The mushrooming scientific knowledge base
that underpins the
identification and management of auditory processing disorders (APD) in children,
has brought with it a flurry of Web activity.
In a climate of increasing certainty among
speech and hearing professionals that APD is a valid diagnostic entity
(Jerger & Musiek, 2000) extensive information
for consumers has been developed, and chat
and listservs for general
and professional
discussion have blossomed.
As well, several comprehensive overviews
explain why definitions have been refined in recent years,
and why the "c" for "central" in the older,
more familiar term, CAPD, is gradually disappearing.
Complex disorders
Contemporary research reveals the complexity of auditory
processing disorders in children (Ferre, 2001). Affected children may have
problems in
understanding the speech signal when background noise is present, in
understanding degraded speech, in comprehending verbal instructions, or in identifying
and discriminating between speech sounds.
Differential diagnosis
An APD diagnosis may reflect "central" issues where cortical functioning of the
brainstem, hemispheres or corpus callosum is compromised.
Alternatively, difficulties may be occurring at the level of more peripheral
structures such as the cochlea mechanism and the auditory nerve. Or there may
be a mix of the two, possibly complicated by specific language
impairment (SLI), language processing difficulties,
pragmatic
issues, attention
difficulties, ADHD
and problems with
auditory memory.
The role of the audiologist is to rule out
auditory
neuropathy and to accurately identify the nature of the auditory processing
breakdown and the level
at which it is taking place.
Cross-disciplinary collaboration
Many audiologists will say that the results of in-depth language
assessments by speech-language pathologists provide vital clues in pinpointing why these individuals with
normal hearing sensitivity find it so difficult to make sense of
auditory information. Fifty or more APD articles and documents
available on the ASHA web
site (go here, enter the
search criterion CAPD in the search box, and click 'go') attest to the
extensive collaborative research occurring between audiologists,
speech-language pathologists and educators.
APD and school
The functional implications of APD in the classroom
and other school situations, and for language learning and literacy are far-reaching (Pulaski
& Moskow, 1996), providing a cheerless segue
to Webwords 15, and an interesting selection of literacy links.
References
Ferre,
J.M. (2001). Complex, not complicated: Understanding children’s
auditory processing disorders. IDA Northern California Branch, 4-6
Jerger, J., & Musiek, F. (2000). Report of the Consensus
Conference on the Diagnosis of Auditory Processing Disorders in
School-Aged Children. Journal of the American Academy of
Audiology, 11,467-474.
Pulaski, M. & Moskow, S.
(1996). Central Auditory Processing Difficulties (CAPD) The
Effects on Reading, Writing, Listening and Speaking with Elementary
and Middle School Children.
Paper presented at the 43rd Annual Conference of the Southeastern Regional Association of Teacher
Educators. Charleston, SC.
Links
ADHD:
about medication
Auditory Neuropathy Info Page
British Society of Audiology... paig
Computer games could aid hearing...MRC
CAPD and auditory neuropathy
Child Neurology Home Page
Institute
of Hearing Research (MRC)
Management
at School
National Coalition on APD
New directions in auditory processing
Advocacy
Graeme Wadlow, chairman of APDUK,
provides information for others with APD on
his dolfrog site.
