Auditory Processing Disorder Testing for Children

APD can affect people of all ages, but it is most common in school-aged children. According to the Hearing Health Foundation, approximately 5% (2.5 million) of the school-aged children in the US experience APD, while researchers estimate the real number could be up to 12% of the population.
A small girl during Auditory processing disorder testing at Denton Hearing Health Care

Early detection and intervention by a doctor of audiology allows children to establish a strong foundation of phonemic detection abilities, speech discrimination, word identification, and comprehension upon which to build in order to limit the effects of APD on their capacity to learn.

APD in children is often missed because the child’s hearing assessments show normal or near normal hearing, which is why Denton Hearing Health Care makes the extra effort to test for and treat auditory processing disorder in both children and adults whenever it is suspected.

What Is Auditory Processing Disorder?

APD, sometimes called Central Auditory Processing Disorder (CAPD), involves how the brain processes speech. The ears and the auditory system function properly, but these systems do not fully coordinate with the brain in order to derive meaning from speech.

The disorder is usually most noticeable when there is a lot of background noise, multiple conversations taking place at the same time, or the individual is not facing the speaker.

When struggling with APD, it is difficult to pick up on the subtle differences between words like cat, bat, and that or seventy and seventeen. In some cases, words in a sentence can become scrambled so that “How are the chair and couch alike?” could be interpreted as “Hour the hair and cow are like?

There have been four categories of processing skills affected by those struggling with auditory processing disorder, including:

  • Auditory discrimination: noticing, comparing, and distinguishing between separate sounds
  • Auditory figure-ground discrimination: focusing on the important sounds in a noisy setting
  • Auditory memory: recalling what they heard (short or long term)
  • Auditory sequencing: understanding and recalling the order of sounds and words

Because APD causes most to assume that the person is experiencing hearing challenges, when hearing tests are normal, many doctors fail to identify the cause.

Central auditory processing disorder testing and treatment uses a multidisciplinary team in order to identify the condition and evaluate its impact on the child. Included on this team are teachers,
diagnosticians, psychologists, and speech-language pathologists.

Essential elements used in the evaluation include a case history, academic profile, and descriptions of school and home behavior, which help identify your child’s strengths and weaknesses, but the specific diagnosis of a central auditory problem must be made by an audiologist.

The Testing Process

Testing begins with a routine hearing evaluation to test for auditory acuity. This is followed by several additional tests broken into two testing categories, behavioral testing and electrophysical testing.

Behavioral Testing

Behavioral testing is broken down further into four categories, including:

  • Binaural Interaction Tests require integration between auditory information that is presented to each ear. These tests assess the ability of the structures low in the brain (brainstem) to take incomplete information presented to the two ears (simultaneously) and integrate the information. For example, one portion of the stimuli is presented to one ear and another portion is presented to the other ear at the same time. The two parts are unrecognizable separately, but a person with normal processing abilities is able to recognize and integrate the information to form the appropriate response.
  • Dichotic Speech Tests use different speech items that are presented to both ears either at the same time or in an overlapping fashion. The listener is asked to repeat everything that is heard or to repeat what is heard from a specific ear.
  • Monaural Low-Redundancy Speech Tests are designed to test an individual’s ability to achieve auditory closure when auditory information is missing. The speech signal is modified in some way and the listener is required to fill in the gaps so to speak.
  • Temporal Patterning Tests are designed to test an individual’s ability to process non-verbal auditory stimuli and recognize the order or the pattern of the presentation.

Your audiologist will select the battery of tests based on factors like your child’s age, the specific difficulties presented, and other case history information. The audiologist will inform you of which tests have been selected, and why, before assessment begins. Assessment may need to be spaced out over a period of two sessions or more and will take place in a sound treated room.

Electrophysical Testing

Electrophysical testing involves measuring the brain’s response to sounds using electronic instrumentation. During this process, electrodes are placed around the ear, either on the ear lobes or behind the ears and on the head and forehead.

As sound is introduced, the electrical responses are recorded. They evaluate processes in the brainstem or higher in the brain and are compared to normative data to determine if an abnormality is present.

Think of an EKG and you will understand what type of test this is.

Treatment Solutions for Hearing Loss in Babies

Our pediatric hearing specialists provide both solutions and ongoing guidance that can include early intervention from the state, parent/pupil teams, speech/language intervention, and hearing aid options.

An early intervention plan within the first six months of age may include input from your baby’s pediatrician, audiologist, and a pediatric otolaryngologist. This team of doctors will help guide your decisions regarding which treatments or devices will provide the best outcomes based on the type and degree of hearing loss he/she is experiencing.

Interventions may include:

  • Meeting with a professional who is trained to work with children who have a hearing loss as well as their families
  • Working with a professional who can help a family and child learn to communicate
  • Fitting a baby with a hearing device, such as a hearing aid
  • Joining family support groups
  • Other resources available to children with a hearing loss and their families
Studies show that quick and consistent treatment can help your baby’s spoken language development to the point of matching the development of other babies of the same age when hearing problems are discovered early and the intervention begins by six months after birth.
A newborn during hearing testing at Denton Hearing Health Care

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Treatment of APD in Children

Once the diagnosis of auditory processing disorder has been made and the type of auditory deficit has been identified, anindividualized management and treatment plan will be developed.

There is no one method or cure for an auditory processing disorder, so treatment generally focuses on changing the learning or communication environment, learning higher-order skills to help compensate for the disorder, and remediation of the auditory deficit itself.

Direct treatment of the auditory processing disorder can include a wide variety of activities from computer-assisted methodologies to one-on-one training with a therapist. Personal assistive devices may also come into play as a part of treatment.

Modifications in the classroom or home may be suggested as part of remediation and will be tailored to the individual’s needs.

Schedule an APD Testing Appointment for Your Child

APD is often difficult to diagnose because it presents similar signs and symptoms of hearing loss, but audiological evaluations often show normal to near normal hearing. Consequently, if your child is demonstrating signs of APD, Denton Hearing Health Care can help diagnose and plan the proper treatment to limit its impact on your child’s growth and development.

Contact us by submitting the adjacent form and a member of our team will help you schedule an APD testing appointment for your child.

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