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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 ear, at the level of detection (i.e. "I hear that"), and ending in the brain, at the level of comprehension (i.e. "I understand that"). 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 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 brain affected and the signs and symptoms exhibited and reported. 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, the four main categories are:
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.
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.
Integration
Integration refers to the communication between the right and left hemispheres of the brain using auditory input from each ear. 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.
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.
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.
Integration
Integration refers to the communication between the right and left hemispheres of the brain using auditory input from each ear. 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.