Auditory Processing Disorder: Symptoms, Testing, and Treatment Strategies

Auditory Processing Disorder (APD), also known as Central Auditory Processing Disorder (CAPD), presents a complex challenge in the realms of diagnosis and management. This condition, often concealed behind normal hearing abilities, significantly affects how the brain processes auditory information. The symptoms of APD can be perplexing, mimicking other disorders and impacting academic and social performance. This comprehensive article aims to dissect the nuances of auditory processing disorder symptoms, delve into the intricacies of auditory processing disorder tests, and explore the efficacy of various treatments.

Identifying Auditory Processing Disorder Symptoms

Auditory Processing Disorder manifests through a spectrum of symptoms that are often misattributed to other learning or attention disorders. 

Key indicators include:

difficulty in understanding speech in noisy environments

problems in following multi-step directions 

challenges in distinguishing between similar sounds. 

These symptoms can significantly impact academic learning and social interactions, making early identification crucial.

 Comparative Review of Key Auditory Processing Disorder Tests: SCAN-3:C, APAT, and TAPS-3

Auditory Processing Disorder (APD) diagnosis requires precise and comprehensive testing. Three significant tests in this field are the SCAN-3:C Tests for Auditory Processing Disorders for Children, the Auditory Processing Abilities Test (APAT), and the Test of Auditory Processing Skills, Third Edition (TAPS-3). This review will explore the features, benefits, and roles of these tests in diagnosing and managing APD.

SCAN-3:C - A Comprehensive Diagnostic Tool

Developed by Robert W. Keith, PhD, the SCAN-3:C is a valid and reliable battery of tests designed to identify auditory processing disorders in children. This battery includes screening, diagnostic, and supplementary tests, such as Gap Detection, Auditory Figure Ground, and Competing Words. Its ability to differentiate APD from auditory attention problems and comprehension difficulties makes it a valuable tool in both clinical and educational settings. Assessments website: SCAN-3:C on Pearson Assessments.

Features and Benefits

• Comprehensive Assessment: SCAN-3:C offers a variety of tests, including dichotic listening tasks and speech processing in challenging acoustic environments.
• Developmental Insights: The test provides insights into the maturation of the auditory nervous system.
• Updated Norms: The test comes with updated norms, ensuring its relevance and accuracy.
  

Auditory Processing Abilities Test (APAT) - Detailed and Versatile

The APAT, created by Deborah Ross Swain, EdD, and Nancy Long, PhD, is a nationally standardized, norm-referenced battery suitable for children aged 5 to 12. It aims to identify those at risk of APD and assess a range of auditory processing skills, from sensation to memory to cohesion. For more information or to purchase APAT, visit the Academic Therapy Publications website: APAT on Academic Therapy Publications.

Test Components

• Diverse Subtests: APAT includes 10 subtests covering areas from Phonemic Awareness to Passage Comprehension.
• Index Scores: It provides composite index scores like Global Index, Linguistic Processing Index, and Auditory Memory Index for a comprehensive evaluation.

Strengths

• In-depth Analysis: APAT allows for a thorough assessment of discrete auditory processing skills.
• Versatility: Its design makes it suitable for use by speech-language pathologists and other specialists.

The Role of TAPS-3 in Auditory Processing Disorder Test

TAPS-3, developed by Nancy A. Martin and Rick Brownell, is instrumental in diagnosing APD in children and teens. It assesses auditory processing skills through subtests like Word Discrimination, Phonological Segmentation, and Auditory Reasoning. For details or to purchase TAPS-3, you can visit the Western Psychological Services website: TAPS-3 on WPS.

Key Features

• Broad Age Range: TAPS-3 is applicable for ages 4 to 18, offering seamless coverage.
• Cluster Scores: The test provides overall scores and cluster scores in areas like Basic Auditory Skills and Auditory Memory.

Advantages

• Precision: TAPS-3's detailed scoring criteria and partial credit system accurately reflect a child's auditory abilities.
• Efficiency: It can be administered and scored in a relatively short time frame.
  

 Each test brings unique strengths to the table. SCAN-3:C is comprehensive and excellent for differentiating APD from related issues. APAT offers a detailed look at a child's strengths and weaknesses across various auditory processing skills. At the same time, TAPS-3 provides a broad coverage suitable for a wide age range and delivers precise cluster scores. These tests can provide a robust and nuanced understanding of a child's auditory processing capabilities, guiding effective intervention strategies.

Evidence-Based Approaches to Treating Auditory Processing Disorder (APD)

Effective management of APD requires a multifaceted approach that addresses the unique needs of each individual. Core components of tretment typically involve:

1. Auditory Training Programs: The programs focus on improving specific auditory skills, such as phonemic awareness, auditory discrimination, and auditory sequencing. Evidence suggests that computer-assisted training programs can be particularly effective in enhancing auditory processing skills.
2. Environmental Modifications: Adjusting the learning or living environment to reduce background noise and enhance speech clarity is a crucial aspect of APD management. The use of assistive listening devices like FM systems can significantly improve auditory input for individuals with APD.
3. Speech-Language Therapy: Targeted speech-language therapy can help in developing compensatory strategies, enhancing language processing skills, and improving communication effectiveness.

Specific Treatment Modalities for APD

Auditory Integration Training (AIT): AIT involves listening to modified music or sounds to improve auditory processing capabilities. It aims to enhance auditory discrimination and attention in individuals with APD. For more information on Auditory Integration Training, you can visit resources such as Berard AIT for one of the approaches to AIT.

Fast ForWord: This is a computer-based program that uses adaptive exercises to improve language, reading skills, and auditory processing. It has been shown to be effective for children with APD and other language-based learning disabilities. You can find more information about Fast ForWord at Scientific Learning’s Fast ForWord.

Interactive Metronome: This therapy focuses on improving timing and rhythm, which are key in auditory processing. The Interactive Metronome has been found to enhance attention, coordination, and timing in children with APD. For details on the Interactive Metronome, visit Interactive Metronome.‍

LACE (Listening and Communication Enhancement): LACE is an auditory training program designed to improve listening skills, auditory memory, and speech comprehension, especially in noisy environments. It is particularly beneficial for adults and older children with APD. More information on LACE can be found at LACE Auditory Training.

Exercises to Improve Auditory Processing Skills at Home or in the Classroom.

 Exercises for Elementary School Children

1. Sound Matching Games: Use various sounds (e.g., animal sounds, musical instruments) and have children match the sound to its source. This helps in sound discrimination.
2. Story Sequencing: Read a short story and ask the child to sequence the events. This improves their auditory memory and comprehension skills.
3. Rhyme Time: Engage in activities that involve identifying and creating rhymes. This enhances phonological awareness, which is crucial for auditory processing.
4. Directional Commands: Give simple, then gradually more complex, multi-step instructions (e.g., "Pick up the pencil and put it on the book"). This helps in processing and following verbal directions.
5. Listening and Drawing: Describe a scene or an object and ask the child to draw it. This enhances listening for details and following auditory instructions.

Exercises for Middle School Students

1. Auditory Scavenger Hunt: Create a list of sounds for students to identify and locate around the school or home. This encourages careful listening and sound localization.
2. Word Association Games: Start with a word and have the student say the first word that comes to mind, continuing in a chain. This fosters quick auditory processing and verbal associations.
3. Auditory Memory Challenge: Read a list of words and have the student repeat them in the same order (increasing the number of words over time). This strengthens auditory short-term memory.
4. Barrier Games: Use a barrier to separate the student from a peer, with each having identical sets of objects. One student gives instructions on how to arrange the objects, enhancing detailed listening and comprehension.
5. Topic Debates: Organize debates on various topics. This encourages attentive listening to others’ points of view, processing this information, and formulating responses.

Exercises for Adults

1. Audiobooks and Podcasts: Regularly listen to audiobooks or podcasts and then summarize the content. This activity enhances sustained auditory attention and comprehension.
2. Sound Discrimination Challenge: Identify subtle differences in sounds or words that are similar (e.g., “think” vs. “sink”). This refines auditory discrimination skills.
3. Conversational Memory: After a conversation, try to recall specific details. This practice enhances auditory memory in real-life social contexts.
4. Auditory Figure-Ground Exercises: Listen to a recording with background noise and focus on extracting the main speech or sound. This improves the ability to focus on important auditory information in noisy environments.
5. Mindfulness Listening: Engage in mindfulness exercises that focus on identifying and attending to different sounds in the environment. This helps in honing overall auditory attention and processing.

General Tips

• Consistency: Regular practice is key to improving auditory processing skills.
• Progressive Difficulty: Start with easier tasks and gradually increase complexity as proficiency improves.
• Positive Reinforcement: Especially for children, positive reinforcement and encouragement are crucial in maintaining motivation and interest.
• Professional Guidance: For best results, the exercises should be used in conjunction with professional therapy tailored to individual needs.
  

Conclusion

In conclusion, addressing Auditory Processing Disorder (APD) effectively requires a multifaceted approach encompassing various evidence-based treatments and interventions. Programs like Auditory Integration Training (AIT), Fast ForWord, Interactive Metronome, and LACE (Listening and Communication Enhancement) substantially improve auditory processing skills, including auditory discrimination, attention, timing, coordination, and comprehension. For individuals and families navigating the challenges of APD, understanding the array of available treatments - from specialized therapies to computer-based programs - is crucial. These treatments aim not only to improve specific auditory skills but to enhance overall communication, academic performance, and quality of life for those with Auditory Processing Disorder. By integrating these approaches with support from professionals, educators, and caregivers, individuals with APD can significantly improve auditory information processing, leading to more successful and fulfilling social and educational experiences.

References:

1. American Speech-Language-Hearing Association (ASHA). (n.d.). Central Auditory Processing Disorder. https://www.asha.org/
2. Keith, R. W. (2000). SCAN-3:C Tests for Auditory Processing Disorders for Children. Pearson Assessments. https://www.pearsonassessments.com/
3. Martin, N. A., & Brownell, R. (2005). Test of Auditory Processing Skills, Third Edition (TAPS-3). Western Psychological Services. https://www.wpspublish.com/
4. Swain, D. R., & Long, N. (2006). Auditory Processing Abilities Test (APAT). Academic Therapy Publications. https://assessments.academictherapy.com/
5. Berard, G. (1993). Hearing Equals Behavior. Keats Publishing.
6. Tallal, P., Merzenich, M. M., Miller, S., & Jenkins, W. (1998). Language Learning Impairments: Integrating Basic Science, Technology, and Remediation. Experimental Brain Research, 123(1-2), 210-219.
7. Shaffer, R. J., Jacokes, L. E., Cassily, J. F., Greenspan, S. I., Tuchman, R. F., & Stemmer Jr, P. J. (2001). Effect of Interactive Metronome Training on Children with ADHD. The American Journal of Occupational Therapy, 55(2), 155-162.
8. Sweetow, R. W., & Sabes, J. H. (2006). The Need for and Development of an Adaptive Listening and Communication Enhancement (LACE™) Program. Journal of the American Academy of Audiology, 17(8), 538-558.