping to describe how the processes that mediate sound recognition and comprehension work in both normal and disordered systems. Research into the rehabilitation of child language disorders continues. In the future, both basic and clinical research will help us better understand the nature of auditory processing disorders. Where can I learn more? If you have questions, contact us at the NIDCD NIDCD National Institute on Deafness & other Communication Disorders Information Clearinghouse. 1 Communication Avenue Bethesda, MD 20892-3456 Toll Free: (800) 241-1044 TTY: (800) 241-1055 E-mail: nidcdinfo@nidcd.nih.gov Internet: www.nidcd.nih.gov Contact the following group for information related to audiology audiology /au·di·ol·o·gy/ (aw?de-ol´ah-je) the study of impaired hearing that cannot be improved by medication or surgical therapy. au·di·ol·o·gy n. and audiology professionals and services. American Academy of Audiology 8300 Greensboro Drive, Suite 750 McLean, VA 22102 Voice: (703) 790-8466 Toll-free: (800) AAA-2336 TTY: (703) 790-8466 Internet: www.audiology.org Or, for information related to audiology and speech-language pathology professionals and services, contact American Speech-Language-Hearing Association 10801 Rockville Pike Rockville, MD 20852 Voice: (301) 897-3279 Toll-free: (800) 638-8255 Hours: 8:30 a.m.-5 p.m., eastern time TTY: (301) 897-0157 Fax: (301) 897-7355 E-mail: actioncenter@asha.org Internet: www.asha.org NIH "Not invented here." See digispeak. NIH - The United States National Institutes of Health. Pub. No. 01-4949 March 2001 For more information, contact the NIDCD Information Clearinghouse. Health Information | Strategic Planning | Research Funding | Intramural intramural /in·tra·mu·ral/ (-mu´r'l) within the wall of an organ. in·tra·mu·ral adj. Occurring or situated within the walls of a cavity or organ. 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