Jj is for Jottings 137.  Auditory Processing Disorders.

Following on from auditory skills and developing auditory processing skills, we now turn our attention to auditory processing disorders.  There are so many conflicting ideas in the literature as to exactly what constitutes auditory skills. One could really become bogged down by this and therefore any resulting disorders.  There is even disagreement as to whether it should be “auditory processing disorders” or “central auditory processing disorders.”  I’ve decided to go with the thinking that “central” implies problems only at the brain level and consequently limits the definition.

CHARACTERISTICS OF AUDITORY PROCESSING DISORDERS.

Some key characteristics of auditory processing disorders are:

• Listening problems in background noise.
• Poor auditory memory span and sequencing.
• Slow responses to speech stimuli.
• Inconsistent responses to sound/speech stimuli.

As a result of this, the child often:

• Misunderstands what is said.
• Asks for information to be repeated.
• Shows behaviour problems.
• Has trouble with phonics.
• Displays reading, spelling and other academic problems.

The deficits can be found in the following areas:

• Attention
• Language
• Development of concepts
• Memory
• Relationships relating to time
• Reading
• Writing
• Speech sound production (articulation)
• Social use of language (pragmatics)
• Social relationships
• Low frustration tolerance.
• Low self-esteem
• Disorganisation
• Logic

There is often a related family history.

 

EXAMPLES OF AUDITORY PROCESSING DISORDERS.

Following are characteristics of two children taken from real life, to give a picture of how auditory processing disorders might look.

Child A.

At 8 years old, Child A had speech which is often difficult to understand, and was sometimes described as “muffled”.  Sound errors were inconsistent.  Hearing testing showed no problems in actual hearing, but he had great problems with learning sound-letter links. He was good at using cues from pictures to help him understand what he was reading, but few word attack skills.  Despite extra help, spelling wasn’t progressing.  Short term memory was poor, making things very frustrating for parents, teachers and the child.  Psychological testing indicated average potential, but he clearly wasn’t living up to that potential.

Child B.

Child B was in Year 6, and had had extra tuition since Year 4 to try and help him to keep up with his peers, but he still found schoolwork difficult. Speech was fine.  His teacher was concerned that he didn’t seem to follow what she was saying in class, despite the fact that he was paying attention.  Teachers often needed to repeat instructions.  Organisational skills were poor, with the wrong book or the wrong page open.

Both children.

When their language comprehension was tested, both children were several years behind their year group in their academic language skills.  Their language output was also behind expectations for age.  Conversational language was acceptable, but the gaps became obvious in the more formal written and spoken language required for the school curriculum.  This is a huge problem: because superficial conversational skills are fine, it tricks people into thinking the child’s language is within normal limits.  For more about this aspect in my experience with another child, see this article on direct vocabulary instruction.

What Lies Behind These Children’s Difficulties?

If you think about learning in computer terms, both children’s hardware is intact i.e. there are no vision or hearing problems and they have average potential.  The input in the classroom is good, since the other children in the class are learning successfully, but the output is faulty.

Child A.

Child A’s faulty output manifests as poorly discriminated sounds in speech, and difficulty retaining the sound concepts needed for reading and spelling.  So the problem lies with the software – the way Child A processes sound.  His auditory perception is impaired, so he is not certain which sound he needs to make.  He probably has more difficulty than the other children in hearing the teacher’s voice clearly above other classroom noise (poor auditory figure-ground – see developing auditory processing skills).  This contributes to the “muffled” quality of his speech: he isn’t perceiving the differences between sounds clearly, so his output is unclear.  His auditory memory is also short, which means it is hard for him to remember sound-letter links and other verbal facts.  So Child A has many problems which appear as a speech problem, but which also lead to limited comprehension and, as a result, limited expressive language use.  After all, we cannot express more than we understand.  And his poor academic performance also results from falling behind in remembering the vocabulary of his lessons.

Child B.

Child B is actually an older version of Child A’s difficulties.  His speech problems resolved years ago, but he has the same basic output problems.  It is likely that his auditory perception has always been weak, so sound awareness is still limited.  His mistakes in spelling and note-taking indicate that he is still unsure as to which sounds he is hearing or how to represent them on paper.  He has memorised most of his spelling, but since auditory memory is a problem, he makes many errors.  His poor auditory memory interferes with all verbal input – and of course there is plenty of this in the classroom.

GENERAL STRATEGIES TO HELP THESE CHILDREN IN THE CLASSROOM.

Some of these strategies apply to home as well, of course.

• Pre-read material with the student, so he has a head start before the teacher presents it to the full class. This may involve the family reading the material with the child the night before.  And it also obviously involves working closely with the classroom teacher.
• If the child is in a literacy group (and these children very often are), important targets are sound awareness as well as vocabulary revision.
• Adults need to give instructions slowly, one step at a time. Teachers can put visual prompts on the board.  It is even helpful for the teacher to put a finger up as she says each step, and use words like “first”, “next” or “second, third” etc.
• Involve pictures when explaining concepts. Use objects, sketches etc.  The problems are auditory in nature, so visual support is important to assist learning.

 

In this increasingly visual world, there is greater likelihood of children experiencing auditory processing problems.  We need to be acutely aware of good quality auditory input and developing auditory skills to try and counteract this.

 

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