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Auditory Processing Disorder

Silicon Valley Hearing, Inc. offers comprehensive audiology services to diagnose auditory processing disorders (APD). APD testing allows us to examine which specific areas of the auditory processing pathway that are causing breakdowns for you or your child. These results will enable us to provide you information, guidance and resources tailored to you or your child’s needs to help manage the daily challenges of APD.

What is an Auditory Processing Disorder?

Our ears are busy with the task of sending sounds from our outside world to the brain. Along the way, the central auditory pathway is responsible for decoding each individual sound, which allows our brain to attach meaning to a particular sound. It’s how we can determine what the sound is and determine what we need to do with it. Our brains have this magical way of stringing together individual complex beads of sounds, process those sounds and give us the ability to understand words, ready a story and sing a song. The brain is responsible for collecting and processing all the information it receives to paint the beautiful picture of our world.

While you or your child may have normal peripheral hearing (cochlea or sound organ), the dysfunction occurs beyond the cochlea in the central auditory processing pathway, which encompasses all the anatomical and processing mechanisms between the cochlear nuclei (in the brainstem) to the auditory cortex (auditory processing center of the brain). Somewhere along the way, sounds get jumbled and mixed up. APD is simply a disruption within auditory processing pathway that causes a breakdown in the brain’s ability to piece together the acoustic puzzle correctly. Manifestations of APD include delayed auditory development, learning problems and poor academic performance.

An APD test battery includes tests designed to challenge the auditory processing pathway. You will be tested using headphones in a sound proof booth. Several core tests are administered, in which you or your child are asked to repeat back information (words, numbers and pitches) presented to each ear individually or both ears binaurally. These tests give us the ability to assess the auditory skills of decoding, integration and prosody. It is our job to help determine which skill areas are affected and to help you plan what’s needed to improve your or your child’s auditory processing abilities.

anatomy

Symptoms of APD

Symptoms of an APD can vary between individuals. Children and adults can experience the following challenges:

Preschooler
Elementary Schooler
High Schooler
College Age/Adult
Preschooler
  • Delayed speech and/or language development
  • Easily distracted by background noise
  • Inability to listen for long periods of time
  • Doesn’t like to sit for story time or looking at books
  • Unable to tell or retell a story
  • Doesn’t like loud sounds (often covers their ears)
  • Often says “What?” or asks for constant repetition
  • Acts like he/she has a hearing loss
  • Difficulty pronouncing certain sounds and words (e.g., confuses sounds like "da" for "ga")
  • Difficulty with learning songs and nursery rhymes
Elementary Schooler
  • Appears forgetful or easily confused
  • Difficulty following multi-step instructions
  • Difficulty with expressing needs and his/her emotions
  • Often doesn’t get the “punchline” of jokes or understand humor and sarcasm
  • Low appreciation of music and songs
  • Difficulty in background noise; highly distractible by noise in classroom
  • Doesn’t want to participate with friends at recess or in classroom group projects
  • Described as a loner
  • Uninterested in books, difficulty with reading out loud
  • Learning difficulties (e.g., poor vocabulary, poor reading comprehension, poor spelling ability, poor writing skills, difficulty with math word problems)
High Schooler
  • Often asks “What?”
  • Seems like has a hearing loss
  • Struggles in background noise
  • Learning difficulties (e.g., poor vocabulary, poor reading comprehension, poor spelling ability, poor writing skills, difficulty with math word problems)
  • Struggles with learning a foreign language
  • Forgetful and has difficulty with multi-step directions
  • Difficulty grasping abstract concepts (e.g., struggling with math assignments)
  • Trouble with non-literal language and drawing inferences (e.g., misunderstands sarcasm)
  • Hurt feelings because “mishears” or “misinterprets” what is being said
  • Difficulty with written exams, especially when under a time constraint; poor grades
College Age/Adult
  • Difficulty in reverberant listening conditions
  • Difficulty in background noise
  • Struggles with listening and note-taking simultaneously
  • Continues to struggle with written exams, needs extra time to complete exams
  • Difficulty tuning out co-workers while engaging in telephone conversation
  • Avoids social gatherings where loud background noise is present
  • Difficulty understanding foreign accents and rapid speech
  • Frustration in work meetings, especially with teleconferences
  • Cannot follow conversation in background noise (e.g., restaurants, cocktail party)
  • Misinterprets sarcasm spoken by others
  • Low appreciation of music (difficulty with understanding lyrics in a song)

Prior to Your APD Testing Appointment

If you or your child’s teacher suspect an auditory processing disorder, your child will need to undergo testing by a speech-language pathologist and an educational psychologist prior to being evaluated by Dr. Novick. An audiologist should be the final professional you or your child sees for diagnosis of an APD. The child must be at least 7 years of age to undergo a complete APD assessment at Silicon Valley Hearing, Inc.

Prior to an appointment, Dr. Novick will schedule a 30-minute phone conversation with you in order for her to gain insight into what your or your child’s needs are. She will ask very specific questions to help determine what the next steps will be. If your child has already had tests conducted by a speech-language pathologist and an educational psychologist, please kindly obtain copies of all test results and reports and forward them to Dr. Novick prior to scheduling an appointment for your child.

You will need to allow a minimum of 2 hours for a full APD assessment. Your child will be given numerous breaks between tests. Dr. Novick advises you to bring healthy snacks for your child to help sustain good energy levels for focus and attention. For children who have been diagnosed with ADD/ADHD, please be sure your child has taken his/her medication prior to APD testing.

A follow-up parent educational session will be scheduled 1 week following the APD assessment to fully review the test results with you; expect this appointment to be scheduled for 1 hour. Please do not bring your child to this appointment.

The APD assessment battery consists of tests in the following skill set areas:

  • Peripheral auditory system: assessment of outer, middle and inner ear structures & function) - think, “comprehensive hearing test”
  • Auditory discrimination: ability to discriminate individual speech sounds
  • Dichotic Listening: binaural integration and separation
  • Binaural integration: evaluates the ability to integrate (combine) two different messages being presented to both ears (binaurally) simultaneously
  • Binaural separation: evaluates the ability to listen to auditory cues in one ear while ignoring competing auditory cues in the opposite ear
  • Temporal patterning: ability to recognize the order (sequence) or pattern of non-verbal acoustic signals; also, examines the rate (temporal resolution) at which we can process auditory information (rhythm and timing of spoken message)
  • Auditory closure: ability to “fill in the gaps” when parts of the acoustic signal is missing
  • Auditory figure ground discrimination: assesses the ability to understand speech while in presence of noise
  • Binaural interaction: ability to detect a signal embedded in noise and localization of auditory signals

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We treat and test for tinnitus, hyperacusis and auditory processing disorders. It is important for us to be sure your experience at our clinic is a positive and enlightening experience.

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340 Dardanelli Lane
Suite 22
Los Gatos, CA 95032

Phone: (408) 540-7128
Fax:(408) 599-3013

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