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UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

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UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1
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Page 1: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

UNDERSTANDING AUDITORY PROCESSING DISORDER (APD)

Maureen E. Jones, M.A., CCC-SLP

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Page 2: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

What is Auditory Processing? Term used to describe what happens

when your brain recognizes and interprets the sounds around you.

The disorder part of APD – something is interfering or affecting the processing and interpretation of the information.

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Page 3: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

ASHA definition of APD (ASHA, 2005)

Difficulties in the processing of auditory information in the central nervous system (CNS) as demonstrated by poor performance in one or more of the following skills:

• sound localization and lateralization• auditory discrimination• auditory pattern recognition • temporal aspects of audition• auditory performance in competing acoustic signals • auditory performance with degraded acoustic

signals

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Page 4: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Sound localization

Sound localization and lateralization: the listener’s ability to identify the origin of a sound in distance and direction.

Basically it is knowing where the sound occurred.

One must be able to aware of the sound source in order to identify and interpret.

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Page 5: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Auditory discrimination

Auditory discrimination: the ability to discriminate speech sounds.

Knowing the difference between an /m/ and /n/.

Knowing the difference between ‘cake’ and ‘lake’.

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Page 6: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Auditory pattern recognition Auditory pattern recognition: the ability

to identify similarities and differences in patterns of sounds.

Which sounds are the same in ‘lake’ and ‘cake?

Which sounds are different?

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Page 7: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Temporal aspects of audition 1. the ability to sequence sounds: what

sounds do you hear in ‘cup’? 2. combine sounds into words and make

meaningful combinations: combine these sounds: /a/, /p/, /l/. What word do you make?

3. perceive sounds individually when they quickly follow one another: /k/ /uh/ /p/?

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Page 8: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Auditory performance in acoustic signals The ability to perceive speech or other

sounds when another signal is present. This can be noise or another similar

speech signal Competing signal can be loud or soft.

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Page 9: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Auditory performance with degraded acoustic signals The inability to “fill in” the missing parts

of a word. We all miss words in conversation.

However our knowledge of words and sounds allows to fill-in parts when we miss a sound or word.

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Page 10: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Hierarchy of Auditory Processing Skills

• Step 1: Auditory awareness: includes being aware localizing, and attention

• Step 2: Auditory discrimination: discriminating environmental sounds, suprasegmentals (non-speech sounds rate, prosody, pitch) and segmentals (speech sounds).

• Step 3: Auditory Identification: auditory association, auditory feedback, phonological awarenes.

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Page 11: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Hierarchy of Auditory processing Skills Step 4: Auditory Comprehension: understanding longer conversations,

stories, following directions, auditory closure (filling in the missing pieces), auditory memory, linguistic auditory processing (interpret, retain, organize, and manipulate spoken language for the purpose learning and communication)

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Page 12: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Characteristics seen in children with APD• Says “huh” or “what” frequently• Gives inconsistent responses to auditory

information• Often misunderstands what is said• Poor auditory attention• Easily distracted• Difficulty following oral directions• Difficulty listening when background

noise is present

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Page 13: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Characteristics seen in children with APD

• Poor receptive and expressive language skills• Often repeats questions or last word in a

sentence• Slow to respond to questions• May have reading, spelling, writing or

academic difficulties• May have behavioral problems • Needs extra time• Poor perception of prosody• Difficulty understanding humor

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Page 14: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Diagnosing APD

Must be diagnosed made by an Audiologist Should also include a multidisciplinary

approach SLP, teacher and psychologist Child must be at least 7 years. Some

Audiologist prefer to wait until 8 due to brain maturation.

Cannot use a symptom checklist Comprehensive battery of tests needed

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Page 15: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

APD Assessment

Audiologist administer a number of tests is sound-treated room

Child required to attend to a number of signals

Must respond via repetition, pushing a button or respond in some other way

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Page 16: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

APD Assessment: Areas Tested• Figure ground• Auditory Closure• Binaural Integration• Binaural Separation• Binaural Interaction• Phonemic Synthesis• Pitch Patterning• Gap Detection• Sustained Auditory Attention

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Page 17: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

APD Assessment

Once diagnosed, area of auditory deficit must be determined.

Ex: decoding, auditory memory, auditory comprehension, auditory discrimination, etc.

This allows to individualize the patient and type of treatment.

No two cases are the same.

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Page 18: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

SLP Evaluation

Tests receptive and expressive language skills

Auditory processing, comprehension, decoding, listening

Following directions Sound blending, discrimination, rhyming CELF-5 TAPS TOPS CASL TOWL

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Page 19: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

APD Classroom Manifestations Difficulty with spelling, reading, writing

and math Taking a long time to complete

assignments Poor perception and use of prosody Difficulty with multimodal tasks Difficulty following instructions Poor Attention and easily distracted

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Page 20: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Treatment

SLP provides therapy Incorporates a variety of techniques and

strategies No one cure-all method Usually focuses on 3 areas:

Changing the learning or communication environment

Compensatory strategies to address higher-level language skills

Remediating APD skills directly

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Page 21: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Treatment

Changing the learning or communication environment: Improve access to auditory information

presented (ex: changing seats) Using devices to assist listening Teacher/classroom modifications to allow

student focus attention on the message

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Page 22: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Treatment

Compensatory strategies: Increase language, problem-solving,

memory, attention, or other cognitive skills Teach children to take responsibility for

their own listening Active participant in daily active listening

activities

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Page 23: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Treatment

Direct-treatment of APD Computer-assisted programs One-to-one training with a speech therapist Home-based programs

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Page 24: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Things to Remember

No one treatment is appropriate for all children

May need a combination of strategies Treatment should be individualized Therapy may need to be adjusted and

modified as children grow and mature

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Page 25: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

Questions????25

Page 26: UNDERSTANDING AUDITORY PROCESSING DISORDER (APD) Maureen E. Jones, M.A., CCC-SLP 1.

References26

American Speech-Language Hearing Association (2005). Auditory Processing Disorders: Technical report and Guidelines. Rockville, MD.

Nevins, M.E., & Garber, A. (2006, May). Auditory skill development. Cochlear America Habilitation Outreach for professionals in education. Retrieved from http://professionals.cochlearamericas.com/sites/default/files/resources/HOPEFUN666.pdf

Roeser, R.., & Downs, M.P. (2004). Auditory disorders in school children: The law, identification, remediation 4th ed. New York: Thieme Medical Publishers, Inc.

Stredler-Brown, A. & Johnson, C.D. (2004). Functional auditory performance indicators: An integrated approach to auditory skill development (3rd ed). Retrieved from http://www.cde.state.co.us/cdesped/download/pdf/FAPI _33-1-04.pdf

Vinson, B.P., 1999). Language disorders across the lifespan: An introduction. New York. Singular Publishing Group.


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