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Not sure where to go to test for auditory over-sensitivity


SEGway
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Hi! I think this is the place to ask.

 

One of my daughters seems to have difficulty focusing in/filtering out everyday sounds in normal environments. I think it's a problem that's been there for a while, but I'm just starting to notice it. My DH's sister struggled with this, too, as a child.

DD9 learned to read well at around 7-8, and now she can read (and enjoys) books like Nancy Drew and Mysterious Benedict society. The process was sometimes a struggle, though. I think using phonograms as chunks of words was key for her. I've wondered recently about her eyesight, too, and I think I've found a place that does COVD about an hour from where we live. So, that's on the short list of things to work on making happen.

What kind of hearing testing is appropriate to see if she hears so much that it's hard to sort through all the sound? Is that what CAPD is? Or is there another acronym? I'm new at this.

TIA

 

Sarah Gwin

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Auditory processing problems can make it hard to filter things out, but so can ADHD. My ADHD kiddo tunes into sounds all over the place instead of what he should be listening to, but he can hear what he's supposed to. For him, it's all attention-based. He passed the auditory processing screening with flying colors. My younger one has trouble hearing with background noise--it just mashes together.  

 

Some kids with auditory processing problems are also acutely aware of sounds, and it bothers them (in a sensory way). That doesn't have to be the case, but it can be.

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Yes, you're saying auditory hyper-sensitivity, but what you're describing is APD (auditory processing disorder).  There are audiologists who specialize in it who can run the screening portion of the SCAN3 for you.  Sometimes another practitioner (SLP, psych, whatever) will be able to do it too.  So if your insurance covers one type of service and not another, that could give you a start.  

 

How old is this dc?  They won't want to run a full booth APD eval until at least 7.  Some audiologists will want SLP and psych evals first.  Our university has big name researchers in this, and they will do a basic audiology eval and the screening portion of the SCAN3 for $35.  I have taken both my kids.  My dd is *borderline* on the SCAN3 screening portion.  It gives her definite problems, but they didn't want to refer over for the full SCAN3.  Doing the eval, in her case, gave us info on how to accommodate it.  I would DEFINITELY do the eval with your dd, since you're going to learn something.  

 

There's also testing for auditory hyper-sensitivity.  They did this on my dd, since it's something she has complained of.  By the numbers, she is not.  It's controversial testing, because they're testing threshold tolerances.  I would never allow it to be done on me.  My dd wanted it and was of age, so she chose it.  

 

Fwiw, ADHD will often be co-morbid, and ADHD meds anecdotally help the APD symptoms.  So definitely pursue evals and get it sorted out.  With the presentation you're describing, you will probably get some labels, learn some things, and get useful information.

 

Agree on the eye exam, btw.  But I would up-prioritize the audiologist.  Don't just go random though.  Do it with someone who knows APD, who has the full booth set-up.  For the eyes, I would start with just a basic eye exam with a developmental optometrist and ask them to screen.

Edited by OhElizabeth
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No insurance, and other kids with medical bills, so I'm doing as much homework upfront as I can so I know which tests to call around for and ask if they do it and their pricing. Is this something with a directory of specialists who test APD specifically? Google is mostly taking me to hearing aid stores (who have audiologists). Is it something to call a general practitioner and ask who they typically recommend? Does it require a referral of some kind?

 

DD just turned 9. I don't think there are typical/common developmental delays. Just some things that I've noticed are more frustrating to her than I would have guessed.

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Yes, sometimes you'll find a private audiologist (not with a hospital or large practice) who has a full booth set-up to test for APD.  They'll say that on their site and it will be sort of a specialty for them.  But just to pick some random audiologist, I would NOT do that.  You want one who has learned a lot about APD, who has the full booth set-up, who will run the screening portion of the SCAN3.

 

Have you checked to see if they qualify for your state's children's health insurance program?  

 

When you say she has difficulty filtering our sounds in noisy environments, how severe is this?  At the less severe end, she'll get an ADHD label, meaning you're looking for a psych.  At the more severe end, she'll get an APD diagnosis and maybe the ADHD label as well.  (audiologist and psych evals)  I'm saying saying sort through that and don't do more than you need.  Our university has a huge audiology clinic and can do the basic audiology and SCAN3 screening portion for $35.  You might see if you have an option like that.  My dd has trouble distinguishing sounds in normal backgrounds, and she has ADHD.  Kids who push over into APD will have more extreme symptoms, almost seeming deaf in the noisy backgrounds.  My dd is right on that line where she could push over.  We've wondered what would happen if they did the full eval.  The audiologist said it's an area of weakness and to accommodate.  

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Yes, sometimes you'll find a private audiologist (not with a hospital or large practice) who has a full booth set-up to test for APD. They'll say that on their site and it will be sort of a specialty for them. But just to pick some random audiologist, I would NOT do that. You want one who has learned a lot about APD, who has the full booth set-up, who will run the screening portion of the SCAN3.

 

Have you checked to see if they qualify for your state's children's health insurance program?

 

When you say she has difficulty filtering our sounds in noisy environments, how severe is this? At the less severe end, she'll get an ADHD label, meaning you're looking for a psych. At the more severe end, she'll get an APD diagnosis and maybe the ADHD label as well. (audiologist and psych evals) I'm saying saying sort through that and don't do more than you need. Our university has a huge audiology clinic and can do the basic audiology and SCAN3 screening portion for $35. You might see if you have an option like that. My dd has trouble distinguishing sounds in normal backgrounds, and she has ADHD. Kids who push over into APD will have more extreme symptoms, almost seeming deaf in the noisy backgrounds. My dd is right on that line where she could push over. We've wondered what would happen if they did the full eval. The audiologist said it's an area of weakness and to accommodate.

The SCAN may have been the test that the first audiologist used when she told me it wasn't APD but must be ADHD with those symptoms. Years later I went to a children's hospital where they felt justified in doing the full eval and she did get the APD dx. And the NP eval supposedly ruled out ADHD. So who knows?

 

If I were you, OhE, I might get the APD eval if it would get any helpful understanding or accommodations. Your DD has the left ear advantage, too, doesn't she?

 

I'm also highly skeptical of the no ADHD dx, and I think it would be very interesting for her to do a trial of meds. My younger DD didn't get the ADHD dx either but at that point we were already using meds and saw a significant benefit. And now there's a big difference in school after the meds wear off.

 

Sorry for the rabbit trails.

 

But, yes, the OP's DD sounds like mine who has CAPD: sensitive to noise, very poor comprehension and overwhelmed in noisy environments.

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Misu, that's something I've been thinking about lately.  I talked with a private audiologist who wasn't insanely expensive who could do the whole thing.  It's just the university wouldn't refer her for the full.  It's crazy, because yes LEA and yes she was right on the line, just 1 point from failing the screening.  And the symptoms are pretty overwhelming for her in some scenarios.  I think she probably would have pockets of problems that could be identified.

 

Technically I could call and just schedule the full eval with the univ even though they didn't want to refer.  Or go to the private.  I don't remember the cost of private.  But yes, it's on my list of wow in reality we'd probably finally get some explanations.  I think there's probably *something* in there that's at a clinical level.

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Elizabeth, My DD only had a couple areas of concern, the signal in noise and the competing sounds or whatever it's called. The scores I we're not all horrible either; some were. I really can't remember all the details. And my DD is a musician who never had obvious trouble reading or spelling like one might expect. But, in real life, her weaknesses are glaringly obvious and cause significant issues in functioning in certain environments. She's smart and compensates but it's there, making life hard.

 

So then you have that, and add in the visual stuff that's there but not quite severe enough for a dx, and the motor stuff that also there but not enough for a dx, and the visual-motor stuff. And we may only have a CAPD dx officially but sheesh, it's not easy for these kids when you put it all together.

 

And never mind the sensory, and the relatively low WM and PS.

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My dd has different problems, but in our city, the school district covers audiologist visits for children at no charge until the child turns 21, even if they are homeschooled.  (As was our case.)  This was done at the local hospital.  The visiting audiologist at the time was excellent.  He was older with lots of experience, and was a great place for us to start.  

 

Also, my dd has actual hearing problems (wears hearing aids), but she also has trouble filtering out some sounds.  You'd think having a hearing problem would muffle all sounds, but some sounds seem to come in even louder (at least that's how she perceives them) and even hurt.  I don't know if that's a possibility in your situation, but thought I'd throw it out there.

 

Another family member meets with a speech language therapist, and I know that she also does some work with auditory processing disorders.

 

 

 

 

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You wrote that she: 'seems to have difficulty focusing in/filtering out everyday sounds in normal environments.'

 

With our hearing, we can focus it, in much the same way as our vision.

Which is due to having 2 ears, that enable bi-aural focusing.

 

A simple test for this, just involves having someone sit on a chair, in the middle of a room.

Then keeping their eyes closed.

A person moves to different points around them, and says something, or makes some sounds.

The person sitting in the chair, without opening their eyes.  Then needs to point in the direction that they think that the sound is coming from?

The other person moves to random points around them, and tests their ability to locate a sound?

 

Quite likely, you will find that she isn't accurate with locating sounds?

 

Though this ability to 'locate sounds', is what we use to cope with 'competing sounds'?

Where we can shift the focus of our hearing, to different points.

 

As another test, perhaps you could do a test with your TV and  a Radio?

Where you have the TV to one side of you, and the Radio to other side.

Turn them both on, at around the same volume.

 

Then close your eyes, and try to shift the focus of your hearing?  From the TV to the Radio, and back and forth?

 

Where quite likely, you will find that you can shift your hearing?

Which is how we actually filter out, other sounds.

Just by shifting our focus.

 

Though about 8 years ago, I did a study and trials into this.  With members of an APD organisation in the UK.

Where I found that for people with adequate hearing in both ears?

That by doing daily practice for a few minutes a day.

Firstly with trying to locate sounds around them?  They went from being way off, to being able locate sounds.

 

Then the next step, involved practising with a TV and Radio? 

Where they gradually developed the ability to shift their hearing focus, back and forth between.

So that they could follow conversations on either one, and filter out the other.

 

But it does require the special equipment, of a Chair, TV, Radio and another person.

With 4 or 5 minutes practice a day.

The improvement was generally quite rapid. and could be observed.

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