Should I get an auditory processing eval?

[Melaz4]

My eight year old is in the public school system, she's a third grader. Towards the end of last year we had her evaluated for a learning disability. I believe she is dyslexic but, as many of you probably know, the school system does not diagnose this. She was however, diagnosed as having a phonological awareness disorder. She is also behind on her reading fluency but at the end of last year was in a grade appropriate reading level. My main concern was her difficulty in remember her spelling words. She does fine on her tests but can not remember them in everyday writing. She is in outside the school speech as well as school speech for her phonological awareness as well as "r" and "ing" sounds. Lately I've been considering getting her an auditory processing evaluation. I'm concerned about how she says certain words. Like cupboard is cuvord, bathing suit is babing suit etc. There's many more examples, I just can't think of them now. I guess first of all I'm confused on the difference between phonological awareness disorder and auditory processing disorder. Maybe her mispronunciations are just phonological awareness related? I want to make sure she is getting the right help. I'm grateful that she was diagnosed without a fight last year but I don't want her to fall more behind. Opinions?

[Tiramisu]

If she's 8 and there's already a diagnosis of phonological awareness, I would think it's a very good idea to get the evaluation. Pediatric audiologist with experience in CAPD, that's what you should look for. :)

 

Does she have trouble following directions? Does she mis-hear or seem to have trouble remembering what you said? Does she have trouble understanding in a noisy environment? These would also be clues.

[Melaz4]

She's usually okay with following directions. Both her and her brother can not concentrate with any distractions. So I guess my next question would be this. If I get her evaluated and she has Auditory processing disorder what kind of services will she need that is different than what she would get from her speech teachers for phonological awareness? I want to make sure she gets all the help she can. Thanks!

[Mukmuk]

I don't have the answer to your second question, Melaz4, but wanted to chime in that a child does not have to have every item on the checklist to have CAPD. What I found for example, is that my son didn't have good phonological awareness, but speaks very clearly nonetheless. Somewhere between input and output, kids can develop coping mechanisms that make it seem like they have no issue. He did however check off enough items on the list (can't hear when I call, hyperacusis, distracted even in a moderately quiet environment) to warrant an evaluation.

Edited October 6, 2012 by Mukmuk

[Crimson Wife]

If I get her evaluated and she has Auditory processing disorder what kind of services will she need that is different than what she would get from her speech teachers for phonological awareness? I want to make sure she gets all the help she can. Thanks!

 

My oldest did the first part of the CAPD evaluation and I actually asked the AudD. about this. Her answer was that there isn't any solid research evidence of any treatments for CAPD. Basically what they recommend is simply accommodations, which is most relevant in a classroom situation. Now there are programs like Earobics that have anecdotal reports of being helpful, but she said it's a caveat emptor situation.

 

Be aware that if you have not already gotten a full neuropsychological evaluation, you may be sent to get one before the AudD. will finish the CAPD eval. This is the limbo stage that my oldest is in.

[Tiramisu]

My oldest did the first part of the CAPD evaluation and I actually asked the AudD. about this. Her answer was that there isn't any solid research evidence of any treatments for CAPD. Basically what they recommend is simply accommodations, which is most relevant in a classroom situation. Now there are programs like Earobics that have anecdotal reports of being helpful, but she said it's a caveat emptor situation.

 

Be aware that if you have not already gotten a full neuropsychological evaluation, you may be sent to get one before the AudD. will finish the CAPD eval. This is the limbo stage that my oldest is in.

 

I was told by one audiologist that there isn't any treatment for CAPD. But another, a published audiological researcher, said very strongly that there are effective treatments. He didn't specify what they were. He did point me to one study that's still going on for a therapy that seems to be very effective, but that could be for my dd's specific problem. I haven't checked into it to see if we could participate because it's rather far.

[Mukmuk]

If you're looking for specific ways to help with CAPD, yes, I was told by the audiologist that nothing works except a developmental shift at around age 10-12.

 

The NP we saw half a year later had a different opinion. We were recommended Fast Forword. This is the early-prereading levels where the focus is on the recognition of sounds. I was stunned that my son couldnt recognize a "b" from a "d". It was a grueling 9 weeks for him, but it definitely worked on his sound recognition. Other recommendations included looking at lip movement for making various sounds, for him to practice and also to watch, so that he can learn to lip read. If the noise level got overwhelming for him, both the Aud and the NP recommended ear muffs. I also encouraged him to wear it for about 15-30 minutes a day so that he could take a rest from listening. Surprisingly, that led to better sleep at night. Cogmed was recommended for improving auditory working memory (and WM in general).

 

We found this entire combination to be very helpful, although my son doesn't want the ear muffs now. He's only still 9.5 and I'm looking for that developmental spurt to take effect. But things have definitely improved since the NP visit at the start of the year.

 

I want to emphasize that before we went to the NP, we tried many other programs that have worked for others but have had no effect on my son. Similarly, I've read that Fast Forword has not been as helpful for others. It just seems like each child responds differently, and you have to find that correct hammer for your individual nail! It can be so frustrating :(. My advice is to keep trying where you see fit, and take rests for yourself because it's very tough on you as well. It's been a wild ride for us!

[Lecka]

My son was mis-hearing sounds. It was just mis-hearing sounds, I think, not really CAPD (from reading about it). He had pretty poor articulation, below the 10th percentile when he was 6, and with an age equivalent of 2 years 11 months.

 

He did 2 years of speech therapy that was pretty ineffective (unfortunately), and then got referred to one-on-one speech at a university speech clinic. They used some different techniques with him. He was able to learn to differentiate the speech sounds. It was 10 months of 2x/week one-on-one.... pretty intense. He was still going to speech at school at that time, too, so he had speech 5 days a week.

 

His speech was similar to Lips (a package curriculum by Lindamood-Bell), though. They teach speech sounds in a multisensory way, and practice, and for some kids it can really help with speech sounds.

 

It is maybe worth looking in to. I tried a computer program (Hear Builder by Super Duper) that was being compared with Earobics at the time, but it did not help for my son. However I have heard of Earobics working, and I had a good impression of Hear Builder at the time (though I haven't heard of it as much sense -- but at the time it did seem to be something that was working for people).

 

It seems like one approach is to slow down the sounds. The approach of making it multisensory by teaching mouth position and stuff and linking that to the sound is another approach.

 

For my son -- he started making some improvement in his speech therapy, and that is what made me think, it was not CAPD. I think if it was, it would not be something helped by his speech therapy. I think to some extent the two labels are two different professions seeing the same issue, and to some extent maybe sometimes the issue is going to be more something helped by speech therapy or by the listening programs.

 

I would say -- look for improvement with the outside-of-school speech therapy, and read up on CAPD. If there are not results from the speech therapy I think it makes sense to look at CAPD. At the same time, I felt a lot better about the speech therapy after I looked into Lips and could see his private speech was using similar techniques (though not the actual program) and that his school speech (where he had NOT made progress) had not been using similar techniques. I would not have a problem with different techniques, if there was progress, but seeing it be similar to things I read about Lips, and seeing that he made progress ----- was very nice after his 2 years of no progress with his other speech therapy. Which was not bad and I saw it work for other children, it was just not what he needed.

 

Specifically -- I think his other speech therapy didn't focus enough on telling apart sounds he was confusing. His private speech could focus on just a set of sounds that sounded the same to him, and work on just telling apart those sounds, and making each of the correctly, and how they were similar and different, in what the mouth was doing, and felt like, and looked like (in watching the teacher). His other speech would try to teach him to make a sound, but not try to tell apart sounds.

 

He was missing many sounds in his speech, so he was not even producing sounds.... it was really hard for him.

Edited October 7, 2012 by Lecka

[Guest Chearsaudiology]

HI, I am an audiologist and happened to see these posts. I have many opinions on APD diagnosis and therapy. It is my opinion to treat with a neural processing type of therapy. I understand the importance of a diagnosis however APD diagnosis is a long process and if you already know there is processing issues the best option is to find some accommodations as one person wrote or a therapy that works for your lifestyle to include time and cost. I have recently opened my own private clinic and have begun an integrated processing therapy. I am excited at the potential for the patients. Feel free to private message. Thanks, Kim

[JadenCalebMom]

My son was diagnosed earlier this year with CAPD and was referred for Speech and Occupational Therapy. The school system would not provide either. He goes to Speech privately once a week. She is doing some work specific to his diagnosis, which included background noise, phonemic awareness, and letter specific v, b, r pronunciation. He is making great progress with her. Her group is looking into incorporating Fast Forward. They are also looking at a program that uses music, frequency and bones of the skull to stimulate parts of the brain that are not "awake" and are part of the problem. When working with a Speech Therapist, make sure they KNOW the diagnosis and are trained to work with that diagnosis. He also goes to OT once a week. They are working with "crossing the mid-line" activities, handwriting, and visual tracking. We also had to switch phonics programs to cater to his learning style and learning disability. He is very smart. He just struggles with the processing. He can memorize words for a spelling test but cant read or write them half the time.