auditory processing disorder.....the hidden problem in many kids.

Yet another child diagnosed today with Auditory Processing disorder (APD)

The parents were left open mouthed when they were told about it. They were expecting a diagnosis of Autism for their 3.6yr old!

So what is APD?

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is a complex problem affecting mainly school-aged children. These kids can't process the information they hear in the same way as others because their ears and brain don't fully coordinate. Something probably adversely affects the way the brain recognizes and interprets sounds, most notably the sounds composing speech.
Kids with APD often do not recognize subtle differences between sounds in words, even when the sounds are loud and clear enough to be heard. These kinds of problems usually occur in background noise, which is a natural listening environment. Very often, they repeat the last part of a word or a question asked to them.

How do you find out if your child has this problem?

Kids with APD usually have normal audiograms (Pure-t
one). But they do not process auditory information normally.
If the auditory deficits aren't identified and managed early, many of these kids will have speech and language delays and academic problems.
Symptoms of APD can range from mild to severe and can take many different forms. If you think your child might have a problem processing sounds, consider these questions:

• Is your child easily distracted or unusually bothered by loud or sudden noises?
• Are noisy environments upsetting to your child?
• Does your child's behavior and performance improve in quieter settings?
• Does your child have difficulty following directions, whether simple or complicated?
• Does your child have reading, spelling, writing, or other speech-language difficulties?
• Is abstract information difficult for your child to comprehend?
• Are verbal (word) math problems difficult for your child?
• Is your child disorganized and forgetful?
• Are conversations hard for your child to follow?
• Are there frequent repetitions (of your speech) with blank expressions?

Although APD is often confused with ADHD, it is possible to have both. It is also possible to have APD and specific language impairment or learning disabilities.

Once diagnosed, kids with APD usually work with a speech therapist. Diagnosis in India is hampered in the absence of standardized tests for the same. However we co-ordinate with other team members like the occupational therapist and zero in on the diagnosis.

Problem Areas for Kids With APD

The five main problem areas that can affect both home and school activities in kids with APD are:

1. Auditory Figure-Ground Problems: when a child can't pay attention if there's noise in the background. Noisy, low-structured classrooms could be very frustrating.
2. Auditory Memory Problems: when a child has difficulty remembering information such as directions, lists, or study materials. It can be immediate ("I can't remember it now") and/or delayed ("I can't remember it when I need it for later").
3. Auditory Discrimination Problems: when a child has difficulty hearing the difference between words or sounds that are similar (COAT/BOAT or CH/SH). This can affect following directions, and reading, spelling, and writing skills, among others.
4. Auditory Attention Problems: when a child can't stay focused on listening long enough to complete a task or requirement (such as listening to a lecture in school). Kids with CAPD often have trouble maintaining attention. Very often they keep repeating parts of commands and other verbal instruction.
5. Auditory Cohesion Problems: when higher-level listening tasks are difficult. Auditory cohesion skills — drawing inferences from conversations, understanding riddles, or comprehending verbal math problems — require heightened auditory processing and language levels. They develop best when all the other skills (levels 1 through 4 above) are intact. Very often this is a feature confused with other diagnoses.

 Remediation:
Speech-langauge therapy , occupational therapy (sensory integration),  Remedial education.

One of the most important things that both parents and teachers can do is to acknowledge that APD is real. Symptoms and behaviors are not within the child's control.
What is within the child's control is recognizing the problems associated with APD and applying the strategies recommended both at home and school.