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A hearing test is the very important first step to a diagnosis.
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What is Auditory Processing?
Dr. Jack Katz, a pioneer in the field, describes auditory processing as "what we do with what we hear." Auditory processing involves many steps, starting from the outer ear, at the level of detection (i.e., "I hear that") and working upward to the cortical structures in the brain, for higher levels of comprehension (i.e., "I understand that") and manipulation (i.e., "How should I act in response to what I just heard?"). Auditory processing is the ability to separate the speech or sound from the background noise, remember it, maintain the sequence of it and combine the auditory information with other sensory inputs. In most cases, children with auditory processing disorders (APD) pass a routine hearing test and detect sound normally. However, they demonstrate difficulties on tests that tax the auditory nervous system, such as recognizing words in the presence of background noise and listening to speech presented to both ears simultaneously, for example. While a routine hearing test is an important first step in identifying and classifying hearing problems, the audiogram does not tell the whole story. A routine hearing test assesses our ability to sense sound vibrations in the ear, also known as peripheral hearing. Auditory processing is related to how we process those sounds we sense into meaningful information, also known as central hearing. Our ability to hear, listen, understand, attend, remember, and function in everyday communication situations, involves the WHOLE BRAIN and the WHOLE BODY! Auditory processing disorder is both a medical diagnosis and an educational diagnosis; it is a neurological delay or disorder that may affect the learning and the education experience.
Types of Auditory Processing Disorders.
There are different types of auditory processing disorders. The various types are related to the areas of the auditory pathway affected and the signs and symptoms exhibited. Any disruption (or distortion) in the transmission of the sound signal from the ear to the brain can be classified as an auditory processing disorder, including peripheral hearing loss. Treatment will vary depending on the type of auditory processing disorder. Peripheral hearing loss is often successfully treated with customized personal amplification, such as hearing aids. Auditory processing disorders without peripheral hearing loss are successfully treated with customized auditory training. Historically, we first learned about auditory processing disorders by studying patients who had brain lesions in the temporal lobe. Since then, we learned that individuals without brain lesions can suffer the same types of listening difficulties. In the Buffalo Model Approach, the four main categories are decoding, tolerance-fading memory, integration, and organization. Spatial processing and localization are different types of APD but may be related to one or more of these categories. You may hear or read other terms used describe a range of auditory symptoms related to sound tolerance and speech understanding, such as ambylaudia, misophonia, and hyperacusis.
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Decoding
Decoding refers to how quickly and accurately one digests speech, especially at the phonemic level. The associated communication and school problems are: difficulties developing clear speech, delayed responses, difficulties understanding what is said, and poor phonics. Integration
Integration refers to the communication between the right and left hemispheres of the brain using auditory input from each ear. Also called "ambylaudia," when one ear is weaker than the other. The associated communication and school problems are: severe difficulties with reading and/or spelling, long delays in speaking, and auditory-visual-motor integration problems. Children with integration type of APD may also have decoding problems and are often diagnosed as “dyslexic.” |
Organization
Organization refers to the order and sequence of the auditory information. The associated communication and school problems are: difficulties with sequencing and organizing. Children with organization type of APD often lose things. An organization type of APD often makes other problems much worse. Tolerance-Fading Memory
Tolerance-Fading Memory refers to speech understanding in noise, tolerance for noise, and short term auditory memory. The associated communication and school problems are: difficulties with reading comprehension, understanding in noise, short-term auditory memory, and attention. Children may also have difficulty tolerating noise and avoid noisy environments. |
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Spatial Processing
Spatial processing refers to the ability to use spatial cues in a three-dimensional auditory environment to understand speech in noise. |
Localization
Localization refers to the ability to perceive where sound is coming from based on timing and intensity information when sound reaches the ears. |
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