Distracted. Inattentive. Forgetful. Unable to follow directions. Never seems to listen. Spacey.
Perhaps these words can describe a child that you know. Perhaps you were that child. We often think of children with this type of behavior as having ADD. But what if this child is not hyperactive or impulsive? What if they seem to struggle more in noisy environments? What if they struggle to follow a conversation or tend to zone out when someone is talking to them?
This child may have auditory processing disorder.
Auditory processing disorder occurs in children or adults who have normal hearing but their brains have difficulty processing what they have heard, especially in regards to language.
According to Rachel Cortese, a speech-language pathologist at the Child Mind Institute, auditory processing involves four basic skills and children with this disorder may struggle in some or all of these areas.
Auditory discrimination involves being able to notice and distinguish between distinct sounds. This is what allows us to distinguish between similar words such as pear and bear or nine and ninety. Children with auditory processing disorder often mishear words because they can’t distinguish between similar sounds. According to Rachel Cortese, these children may mix up similar sounds and drop syllables out of words. They may struggle to read or speak clearly and have difficulty with rhyming words. This may be because they are only able to pay attention to what the beginning of the word sounds like, instead of listening and comprehending the full word. So, they may say ‘maf’ instead of ‘math.’
Figure to Ground Discrimination
Typically, when a person is listening to someone in a noisy environment, they are able to tune out background noise and only focus on what they need to hear. Children with auditory processing disorder are unable to do that. They are unable to pick out what sounds or voices are important and what sounds can be ignored. So, they may have more difficulty in a classroom or other environment where they have to focus on the teacher and ignore all the other competing noises.
This is also something that many people who wear hearing aids struggle with. Because hearing aids amplify all sounds, it can be difficult to pick out the sounds that are necessary to hear and ignore the rest. This is why many people use personal listening devices in addition to their hearing aids because this technology streamlines the sounds you want to hear into your hearing aids and allows you to block out the rest.
Auditory memory is the ability to remember what we hear. Children with auditory processing disorder have trouble remembering verbal instructions and information. It is easier for them to remember information that is written down instead of being given verbally. These children are typically visual learners, not auditory learners.
When we listen to sounds, we are able to hear them in a precise order. Children with auditory processing disorder struggle in this area, often switching up numbers with the same digits (saying 28 instead of 82) or mixing up the sequence of sounds in a word (ephelant instead of elephant). They may also struggle to remember information given in lists or a series of directions.
Kids with auditory processing disorder can be divided into two groups. One group has trouble with language in general, including having difficulty understanding the meaning of words, understanding grammar and syntax, etc. These children are likely to struggle with auditory processing as adults as well.
Then there is a second group that struggles with some aspects of auditory processing but foundational language skills are still intact. For these children, they are likely to outgrow their difficulties with auditory processing. They also tend to more issues with attention and focus and may often be misdiagnosed with ADHD.
While the second group may have some similar characteristics to children with ADHD, there are some key differences. Children with ADHD tend to be easily distracted but are also hyperactive, impulsive and fidgety. They often interrupt and intrude. In contrast, those with auditory processing disorder have difficulty following or remembering oral instructions but are able to follow and remember instructions if they are written down. They have trouble listening and often struggle in school.
The Child Mind Institute has several suggestions to help with auditory processing disorder in the classroom. They suggest moving the child to the front of the classroom so they can focus more easily on the teacher’s voice. Teachers can use visual cues and emphasize key words. Teachers and parents can also use catchphrases to indicate that kids need to pay attention to what they are about to say. They can also use words that indicate a sequence in order to help children follow instructions more easily i.e. First, I want you to….Then, you will do…and lastly, you do….
Occupation therapists can also help with auditory processing. Some suggestions for occupational therapy type activities that you can do at home involve backyard activities such as playing hide and seek where the ones hiding make different noises and the the ‘seeker’ has to locate them by following where their voice is coming from, or play a listening scavenger hunt where you listen for different sounds as you walk around the neighborhood and have your child describe where they are coming from.
Although auditory processing disorder may be frustrating for both the child and the parent (or teacher), remember that patience is the key. Respond with empathy and work with your child to find what strategies work best for them. With the right tools, this can be overcome and your child will be on their way to academic and life success.