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.

Signs of Auditory Processing Challenges

• Delayed speech and/or language development
• Easily distracted by background noise and avoids social situations
• Does not like loud sounds (often covers their ears)
• Often says “What?” or asks for constant repetition
• Inability to listen for long periods of time
• Difficulty following multi-step verbal instructions
• Low appreciation of music and songs
• Learning difficulties (e.g. problems with phonics, reading comprehension, spelling and writing skills, and understanding math word problems)
• Appears forgetful or easily confused
• Does not get the “gist” of jokes/humor or understand sarcasm
  

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 5 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.

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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

APD Phonemic Therapy Program

The APD phonemic therapy program is targeted to improve the following areas:

• improve sound-symbol association ability (pairing the sound of the phoneme with the orthographic symbol of the letter) 
• speech understanding in noise (extracting key words out of competing noise)
• phonemic blending and segmentation (blending individual phonemes into words and breaking down words into its individual sound parts) 
• short-term auditory memory

The phonemic therapy program is administered over a 15 week period, one session (45 minutes) per week. After the therapy round is completed, the individual’s auditory processing skills are re-evaluated for progress. This program was created by Jack Katz, Ph.D., an esteemed clinician and researcher in the area of auditory processing disorders. Please check out this video to learn more about the program.

‍CAPDOTS On-line Auditory Therapy Program

CAPDOTS is an audiological, evidence-based therapy program designed to help specific auditory processing deficits, known as binaural dichotic integration (auditory divided attention) and binaural dichotic separation deficits. It’s a program that can be administered by a parent, over a 12-week period. It’s designed to be delivered 5 nights per week, for 25-20 minutes per session. Dr. Novick is a licensed distributor for the CAPDOTS-Integrated and CAPDOTS-Separated programs.

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