Often parents and teachers are concerned because a child can’t listen. Many times parents and teachers think the problem is the child not paying attention. But, is that really what is causing your child to have problems learning?
One problem that can cause a child to have difficulties learning is an auditory processing disorder or APD. Auditory processing involves how the brain deals with information we hear.
What is involved includes:
- How we hear sounds
- How the sounds are identified as individual sounds (called phonemes) in words
- How the individual sounds are made into whole words
- The whole words go together in sentences leading to our understanding the meaning of what we hear
As we are processing what we hear we are interpreting the language and making sense of its meaning (cognitive thinking and decision making). We also are attending to what is important in the listening environment and filtering out what is not important while focusing on the key important verbal information we hear. We also react to what we hear so that some messages are funny, some can be scary, and others can be sad or some other emotional reaction. Last, after making sense out of what we hear, we start to develop a response by integrating all the information we hear and putting the pieces together in an appropriately organized manner.
If you look carefully at the description above, you will see that auditory processing does not involve merely the auditory system. However, most professionals today only see it as an auditory system disorder. Thus, accommodations to change how the auditory system receives information (such as the use of FM systems) may not be appropriate for most children with APD problems. Additionally, the attention, focusing, and filtering involved in processing what we hear can be related to auditory based functions or attention/self-regulation issues. Thus, it is important that an appropriate evaluation of auditory processing be provided by a professional who understands all factors that go into how we process what we hear.
As early as the 1980s, I looked at auditory processing from a multisystem perspective. My research and clinical experiences led to my identification of auditory processing involving the auditory, language, and cognitive systems. Since that time, I have modified my multisystem approach so that it now includes the following:
- The auditory system
- The cognitive system (thinking/problem solving and memory)
- The attention and executive functioning system, the language system (making sense of verbal messages)
- The emotional system that reacts in certain ways to different sounds and verbal messages
- The sensory system that deals with how we take in, filter, and choose what we want to hear and what will be ignore
What is important to remember is that these systems work (integrate) together so that problems in successful process can be due to one system not functioning properly or the integration between systems breaking down.
In order to better understand what is said above, consider the following:
Your child hears, “Go get your coat. We are leaving now.” Your child has to do the following. First, hear all of the auditory information in these words. The child’s sensory system has to allow this message to pass and not be filtered out while the attention/executive functioning system focuses on the voice and specific words spoken. The auditory system breaks down the message so that the first sentence would initially look like this (in the neural auditory system): Go—get—your—coat. Your auditory neural system realizes these are four distinct words and not some slur such as “Gogetyuh ork oat” which the language system realizes makes no sense. If the auditory system breaks down each part into the individual words, it also recognizes the slightly longer time between “coat” and “we” so that the language system realizes there are two different sentences and “coat” and “we” does not get translated into “cohtwee”. Additionally, the auditory system processes each sound (phoneme) and makes the distinctions between phonemes so that “coat” does not get misinterpreted as “goat”.
Once these two sentences are processed appropriately by the auditory, sensory, and executive functioning/attention systems, we reflect on the meaning of the utterance. We realize that these two sentences really mean “go to my room – look for my coat – take my coat – put it on – get ready to exit the house and do it quickly” with the latter “do it quickly” interpreted based on the speaker’s tone of voice. This interpretation by tone of voice is an integration of the auditory, cognitive, and emotional systems. We would react very differently if the emotional system processed the speaker as speaking softly and easily vs. rushing through the words that were said. The first emotional interpretation would be “take your time,” while the second one is “better do that fast”.
In looking at the complexity of how we process what we hear, you can see that merely focusing on an auditory system approach to APD misses many of the real, underlying factors that could lead someone to have problems listening, understanding, learning, and communicating. Thus, what is needed is a comprehensive assessment with results of the evaluation interpreted by the professional (an audiologist) who understands this multisystem, integrative approach. This is the approach I take and have taken for decades focusing on interpreting all available data to understand what specific system(s) could be causing the breakdown a child has in processing what is heard.
Understanding that auditory processing involves multiple systems should lead you to realize that there is no one appropriate treatment for APD problems. There are different treatments for auditory based issues, cognitive problems, executive functioning/attention disorders, language deficits, emotional factors, and sensory system malfunctioning. My work, evaluations, and research specializes in identifying the specific system(s) involved and what are appropriate modifications (accommodations) and treatments to improve the processing functioning of all systems and the integration of the systems so your child can successfully understand what is said in school, at home, and in conversations with peers.
If you are interested in scheduling an evaluation or have further follow-up questions, contact us at (301) 652-5550.
Jay R. Lucker, Ed.D., CCC-A/SLP, FAAA
Certified/Licensed Audiologist and Speech-Language Pathologist
Specializing in Auditory Processing Disorders and
also Professor at Howard University in Washington, DC