Resources – Additional Explanations about APD

I have come upon a few explanations about auditory processing disorder that are succinct and clear. One mom of an APD boy posted a couple of topics:

• Information and Support for Central Auditory Processing Disorder (CAPD) – http://www.squidoo.com/capd
• Helping Children with Auditory Processing Disorder – http://www.squidoo.com/auditory-processing-disorder

Thanks to Bonzlee for posting those – I hope more people will discover and benefit from them now!

Also, a disabilities ministry in Buffalo, N.Y. has the following list online that seems accurate and clear:

(http://www.buffalodiocese.org/Portals/0/disabilities/Helpful%20Tips%20for%20Central%20%20Auditory%20%20Processing.pdf)
CENTRAL AUDITORY PROCESSING
The basic problem is perceptual or cognitive inefficiency or delay in perceiving, processing,
organizing or responding to what is heard – primarily, and most important in the classroom, it refers to the speed and effectiveness with which a child can process the spoken word.
Five points to know from parents:
1 . My child has trouble listening. Please understand that this is a learning problem and not a
behavior problem.
2. My child needs to hear things more than once to understand them. Please send important material home so that we can review it with them.
3. My child may have trouble filtering out background noise, and may be sensitive to sounds we wouldn’t notice. Please understand that they are trying to pay attention.
4. My child will benefit from being seated in clear sight of you, and having as many visual aids and cues as possible.
5. Please keep the lines of communication open between our home and your program . My child needs all the adults in her life working together.

Helpful Tips:

• Background noise may be extremely distracting – a seat near the blackboard or front of class may help.
• Be ready to repeat things – hearing is not a problem, but absorbing and processing the information can be laborious.
• Information needs to be presented in a multisensory way – that is, visual, auditory, kinesthetic and tactile. Children with these difficulties have a difficulty in obtaining information through the auditory modality, so it is important that visual materials are used when presenting new learning.
• Do not expect immediate answers to oral questions, or assume that because the child’s hand is not up, the child does not know the answer – the right answer may be there, but takes time to be formulated.
• Allow for some measure of frustration – remember that the child may be continuously undergoing a ‘tip-of-the-tongue’ experience.
• Word retrieval can be aided by providing structure words or the key words which the child is likely to use: this can help them write more purposefully and ease the frustration in trying to access words which they may have difficulty accessing.
• Let the child know you are aware of their difficulty, and that you are sympathetic – but that you have high expectations.
• Be specially generous with praise and cautious with criticism. Praise can be a natural motivator as long as the child feels the praise is genuine and deserved. It is important to let the child know why they are being praised rather than just to provide praise. In a behavioral reward system with extrinsic rewards such as stickers or points, the child can easily see why they are being praised. This can be an effective motivator, as long as the rewards are meaningful and appropriate.

I hope these are helpful. (The last one was mentioned in a comment by me on this blog, but I thought it would be good to gather a few resources in a single place.)

Subtypes of APD

From a checklist by audiologist Judith Paton of San Mateo, Calif., whose explanations seem helpful:

Tolerance/Fading Memory” subtype
Symptoms include:

• Often seems to “ignore” people, especially if engrossed.
• Hears less well, or is less attentive/productive, in ordinarily busy surroundings.
• Difficulty following a series of spoken directions.
• Unusually forgetful of information previously memorized (such as multiplication tables, correct spelling), or of household or school routines and responsibilities, despite frequent reminders.

“Decoding” subtype
Symptoms include:

• Difficulty with phonics (sounding out words) approach to reading.
• Confuses similar-sounding words; may learn words wrong.
• Poor speller: errors phonetically correct (e.g. “littul” for little) or seem random (wrong sounds, sounds/syllables missing/added).
• Problems with speech clarity or articulation, or with grammar, now or in the past.

“Integration” subtypes
Symptoms include:

• Marked difficulty reading or writing efficiently, despite knowledge of phonics.
• Needs to (or should) ask many extra questions to clarify task before starting; “doesn’t get the picture.”
• Interprets words too literally, becoming confused or suffering hurt feelings.
• Poor “communicator” -— fails to explain, apologize, negotiate, defend.
• Speaks or writes “telegraphically” -— omits facts or switches topic, so that audience cannot follow train of thought.

“Prosodic” subtype (often seen with NLD or non-verbal learning disability)
Symptoms include:

• Absorbs details and facts, but misses the “big picture” — cannot prioritize or summarize information.
• Insensitive to tone of voice; may misjudge speaker’s mood or be unintentionally tactless.
• Problems with cause-and-effect reasoning; difficulty surmising the unspoken rules of conversation, play, and other situations.

Another Voice – Auditory Processing is an Invisible Disability

My acquaintance Bonnie just found out eight months ago she developed APD as she was getting her hearing aids adjusted over the course of a couple of years.

She wrote the following letter to her adult kids to try to help them understand, and offered to share it in case it helps others to read how she expressed what she wanted them to know about its effect:

To my dearest children,

I thought I would put in writing what is going on with my hearing. I can explain it verbally, but, sometimes when written, it can be understood better. So here goes:

Auditory Processing Disorder is an invisible disability, a developmental condition that interferes with the processing of speech. Although my hearing is not good (40% loss) I have a problem with perceiving and decoding what people are saying. (Even if I had perfect hearing I would have the decoding problem … it’s not governed by my hearing loss).

Sometimes although the other person knows what they mean or what they’re saying, what I think they mean or saying are two different things. It’s like having poor cell phone reception, where the signal gets static or drops out.

How it affects me:

It’s difficult trying to keep up with conversations or to understand what’s being said, especially when there is “background” noise. This is especially true when I’m on the phone. This means I must spend extra mental effort to unscramble words. Sometimes it’s the decoding where I bog down. What I think I heard and what was actually said seems fine during the blah blah blah part, and then at the “mumble” section, the letters go bad and I have no idea what the words are. My brain goes limp at this point, thus the puzzled look or handing the phone off to someone else. Doing all this decoding takes up working memory. Because I have to attend to what is being said in words, I have less attention for figuring out what is meant in conceptual content. Discriminating between voices and background noises is difficult. Situations with multiple people speaking are especially challenging because all the conversations and background noises keep weaving together.

My working and short-term memory are used to process the conversation, rather than to remember what I’ve heard. The result of this is that many times I don’t have a clear idea of what the whole conversation was about, because I’ve not had much extra short-term memory left for storage. This again creates mental fatigue, especially at the end of a day.

Verbal directions can be difficult. I have trouble understanding, recalling and keeping straight a series of commands, i.e. … directions on how to get somewhere, steps involved in figuring a deal etc. … Additionally, many numbers/words sound very similar, frustrating for sure.

I am trying to learn how to cope. Talking one on one in a quiet area is great. When it gets to loud in my office, I can shut the windows on each side of me, or even the door if necessary. Speaking slowly is also important as it gives my brain time to “decode” what’s being said. And, if you notice that I still didn’t get it, try rephrasing what you are trying to say. Tapping me on the shoulder, or calling my name before you speak to me will get my attention and thus I can concentrate on the conversation. Many people think that APD is a volume problem and that talking louder will help, not so. My hearing aides will help with my hearing loss as a whole but they can not help with the APD.

It’s also going to affect my speech response to some degree as I’m trying to “decode” and answer back … it equals a slow response at times or at times I have a problem pronouncing my words properly… sort of like being drunk and trying to talk without slurring.

Meantime, my goal is to learn to lip read so that when the time comes that my brain decides it doesn’t what to decode anymore … I’ll have something to fall back on.

There is no cure for APD. It’s something that I will have to live with and cope with. It will allow me the opportunity to learn more about it and to be better able to find ways to communicate more clearly and more efficiently. Please understand that my conversational difficulties do no affect my motivation or abilities to learn and move forward. I’m stubborn like that.

I’m not looking for pity or want you to feel sorry for me as I’ve been blessed with so many things, i.e. … I can see, talk and get around without any assistance. I’ve been blessed with you all as my children and I couldn’t ask for anything more. I just wanted you to understand what’s going on, or not.

I love you all,

. . . Bonnie adds she has two grown sons, their wives, a grandson and a very supportive boyfriend (as I recall, she is in her 50s). Her journey to a diagnosis was, “I just couldn’t hear well. I had an MRI of my brain to make sure everything was OK and went back to my ear, nose throat doctor for exams of my ears and all was perfect. After my old audiologist retired, I had to get a new one and after much more testing, I was diagnosed. Actually, as we get older, it is something that can be acquired as our brains naturally aren’t functioning at top speed … I’m still having some other difficulties, and I’ll be going back again, as I seem to have some clumsiness about me and my hearing is diminishing more so.. but, that is to be expected from what I understand. I do hope my article helps others and thanks for your support as well.”

APD Can Mean That Being Atypical Challenges Mutual Understanding

On the topic of APD (also known as CAPD) and its impact, the following excerpts and/or paraphrases from an online discussion group for adults with APD rang true for me. We may exhibit idiosyncrasies, but have some commonalities of experience:

• It’s amazing how complex this disorder is, one recently diagnosed woman observed.
• Acceptance, understanding and support by family, friends and partners are essential, said a co-moderator.
• The ability to hear/process sounds and related symptoms varies and is affected by many things, such as fatigue, noise, stress, and hunger, said one member.

She voiced an experience shared by many, saying:

• It hurts so bad to be ridiculed about something that you have no control over. Many people do not understand APD is permanent and ongoing. Just because it is not visible or I do not reveal it, does not mean I do not experience its symptoms.

Several forum members said:

• They did, or almost did, have “nervous breakdowns” from the pressure, ending up at a hospital with panic attacks, for instance, when trying to keep up, fit in, perform, and deal with hostility and unsupportiveness for being different all became too much.

Meanwhile, it was heartening when, in the comment section of the blog Andrea’s Buzzing About, Laura wrote as a non-APD’er: “Boy, do I feel like crap after reading how hard life is with CAPD. … My husband and I are having severe marital problems … traditional Speaker/Listener exercises are not working … I took his behavior personally … would … explain myself over and over … He construes this as I am … insisting on changing his opinion … I holler at him ‘Listen to me! What I said was…..!’ I experience anger and frustration …” (especially when discussions are lengthy). [http://qw88nb88.wordpress.com/living-with-auditory-processing-disorder/] (1)

Reference:
1. Andrea. Andrea’s Buzzing About: Living With (Central) Auditory Processing Disorder[Internet]. San Francisco: Andrea’s Buzzing About: c2006-2008 – [cited Dec. 30, 2012]. Available from: http://qw88nb88.wordpress.com/living-with-auditory-processing-disorder/ .