Diagnosing an Auditory Processing Disorder

[Oak Knoll Mom]

I'm pretty sure one of my sons has an Auditory Processing Disorder. From what I've read, the first step would be to go to an Audiologist then possibly on to a speech pathologist. I started asking around for recommendations for and Audiologist and ended up in an email conversation with a speech therapist who is a friend of a friend. Here is her most recent email.

 

I would recommend AHNE for children in general, however, I don't know of anyone in this area who does central auditory processing testing. True CAPD testing by an audiologist takes hours to do, and I think that it is done so infrequently that places have stopped doing it. It is sometimes done at Universities, so you might want to check with [insert local university]. When I was in clinic, the general rule was that if a child has trouble in school, and central auditory processing was thought to be the cause, the recommendations were the same whether the child was actually diagnosed with CAPD or not.

 

Have you found this to be true? Is it really that hard to find someone to test and diagnose APD? She keeps mentioning problems in school, and he does have some academic issues, but his language problem is affecting his life in general, not just school.

 

Help! I'm at the end of my rope and I know my son has been at the end of his rope for quite awhile.

 

TIA

[Renee in NC]

This has been true here as well. As of yet we have not been able to get CAPD testing, but I haven't given up yet. Easter Seals (where my two get OT and ST) used to do it, but not anymore. I've been told we may need to go to a bigger city to have it done.

[LizzyBee]

That is surprising to me. Our audiologist is in Raleigh, only about 40 min from our home. She works for a local ENT/ST practice, not affiliated with a hospital or university. Duke has an APD department, too, so if we hadn't found our audiologist, we would have gone to Duke. A friend of mine had her son's testing at Duke. I guess I am lucky to live in a place where these services are available.

 

Our audiologist was very helpful and getting the diagnosis was worthwhile. She spent a lot of time going over her report and recommendations in a separate appt without our kids.

 

For kids who are in school, why would the school give them modifications for APD if they didn't have the diagnosis?

 

You mentioned language problems. Has he been evaluated by an SLP? Even though an audiologist does the diagnosis, most of the recommended treatments are provided by SLPs. A good experienced SLP doesn't need an APD diagnosis to diagnose and treat the related language issues. Just find one that has a lot of experience. My dd8 was evaluated once by a young SLP who didn't see any evidence of APD (!) even though my poor dd failed the evaluation so badly that the audiologist didn't even wait to score the results before telling me that there is something serious going on with her and I need to go ahead and start scheduling evaluations with other professionals. The SLP my dd has now is great!

 

ETA: Our insurance covered my kids' APD testing, although I understand that some insurance companies don't.

Edited May 6, 2010 by LizzyBee

[SuperMum]

Hi and well done to you for recognising this could be an issue for your child. I would advise to seek testing ASAP so that you know for sure if you are dealing with CAPD or not. Most audiology clinics will also test for CAPD however I have noticed a growing trend here in Australia for clinics to cut out this service as they cater to and make a larger profit from providing hearing services for the elderly. Having gone through two CAPD testing sessions with my child (we can legally only test every 3*years here) I would like to offer you some pre-test advice.

1. These tests are very expensive well they are here anyway and often not covered by health insurance so be prepared for some financial outlay.

2. Naturally make sure your child is well rested before each appointment as they are exhausting for the child to complete - my daughter would fall asleep as soon as she was in the car even though it was only 1:00pm.

3. It can be worth seeing a speech pathologist before you do the test - why?? Well they can give you an indication of deficits that they are noticing that will help you advise the audiologist as to why you think this test is necessary. Also a speech pathologist can help you interpret the audiology report in a language that you can understand - some reports are better than others but it always helps if afterwards you have some-one who knows you and knows your child to help break all the info down for you and come up with a workable plan.

4. Cost speech pathology is expensive as well so an initial assessment and one appointment only should be all you need b4 you have your audilology appointment.

5. Don't panic if it is CAPD we are living in a time where technology and science have powered on to deliver us many educational alternatives and strategies that will allow our CAPD children to as functional in life as any other child.

Finally I have a blog in which I am discussing my daughters journey and struggles to overcome CAPD and dyslexia.

http://ltuilc.blogspot.com/

All the very best to you on your journey please keep us posted as to your progress.

Kindly

Anne

[LittleHouseHomeschool]

We saw an audiologist at a local hospital. The initial hearing exam and first APD screening at the hospital were paid for by insurance. However, once the diagnosis was made, we were referred to a specialist and we learned that the available therapies are not paid for by "most insurances," because they are controversial and scientifically unproven.

 

Most folks (including the public school system) tackle APD with accommodations. Why? Because they are nothing more than really good study habits! (Like studying in a quiet room with no background noise. Using ear plugs when there is noise. Practicing proper pronunciation by reading aloud a few minutes a day. Actively using a reading comprehension program that exercises comprehension skills daily. Using hands on as a medium to cement what a child might have not "heard." Practicing memory skills, using a intensive and systematic phonics and spelling program, Even Ruth Beechick style dictation is helpful, as well as editing programs such as Editor in Chief. Honing notetaking skills. Writing down directions, etc... The list is endless. ) Good teaching...good studying...practice, practice, practice with the focus of developing stronger skills. The more individual and customized you can make the plan of attack, the better.

 

The testing is helpful for that reason, because it pinpoints the exact APD problem. I would suggest researching the issues, learn about accommodations and put as many of those into place. (Remember, they are good habits no matter who you are.) But I would also recommend the testing to help you be a better teacher for your individual student.

 

I would call your nearest hospital and ask if they know of a facility with an audiologist. Most hospitals have them to diagnose hearing loss. Alternatively, you can ask your pediatrician.

 

~Yvonne

[Oak Knoll Mom]

That is surprising to me. Our audiologist is in Raleigh, only about 40 min from our home. She works for a local ENT/ST practice, not affiliated with a hospital or university. Duke has an APD department, too, so if we hadn't found our audiologist, we would have gone to Duke. A friend of mine had her son's testing at Duke. I guess I am lucky to live in a place where these services are available.

 

I was surprised too! Asheville is the center for medical treatment for all of WNC and we have specialist of every kind here! I wouldn't be opposed to going to Duke for testing if we need to. My kids used to go to the dermatologist there and my dad just had a bone marrow transplant there. We love Duke doctors! :D

 

Our audiologist was very helpful and getting the diagnosis was worthwhile. She spent a lot of time going over her report and recommendations in a separate appt without our kids.

 

This is what I'm hoping for. Someone who will take our concerns seriously and help us navigate our way through this.

 

You mentioned language problems. Has he been evaluated by an SLP? Even though an audiologist does the diagnosis, most of the recommended treatments are provided by SLPs. A good experienced SLP doesn't need an APD diagnosis to diagnose and treat the related language issues. Just find one that has a lot of experience.

 

I've considered that. Do you think it would be worth it to go that route first?

 

My dd8 was evaluated once by a young SLP who didn't see any evidence of APD (!) even though my poor dd failed the evaluation so badly that the audiologist didn't even wait to score the results before telling me that there is something serious going on with her and I need to go ahead and start scheduling evaluations with other professionals. The SLP my dd has now is great!

 

That's terrible! I'm glad your daughter is with someone competent now.

 

ETA: Our insurance covered my kids' APD testing, although I understand that some insurance companies don't.

 

What insurance do you have? We have BCBS. I haven't looked up whether or not they would cover it.

[Oak Knoll Mom]

Thanks for this info and your encouragement. I look forward to reading your blog.

 

I will definitely consider consulting with a SLP first.

[Oak Knoll Mom]

This has been true here as well. As of yet we have not been able to get CAPD testing, but I haven't given up yet. Easter Seals (where my two get OT and ST) used to do it, but not anymore. I've been told we may need to go to a bigger city to have it done.

 

I hope you find some help soon!

[Oak Knoll Mom]

We saw an audiologist at a local hospital. The initial hearing exam and first APD screening at the hospital were paid for by insurance.

 

That's encouraging!

 

Most folks (including the public school system) tackle APD with accommodations. Why? Because they are nothing more than really good study habits! (Like studying in a quiet room with no background noise. Using ear plugs when there is noise. Practicing proper pronunciation by reading aloud a few minutes a day. Actively using a reading comprehension program that exercises comprehension skills daily. Using hands on as a medium to cement what a child might have not "heard." Practicing memory skills, using a intensive and systematic phonics and spelling program, Even Ruth Beechick style dictation is helpful, as well as editing programs such as Editor in Chief. Honing notetaking skills. Writing down directions, etc... The list is endless. ) Good teaching...good studying...practice, practice, practice with the focus of developing stronger skills. The more individual and customized you can make the plan of attack, the better.

 

Great info here. Thanks for all these ideas!

[merry gardens]

...Is it really that hard to find someone to test and diagnose APD? She keeps mentioning problems in school, and he does have some academic issues, but his language problem is affecting his life in general, not just school.

 

Help! I'm at the end of my rope and I know my son has been at the end of his rope for quite awhile.

 

TIA

Yes! I found that to be true.

 

I took my son to two different speech therapist. One when he was five through the school district and another in private practice when he was 6 1/2. The SLP in private practic who evaluated my son discovered some auditory processing problems and referred us to an audiologist for follow-up. We went to a children's audiologist at a children's hospital that has a great reputation. The audiologist tested him for about a half hour and said everything was fine.

 

It wasn't. The audiologist only tested my child's ability to hear whole words, not the individual sounds within words. It was about a year and a half later that I discovered through on on-line screening for a dyslexia program that my son could not distinguish or "hear" the difference between several similar sounds within words. Vowel sounds were particularly difficult, but there were others too. His failure to percieve the difference between short i's and short e's (and numerous other sounds) caused serious problems as he attempted learning to read. Discovering that he could not distinguish the difference explained some of his strange pronounciations of words too. He hadn't qualified for speech therapy because his mouth and tongue could make the difference sounds. BUT he didn't make the right sounds in several words, so he was difficult to understand because he used similar sounds that weren't quite the right. Yes, he could hear the words, but he didn't process the sounds within the words quite right.

 

APD is NOT just about good study habits. Perhaps the quieter background and other accomodations help, but in the case of my son, there was more going on. My son doesn't have any official diagnosis of APD, but he had something going on that the audiologist didn't catch.

 

The second SLP who recommended the audiologist f/u also suggested The Listening Program for my son, which we did. I don't know if it helped or not. The next year he was still having problems with reading and his speech was still difficult to understand.

 

Because of the reading problems, I turned to a program for dyslexia. The Barton program's brief on-line screening revealed some auditory processing problems that needed attention before he could start their reading program. At their recommendation, my son did the LiPS program. LiPS was developed by a SLP. Some speech therapists are familiar with this program, but the one that evaluated my son a year and half earlier wasn't. I learned the LiPS program and worked with my son at home. LiPS provided my son with the physical and visual clues to by-pass his hearing to help him distinguish the different letter sounds/phonograms that he previously couldn't hear. It made a world of difference!!! His speech is easier to understand and he is making better progress with reading. Heavy sigh of relief.

 

I found it very frustrated trying to be pro-active with my son's speech and reading issues earlier. I first noticed problems when he was younger, but for a couple of years people (including professionals at the school district and the audiologist) kept telling me things were fine when I knew something wasn't right. Some days it's still frustrating, but at least I've identified the underlying problem and learned ways to help my son.

Edited May 7, 2010 by merry gardens

[LizzyBee]

I was surprised too! Asheville is the center for medical treatment for all of WNC and we have specialist of every kind here! I wouldn't be opposed to going to Duke for testing if we need to. My kids used to go to the dermatologist there and my dad just had a bone marrow transplant there. We love Duke doctors! :D

 

 

This is what I'm hoping for. Someone who will take our concerns seriously and help us navigate our way through this.

 

 

I've considered that. Do you think it would be worth it to go that route first?

 

 

That's terrible! I'm glad your daughter is with someone competent now.

 

 

What insurance do you have? We have BCBS. I haven't looked up whether or not they would cover it.

 

Since you don't have an audiologist who specializes in APD near you, I think having an SLP evaluation would be a great first step. I'd be sure to let her know your concerns about APD so that she will do some testing in that area. I'd also ask around and try to find someone who is aggressive and forward-thinking. Also someone who will look for and treat deficits in higher level language skills and not just speech deficits. I mean, they all "will" but some of them don't, kwim?

 

We have BCBS too. As you know, coverage depends on your specific plan, but I've had BCBS in 2 states and I love them. They even cover my oldest sister's acupunture!

[newbie]

yellowpagesforkids.com or org. gives you lots of professional info in your area.

 

ncapd.org has references also.

 

Usually a definitive takes a neuropsych eval and an audio, it goes hand and hand.

 

I think there is an audiologist referral w/ their national group.and they would list APD testing.

 

I found ours w/lots of phone calls.

 

It is worth the money and the earlier the better. The audio test was two hrs and the neuro 3. Neither were bad. It is better to do morning b/c if later, kids are tired and give different responses.

 

HTH

[LittleHouseHomeschool]

Yes! I found that to be true.

 

 

APD is NOT just about good study habits. Perhaps the quieter background and other accomodations help, but in the case of my son, there was more going on.

 

I hope you understand that is not what I was saying. APD is not about just good study habits. That's why I encourage others to seek testing...so they can pinpoint their child's specific issues. In your case, LiPs helped. However, LiPs won't help every student. No one treatment will help every student.

 

The best thing any parent can do is teach in a quality educational environment, teach good study habits, and use appropriate curriculum and therapies for their children. That can be done with or without a professional. (But professional guidance is definitely helpful.)

 

Sadly, because APD is such a wide body of symptoms and because none of the available treatments (such as LiPs) are scientifically proven, insurance companies will not pay for them and many, many students go through life without any therapies at all.

 

That said, as homeschoolers we can provide appropriate therapies at home (and that's what I meant about study skills - in my mind, they are broad range of skills and subskills...For example: teaching a child to pronunciate properly, speaking slowly and clearly helps them to hear the sounds and eventually associate them with phonograms, and hence does help a child to learn better), even if insurance doesn't pay for it. :tongue_smilie:

 

We can have our children tested so that we can target their specific issues in whatever way the Lord leads. For some a APD specialist is necessary. For others, just improving their environment helps.

 

I hope that clarifies things. I didn't want you to think I was minimizing APD in any way. It is a serious issue and needs diligent attention.

[merry gardens]

I hope you understand that is not what I was saying. ... I hope that clarifies things. ...

Thank you for clarifying. :)