Anyone Dealing with an Auditory Processing Disorder?

[nature girl]

My DD does not seem to be hard of hearing, she's able to hear when we speak or read quietly to her (can actually listen to/understand audio books at a lower volume than I can.) But she's often asking people to repeat themselves, especially when there are other background noises. We (and especially others) get "What did you say?" many times a day, even when talking at a normal volume, if we are in rooms with other people. Plus she started ballet class yesterday, and the teacher pulled me aside when class was over and told me, "We have a listening problem." Apparently she rarely followed directions, just kind of did her own thing.

 

Maybe she's just being a kid, lost in her own world much of the time. But could this be CAPD? Or some other processing issue? The articles I've read don't quite match what I'm seeing, but maybe there are different flavors and degrees.

[Snow]

An NP or Dev Ped has to figure this out. There are so many overlapping possibilities. 'Listening' requires attention and hearing and receptive language and even memory. Did you read Mislabeled Child? It really is the best place to start. And then you'll find that you will to diagnose her with everything under the sun, lol. Which leads to Evals.

[nature girl]

Thanks, Snow. We actually tried to find an NP a couple of years ago, because we suspected dyspraxia. But the waiting list was 6-8 months long, and while we were waiting our DD showed a lot of progress in motor skills, so we cancelled the appointment (which would have cost us $1,500, not covered by insurance.) I'd rather not get on that waiting list again if I'm worrying for nothing. I'll look into Dev Peds in the area though, if they'd be able to diagnose as conclusively.

 

FWIW, she has a great attention span, her receptive and expressive language are excellent (her receptive has always been above average, although she was a little speech delayed. She'd completely caught up expressively by her 2nd birthday, although she still has an issue with a few irregular verbs.) I haven't really tried testing her memory, so maybe that's something to look into. I haven't noticed issues though, and she's able to listen to and summarize complex stories I've read to her. Of course nobody here can diagnose whether there's an issue, I realize that! I was just hoping some of this would sound familiar to someone.

[LizzyBee]

APD is diagnosed by an audiologist with special training. Part of the testing has to be done in a sound proof booth.  I found our audiologist by googling "audiologist auditory processing disorder" and my city.  She is wonderful and was very supportive of homeschooling. Of all the professionals that were involved with my daughters, she gave us the most practical information.

 

The testing is helpful because remediation can then be tailored to the child. For example, for one daughter, we have to rephrase when she doesn't understand what we told her.  For the other daughter with APD, we have to repeat word for word, because rephrasing creates new gaps.

 

ETA: The evaluation for APD starts by ruling out fluid and hearing loss.

[Lawyer&Mom]

I would definitely do a hearing test.  Partial loss can be hard to pin down.  I have 50% loss in my right ear.  For me that means that various parts of the spectrum are missing, not that the volume was turned down 50%.  How does this play out when I was a kid?  Most of the time I could hear just fine with my good left ear and my residual hearing in my right ear.  Mom reading a book?  No problem!

 

But ambient noise is really hard.  With parital loss it can be harder to triangulate where all the sounds are coming from.  Your brain works overtime, and sometimes things fall through the cracks.

 

Also, I could be a total space cadet sometimes.  If you were standing in just the right angle behind me, I might not hear you at all, even if you were shouting my name.

 

Don't rule out hearing loss just because your kid can hear just fine sometimes.

[kbutton]

I agree with Lawyer&Mom about getting a hearing evaluation one way or another. It might be acuity rather than CAPD.

 

You can possibly get a broad screening for APD--I think the one we had was called SCAN or something like that. It's not definitive. A good audiologist will not test for or diagnose CAPD until at least age 7, and it's probably more like 8 or 9. My DS 6 totally flopped the SCAN screening, has trouble in noisy rooms, etc. However, our real clue is that he didn't pick up on subtle sound differences in words--thin/then/than were all the same to him. He's retraining himself. I have a new acquaintance who is an audiologist, and she said that it's nice to know if CAPD is part of the mix, but if it's not super disruptive, it's expensive testing with fairly few resources for remediation. So, I don't know if we'll test, particularly since learning to read and being aware that he should be hearing differences in words has made him pay attention and learn to discern those sounds.

 

As for noisy classes, it's helped to have him sit near the teacher. He also has signs of inattentiveness, so it's kind of hard to sort it all out yet.

[nature girl]

Thanks all, this is very helpful. I've written to a group nearby that does assessments, although like you mentioned kbutton, their site (and everything I've read online) says they don't evaluate till 7, which is over 2 years away...So what to do till then? I guess I can go to a regular otolaryngologist to have her hearing tested and rule that out for sure. It just feels to me like it might be something more. (I just did some tests this afternoon, whispering behind her and from either side, and each time she was able to hear me...I wonder if an otolaryngologist could test her hearing with background noise to give us more information? Or I guess I could do my own testing just to get a rough idea.)

[Storygirl]

Well, she's four, right? Or maybe five? I don't have experience with auditory processing issues at this point, but I do have a lot of experience with having children in ballet. I would not link her ability or inability to follow one ballet class with a new teacher at that young age with any kind of disability. Have a talk with your daughter about how she is to behave in ballet class next week and see if she does better. Perhaps she did not understand the behavior expectations. Or she just may not be ready for the structure of the class. At that age, a ballet class will be very basic, with a lot of skipping and creative movement, because that is what is developmentally appropriate (true ballet does not start until about age 8). The teacher should be used to having children with a wide difference in attention spans and abilities in a class for that age and should be able to handle a wide variety of behavior. Is this an experienced teacher?

 

I'm not saying that your daughter does or does not have an auditory problem -- I think the others have offered some good advice about that. You probably just mentioned the ballet thing because it was one example of a continuing problem that your daughter has with listening, and it is a good example. I just wanted to suggest that I would chalk up the ballet experience to preschool behavior and not a learning issue, unless it becomes an ongoing thing instead of just one class.

 

Also, consider that ADHD and sensory issues can also prevent children from "listening" (as opposed to "hearing"), so you might want to consider an evaluation that is not just targeted toward auditory things. Once she is school aged and you can see whether her issues impact her learning, it might help you decide whether to pursue in-depth evaluations or not.

[Tiramisu]

Rather than an ENT, I would recommend a pediatric audiologist to test hearing. Even if your dd is not ready for an CAPD eval, she may be able to pick up clues and talk to you about what you're experiencing and give advice that might help.

 

I would definitely consider employing strategies that are helpful for CAPD before you get testing. It could never hurt.

 

As you know, there are different types of CAPD. We have one that was not picked up in any testing other than by an audiologist. Not by the NP or the Ed.Psy. It sounds very similar to what you describe. My dd has issues in noise. More that that, she has a hard time with competing signals. If there is a signal coming in her right ear, she will not "hear" it if something is coming in her right ear at the same time. This is the opposite of what most kids with even this kind of problem deal with and can be indicative of brain wonkiness.

 

Since you mentioned dyspraxia, I highly recommend getting a copy of When the Brain Can't Hear by Terri Bellis. There is a type of CAPD  (I'm sorry but I can't remember the name but I think it may come up last when she lists the types of CAPD) that is also related to visual and visual-motor issues. My dd fits into this category. It read the book and related to the problems of that certain type of CAPD. That experience led us to get an eval with a COVD optometrist, who confirmed neuologically-based visual issues that I honestly had no idea of. The NP later picked up those visual weaknesses but also visual-motor issues. So the end result was that everything was consistent with what I read in Bellis' book.

 

My dd does not technically fit the criteria of dyspraxia but the weaknesses are there. The NP said she would have sent us to the COVD to be check out since the visual weaknesses were also very significant, but we had already been there. Ironically, the CAPD symptoms are by far the ones that most interfere with daily life and they are impossible to pick up by non-audiologists because those other specialists do testing in quiet and dd never had any problem "hearing" in quiet.

 

And for what it's worth, there were times that I really worried about how dd would manage in the world but she is truly thriving. She's in college, loving her program and doing great in group activities. With her audiologist's eval, she is entitled to a notetaker, to use an FM system, and now the college is giving kids like her special pens that record lectures.

[geodob]

Anna's Mom, perhaps you and Anna might like to participate in a study?

For about 6 years, I have been conducting a study into this issue with 'back-ground noise' and APD.

Which directly relates to what Lawyer&Mom wrote about 'triangulation' of sound.

Which is basically the ability to locate the direction that a sound is coming from.

 

Though this ability to locate a sound, is also the ability to focus hearing.

Where the basic hypothesis that I came up with about 6 years ago?

Was that this APD difficulty with 'background sound'?

Resulted from a difficulty with 'locating sound' ?

 

Where a crucial role that this ability to 'locate sound' provides?

Needs to be considered in relation background noise, and competing sounds?

Where this ability to locate a sound, can then be used to separate it from competing sounds.

Where hearing can be focused in a similar way to vision.

 

But the initial test, involves having a person sit on a chair in the middle of a room, with their 'eyes closed'.

Then the other person moves to different points around them. 

Then says something or makes a sound.

Then keeping their eyes closed, the person on the chair. Is asked to point at the direction that the sound came from?

Where I have found that APD people with a difficulty with 'background sound'?

Are unable to locate the direction of a sound.

But then I have had them practice locating a sound?

Where if they practiced it daily, they became more and accurate.

 

Then the next stage, involves the gradual introduction of 'back-ground sound'?

So that a Radio or TV is turned on, at 'low volume'.

With the Radio/TV at low volume.

The exercise of sitting on the chair, and pointing at the direction of a persons voice, is returned to.

Where they practice separating the location of the sound from the Radio, and the person's voice.

Then over time, the volume of the radio/TV is gradually increased.

 

So that essentially, it involves a process of learning to 'focus hearing', and put the background sound into the background.

Another exercise, has a Radio on one side and a TV on the other side?

Practicing shifting the focus of hearing, back and forth between them.

 

So that perhaps you might like to explore these exercises with Anna, and see how she goes with them?

Where I would be interested to hear a report?

[nature girl]

So much to think about, thank you all so much. Storygirl, if it was just the ballet, I wouldn't chalk it up to a hearing issue at all, just a desire to do her own thing without realizing she needs to listen to a teacher. It's this added to the other issues that have made me wonder.

 

Tiramisu, this is so interesting, and especially interesting to think that motor skills can be so closely related to auditory processing. She's definitely clumsy, was a late crawler and walker, and didn't jump till 3.5, so now I'm wondering whether it might all be interrelated. I've put When the Brain Can't Hear on hold at the library, and will start looking through it.

 

Geodob, thank you for the exercises. I'll definitely try them and report back! (It won't be for a few days though, since we're leaving for a short vacation this week.)

[1shortmomto4]

As a mom to a hearing impaired kiddo - question with regards to the ballet class -- is your daughter front and center and able to see the teacher? or is she off to the side placed behind another student?  Is she placed where she can keep her eyes on the teacher's face?  Is the ballet teacher's voice high pitched?  If she is unable to see the teacher's face she may not be able to truly hear what is being said.  Kids with hearing issues learn very early on to compensate and find ways to accommodate their issues. She may have already figured out compensating her hearing by watching faces (mouth movements).  My ds could always hear me so I never suspected a thing but when others began to take notice - well, that was key.  Our children learn our voices since before they're born so for the most part they are able to recognize it - even if it isn't as loud as they'd prefer.  I'd get a really thorough audiology screening and be absolutely sure there is no hearing loss.  My ds was always spaced out, a few seconds behind everyone else (I never noticed until years later when we watched the home videos) and now we know why but he struggled until he was 15!  Long story - well visits and the most common "raise your hand when you hear the beep" never picked up on it over the years (still not sure why).