The Assessment of Auditory Processing Difficulties
Although APD is a very common disorder, many professionals will not consider APD when encountering the associated behaviours because APD can present as a range of symptoms. In the case of anxiety or an attention deficit, there is a tendency towards treatment with medication while children who have difficulties in reading or spelling may be classed as having a poor intellectual ability. Due to this relatively low level of understanding about the disorder, it is often left unconsidered and subsequently undiagnosed.
Assessment and Diagnosis
ASHA (American Speech-Language-Hearing Association) Working Group on Auditory Processing Disorders (2005), position statement on auditory processing disorder (APD), is that it refers to difficulties in the processing of auditory information in the central nervous system. APD is evidenced by deficient performance in one or more of the following skills: sound localization and lateralization; auditory discrimination; auditory pattern recognition; temporal aspects of audition, temporal integration, temporal discrimination (e.g. temporal gap detection), temporal ordering, and temporal masking; auditory performance in competing acoustic signals (including dichotic listening); and auditory performance with degraded acoustic signals.
Currently there is no uniform assessment battery for APD. However a comprehensive APD assessment should include:
a) Auditory Closure: This is the ability to complete or fill in missing parts of auditory information when the auditory signal is degraded, such as when a speaker is speaking from another room.
b) Auditory Figure Ground Differentiation: This is the ability to listen to and understand specific auditory information in the presence of competing background noise.
c) Spatialized listening: Is ability to hear and understand spoken sentences both when background noise is coming from the same direction as the spoken sentences, as well as when background noise is coming from a different direction as the spoken sentences.
d) Dichotic listening is the ability to hear auditory information through both the left and right ears and to either integrate these bilateral auditory sources, synthesizing the two sources, or to differentiate them, ignoring one source while hearing and understanding the other source.
e) Temporal auditory processing skills assessment looks at an individual’s ability to hear and understand speech which is time altered by various methods. For example: assessing if an individual is able to understand rapid speech. d) Language Prosody Assessment: the assessment of comprehension of language prosody (the melody of language) looks at an individual’s ability to hear and understand the prosodic elements of speech which give important contextual and social information. For instance, we know that in English, it is usual for questions to end with a rising intonation; also to perceive differences in pitch and tone which are essential skills for efficient auditory processing.
e) Short-term Auditory Memory and Auditory Attention
Who can undertaken an APD Assessment?
Speech Pathologists, Psychologists and Audiologists with training in APD assessment.
Auditory Intervention Programs
Often clinicians who undertake APD assessments will also have auditory intervention programs. Auditory interventions that are customisable with elements that specifically target the auditory processing skill that is in deficit, have a record of producing better improvements in the targeted skills than generic non targeted computer software, online, tablet or ipod programs.