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Anyone familiar with auditory processing or speech/language issues?


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Our DS, 9, just had an auditory processing eval and we recently got report. One question I forgot to ask the audiologist was just so simple--does he have auditory processing issues?

 

We did discuss the specific results, mostly normal but he didn't pass Auditory Continuous Performance Test (raising thumb for target word), or Memory for Sentences (repeating sentences w/o visual cues), or the RAN/RAS (perceiving visual symbol and retrieving name for it accurately and rapidly).

Audiologist said sensory issues might well be a large part of it and also recommended ST evalu and language therapy for auditory working memory issues. Therapy to include things like visualization and chunking.

 

Our son has sensory issues already (difficulty w/background noise esp), and does have an ADD diagnosis. Very, very bright but difficulty w focus especially in noisy or large environments like classroom. (Thus the HSing this year).

 

If anyone can help me learn more about this, please, I'd so much appreciate it. Will definitely ask more ?s of audiologist. But I was wondering if these scores on a couple of tests constituted auditory processing issues or not. Just wondering if I'm trying to describe issues to someone new, would I mention auditory processing or not?

 

 

Thank you so much for any help....

 

Amy

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Were you given a typed report for your records? When DD9 was evaluated, the audiologist was able to tell me on the day of testing that she definitely had an auditory processing disorder. We received the actual typed report several weeks later, and also had a phone consult to follow up and discuss the results. In the report it specifically says that she is diagnosed with CAPD, and gives recommendations as far as following up with speech/language therapy, as well as recommended accomodations for school work. You should have received some kind of written documentation that explained exactly what the results mean.

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...not a clear diagnosis of auditory processing disorder.

 

We talked in the office about the results of each test and her recommendations. The full report gave all the test results and whether they were normal or not, and accommodations she recommended in the classroom and recommended follow-up with an OT and speech eval and language therapy.

 

But after I read the report it occurred to me that I still wasn't clear whether he had auditory processing disorder or not. The pediatrician had recommended the eval b/c of DS' sensory/auditory issues and said it would be a good idea to exclude any auditory processing issues on top of ADHD-Inattentive. But the report doesn't give a diagnosis OR exclude auditory processing.

 

I will ask her this question (the audiologist). But in the meantime, with the results do you think he might have this?

 

Amy

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Before therapy, I believed that my son had ADD/ADHD, but it's very apparent that now that he has the tools to deal with his language disorder, he's a really calm focused kid with pretty good self-regulation.

 

 

I think you're correct that their wigging out is a reaction to trying to deal with something they can't handle (auditory, visual, sensory, whatever). But I also wonder to what degree the choline you have him on affects attention... I'm getting ready to try it with ds (having used food sources to great benefit so far!), but I've wondered what it would do for dd. In other words, you've been doing SO many great things, they might all be fitting together. Also you have him on some kind of omega3, right? I ran out of capsules and thought I'd have dd take the liquid to save money. Well the taste was so bad she couldn't bring herself to do it. So after a bit of avoiding it like that, she has become really jumpy and reactive. Needless to say, the capsules came yesterday and we're getting her back on!

 

To the op, you asked about exercise in the other thread. Our OT eval showed that dd is low stim. Exercise in the morning is basically impossible. However an appropriate level *at night* can actually be really calming to her. So it's different kids. The OT can help with the sensory that gets in the way of the working memory.

 

Check out "Delivered from Distraction" and "When the Brain Can't Hear."

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I had two daughters evaluated for auditory processing disorder..

 

In the now 8yr old.. They discussed the test with me, talked about her weaknesses, gave me a few examples of what she did, told me what I could work on at home, etc.. But they did not mention APD. And when I asked if she had APD, they said no.

 

In the now 10yr old.. They discussed the test with me, talked about all the sections, her weaknesses, etc.. but then they told me that she has auditory figure-ground processing disorder, told me exactly what that was, told me exactly what therapy she needed for it, etc.

 

So I would think if your daughter had a specific diagnosis, they would have told you and discussed it with you, including any therapies she would need.

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I think the choline may affect attention. I'm not sure yet. There's is this combo phosphatidyl serine product in the stores that is sold specifically for memory, focus, that sort of thing, and it contains choline.

 

Time? Oh mercy, never enough. But I have this sort of impatient way of reading. I start at the toc with my index card, read whatever sections look good to me, read more if those turn out to be interesting, and then return the book to the library. I don't get as much as more thorough readers, but I get enough. Very few books I've been reading have been worth reading every single page. "School of Dreams" was, definitely.

 

Actually, I think what has helped my reading is the index cards (5X7). They're insta-bookmarks and I can see not only where I left off but what I was THINKING when I stopped. It means I can get pulled away and come right back and be fine. And with that external memory, I'm not so worried about reading slowly and retaining, kwim? It's letting me get through more books faster.

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  • 2 weeks later...

I'm the OP -- I contacted our son's audiologist and asked for some clarification. She said specifically auditory processing weaknesses in the areas of auditory memory and auditory attention.

 

In the original report she strongly suggested speech/language therapy followup.

 

Is anyone familiar with auditory processing difficulties in the above two areas and what kind of therapy the ST might do?

 

We also will followup with an OT b/c of sensory issues.

 

But have to say that in the couple of weeks since I posted this, that just pulling him out of school and homeschooling has been HUGE. There has been such a significant difference, the environment is helping a lot as is having a ratio of one-to-one.

 

Amy

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Yllek,

Not sure if you are still following this thread...but the individual tests where our DS scored abnormal were the one where he was instructed to listen to a list of words andraise his thumb when he heard the target word. This was described as children can have processing and attention problems. The other one was being presented sentences without visual cues, varied in length, and instructed to repeat them. He couldn't do this well.

 

Another separate area was two subtests of the RANS test, which was perceiving and quickly naming a visual symbol -- she thinks there may be some weaknesses in visual processing. An OT at our co-op yesterday gave us the results of some of her testing and mentioned visual as an area of difficulty.

 

But what I wanted to ask was how you are working on dealing with situations with a lot of auditory input (noisy rooms, classrooms, lots of talking going on at once etc.). How you described your DD was just how our son is in these environments...like all his circuits are on overload and you REALLY have to work with him to get him to respond or answer questions. Sometimes he'll articulate that "it's just a bit much" if you ask him how he's doing (like last weekend in a crowded room with displays, and lots of people milling around, we were there for 6 minutes and he asked to leave). He just moves slower and slower, and even if you ask him a direct question he has trouble with it.

 

In a quiet environment, mostly, he does very well. All of this is very confusing since we now have sensory issues, an ADHD inattentive diagnosis (just based on questionnaires of behavior), auditory processing, and now maybe some visual issues. How do you balance it all out, especially when he is very bright? It seems that if ADHD is diagnosed on a questionnaire of behaviors, how do you know it is that and not auditory or sensory?

 

 

Homeschooling has been the best ever for him as far as being able to do his work. He didn't like all the noise and commotion of school. But we do want to followup on the audiologist's recommendations.

 

Amy

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I'm the OP -- I contacted our son's audiologist and asked for some clarification. She said specifically auditory processing weaknesses in the areas of auditory memory and auditory attention.

 

In the original report she strongly suggested speech/language therapy followup.

 

Is anyone familiar with auditory processing difficulties in the above two areas and what kind of therapy the ST might do?

 

We also will followup with an OT b/c of sensory issues.

 

But have to say that in the couple of weeks since I posted this, that just pulling him out of school and homeschooling has been HUGE. There has been such a significant difference, the environment is helping a lot as is having a ratio of one-to-one.

 

Amy

 

Yes I am dealing with this with my dtr.

The SLP/Audiologist recommended an auditory trainer for my dtr, which I used at home for teaching certain times of the days. We no longer use it, but will see if she needs it at some future time in school settings.

 

OT helped alot: Therapeutic Listening helped her cope with outside noises, the tone of her own voice. The OT did alot of proprioceptive and vestibular work, sensory, swinging, bi-lateral stuff.

 

She has had speech for 5 yrs now. She needed alot of articulation work and the SLPs constantly work on following directions, first 2 step then3 etc. Recall and retrieval techniques. Chunkingsounds, syllabication, slowing her rate etc.

 

I do alot at home,too... We did Earobics at home for memory and attention. I used LiPs, exercises from Dr. Rosner, Listen My Children and You Shall Hear, Auditory Memory (digit spans, letter spans and word spans) from Addie Cusimano.

 

I can't fix my dtr but I was told I can strengthen her weaknesses.

 

HTH

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I'm not familiar with the RANS test, so I'm not sure how the visual symbol test is set up. One question that immediately comes to mind is how they are parsing out the visual processing issues from the naming issues. Ds has just finished a battery of tests with his SLP (yearly progress eval), and I'm struck by how some of our tests conflate language issues, visual processing issues, and even content knowledge issues. Anyway, I would personally ask how the evaluator (OT or audiologist?) is determining whether the results of that test demonstrate a visual processing issue or a word retrieval/expressive language issue.

...

 

:iagree:

 

I recently was struck by this same thing.

 

Short version of the long story. DS-10 recently had not one, but two vt exams by two different doctors. My ds's visual memory on the first exam scored particularly poor--to which I asked the doctor how they knew it was a vision problem and not memory problem? How could they tell it was a vision problem vs. hand coordination problems? Second vt did look at the auditory system a bit by doing a test to look at auditory-visual processing, but again, it relied memory. These skills are interconnected and trying to parse out which is exactly the problem is difficult.

 

I'm reading this thread with interest because the second vision therapist suggested that my ds may have auditory processing problems and suggeted f/u with an audiologist. Years ago, an slp discovered phonological and memory problems. She recommended and monitored our use of "The Listening Program" and also referred us to an audiologist. Audiologist found his hearing fine and suggested nothing. I don't know if another f/u with an second audiologist at this point would be helpful or not. I spoke with an expert on dyslexia and that person suggested that if I really wanted to f/u on this, then we should see a neuro-psych for a full exam.

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Not to be dumb, but I don't see how a dyslexic could FAIL to have auditory processing issues, since that's part and parcel in the definition of dyslexia (auditory and visual processing differences). To me the only question is the degree.

 

I'm trying to remember here whether our VT ever *evaluated* working memory. They had ways of looking at visual memory and aspects of visual memory and quantifying it on tests. (I would have to pull out the tests to have the names of the categories.) However for WORKING memory, that they only hit as a FUNCTIONAL issue. So working memory came up when they were USING it to work on visual processing. So I'm saying the tests Merry is describing aren't what our VT doc did. They might logically fall more in the province of what the neuropsych would be best to look at. I think any time you're asking one of these specialists to analyze something out of their field you can get into problems. So I don't expect the VT to answer about OT or auditory issues, only vision. They should refer beyond that. And so on. The neuropsych is so expensive because (hopefully) he has a clue about all those and how they work together. But no, our VT didn't tackle anything auditory like that and referred when they say indications of OT stuff. A question of whether it's EYES or HAND is actually an OT question. The OT can easily discriminate that, because that's what they're trained to do. They look at the same organ from a different perspective. So there are actually eye things that are in the realm of OT (I speak as a fool here) and eye things they refer off to the VT.

 

Did I muddle that more? :)

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Not to be dumb, but I don't see how a dyslexic could FAIL to have auditory processing issues, since that's part and parcel in the definition of dyslexia (auditory and visual processing differences). To me the only question is the degree.

 

Mine doesn't. As a matter of fact his Auditory Processing is above average. However his retrieval is terribly low. Maybe you are grouping these processes together. Input and processing is great but trying to get it out of him. Well, we work at it. It's getting better.

 

His Auditory Memory is almost perfect. Hind of the auditory equivalent of photographic memory. A great blessing. It makes remediation much easier. Not easy, but easier. Of course it is only really perfect for contextual, global thinking things. Not as good with rote but better than visual.

 

Definitely speech issues though.

 

Anyhow, there is no way to know without an evaluation. My guy has "issues" but when testing there were no problems at all with processing, it's all retrieval issues and motor coordination.

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Mine doesn't. As a matter of fact his Auditory Processing is above average. However his retrieval is terribly low. Maybe you are grouping these processes together. Input and processing is great but trying to get it out of him. Well, we work at it. It's getting better.

 

His Auditory Memory is almost perfect. Hind of the auditory equivalent of photographic memory. A great blessing. It makes remediation much easier. Not easy, but easier. Of course it is only really perfect for contextual, global thinking things. Not as good with rote but better than visual.

 

Definitely speech issues though.

 

Anyhow, there is no way to know without an evaluation. My guy has "issues" but when testing there were no problems at all with processing, it's all retrieval issues and motor coordination.

 

Ooo, I'm glad you took me to the mat on that! That's interesting to ponder! I found this link http://www.asha.org/public/hearing/disorders/understand-apd-child.htm with this article:

 

**************

In its very broadest sense, APD refers to how the central nervous system (CNS) uses auditory information. However, the CNS is vast and also is responsible for functions such as memory, attention, and language, among others. To avoid confusing APD with other disorders that can affect a person's ability to attend, understand, and remember, it is important to emphasize that APD is an auditory deficit that is not the result of other higher-order cognitive, language, or related disorder.

 

There are many disorders that can affect a person's ability to understand auditory information. For example, individuals with Attention Deficit/Hyperactivity Disorder (ADHD) may well be poor listeners and have difficulty understanding or remembering verbal information; however, their actual neural processing of auditory input in the CNS is intact. Instead, it is the attention deficit that is impeding their ability to access or use the auditory information that is coming in. Similarly, children with autism may have great difficulty with spoken language comprehension. However, it is the higher-order, global deficit known as autism that is the cause of their difficulties, not a specific auditory dysfunction. Finally, although the terms language processing and auditory processing sometimes are used interchangeably, it is critical to understand that they are not the same thing at all.

 

For many children and adults with these disorders and others - including mental retardation and sensory integration dysfunction - the listening and comprehension difficulties we often see are due to the higher-order, more global or all-encompassing disorder and not to any specific deficit in the neural processing of auditory stimuli per se. As such, it is not correct to apply the label APD to these individuals, even if many of their behaviors appear very similar to those associated with APD. In some cases, however, APD may co-exist with ADHD or other disorders. In those cases, only careful and accurate diagnosis can assist in disentangling the relative effects of each.

**********

 

So this article does like you're saying, parsing between what is the auditory processing (actual processing of auditory input, which I agree with you is not my dyslexic dd's problem) and issues with attention, output, etc. due to other, more global problems (like dyslexia, SPD, ADD/ADHD). My dd, when she's watching me play Wii, cannot get out something as simple as "Turn left!!" without getting frustrated. The small amount of reading I had done had honestly left me worried that she *did* have some form of APD. I hadn't seen them split hairs and eliminate the global causes for the same symptoms. And there is a sense in which you start to feel like these kids could honestly go 20 places and get 20 diagnoses, even though there's only one overall thing going on, a thing that's not so much a PROBLEM as a difference.

 

So yes, what you're saying makes a lot of sense, thanks. And I assume that's stuff you learned in your neuropsych eval?

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