Maybe you’ve never heard of it until recently.
I’ve said this before, but kids aren’t born with an instruction manual attached. We get to discover all the amazing and unique details as we go along on this journey. That’s true about parents, too. Many of us adults have experienced the process of discovering we have a learning difference or disability later in life as our kids are diagnosed.
With Auditory Processing Disorder (APD), or Central Auditory Processing Disorder (CAPD), it was when I was filling out a form for one of my kids at a doctor’s office that I had a lightbulb moment. Going down an auditory processing checklist for my son, I saw that I could have checked all of the boxes for myself. I had auditory processing disorder. This can be tricky to get diagnosed, because there is some overlap with other neurological differences. Another problem is that it isn’t the speciality of most audiology centers. It isn’t in their wheelhouse, so they will offer a screening for it, but it is easy for the diagnosis to get missed. Also, people learn to compensate for their deficits and then just internalize or mask the struggle. This is especially true for gifted people who utilize their exceptional strengths to unwittingly mask or compensate for their deficits.
My initial “lightbulb” moment was a few years ago. This summer we made the trek to the Able Kids Foundation in Fort Collins, Colorado, so the kids (and I!) could finally be evaluated and diagnosed.
You might wonder what the benefit is of being diagnosed. Especially, there are expensive listening regimens that are still being studied (such as the Safe and Sound Protocol, Tomatis Method,) but there really is no cure for APD. It can be very affirming to understand why something is hard for you that is not difficult for others. When you can identify and name what is happening, the narrative shifts. Without any understanding of why you or a child is struggling or making mistakes, it is easier to shift into a mentality of : “I can’t follow directions.” “I don’t pay attention.” “I can’t do this.” “I hate school.” “I’m stupid.” “I have blow ups when things go wrong.”
When we identify what is going on, we can flip that script:
I can’t follow directions = I do better with written instructions.
I don’t pay attention = I need an appropriate instructional environment.
I can’t do this= I can’t do this just yet, but we are figuring this out.
I hate school = the school needs to put appropriate accommodations in my 504.
I’m stupid = This curriculum is not designed for visual learners.
I have blow ups when things go wrong= I need to take a break.
Top 10 Symptoms of APD according to Able Kids Foundation:
1. Easily Distracted. Individuals with CAPD often report having “super hearing.” The presence of sound, which may not be detectable by others, can make it difficult to focus and complete work in a timely manner. Staying connected and engaged during conversation is also more challenging.
2. Sensitive to Loud Sounds. Noisy places can be more overwhelming and exhausting, even fun settings such as birthday parties and family holidays. Individuals may withdraw or seek alone-time, appearing disinterested or rude. Auditory sensitivity may also appear as meltdowns, irritability, or avoidance of noisy activities. Some individuals may have received a diagnosis of hyperacusis or misophonia.
3. Mishears. Individuals who mishear auditory information may appear to be “poor listeners” or noncompliant. They may also request repetition of auditory information and say “you never said that!” Mishearing information can create communication breakdowns across all environments.
4. Experiences anxiety. Individuals often experience anxiety related to their auditory environments, including learning and social settings. Frequent restroom breaks or trips to the nurse’s office are often reported in an effort to escape the noise. Other individuals may avoid group situations and have a preference for staying home.
5. Easily Frustrated. Mishearing, being misunderstood, and experiencing exhaustion due to noise can be frustrating. Have you ever had a tag on your shirt bother you all day? Imagine that tag is noise.
6. Appears Confused in Noisy Places. The ability to understand speech is compromised in noisy environments, leaving individuals with CAPD often feeling disengaged, confused, and overwhelmed. This may also present as “shutting down” or as hyperactive.
7. Difficulty Following Directions. Individuals with CAPD often report that they can hear but cannot understand the auditory information, making it difficult to follow directions. The auditory system can also become overloaded, making it challenging to retain large amounts of auditory information, such as in a lecture, group environment, etc.
8. Forgetful. Individuals may appear forgetful when they do not understand what was asked of them. Individuals also report being more forgetful when experiencing auditory overload.
9. Slow at Starting New Tasks. Mishearing instructions, being distracted by noise, and/or feeling exhausted due to CAPD are some factors that can contribute to delaying the start of a task.
10. Easily Upset in New Situations. Structure, routine, and familiarity are important for many individuals with central auditory processing disorder and help to provide control and predictability during the day. Changes to the day can be upsetting, even if they revolve around fun activities.
Here are some supports you could consider putting in place. These could be an appropriate part of a 504, IEP, homeschooling family plan, or ways that an adult self-advocates for their own needs.
Preferential placement in the listening environment. This can mean a seat near the point of instruction with a clear, unobstructed view of the person speaking. It could also mean placement further away from distracting noises, such as away from a doorway or away from the classroom pencil sharpener. It can be helpful to be seated next to a student who tends to be less disruptive and could be a resource for doublechecking a piece of an instruction or note.
Ear plugs or noise dampening head phones for independent work and in loud environments. This can help to lower the distracting background noise. Headphones or earbuds utilizing white noise or music with no lyrics may also be helpful. Check here for my list of various ear plugs and headphones for sound sensitivity.
Custom passive ear filters may be an option. This is something the Able Kids Foundation offers for children and adults. It goes in one ear and you wear it most of the time. Headphones can be worn over the ear filter when needed. Now that it has been several weeks, we are seeing results with the custom ear filter as far as helping to understand and follow conversation in crowded or noisy environments.
Amplifying ear device. This is newer technology that a professional shared about with me. The company Oticon has developed hearing aids that can work with your phone. Utilizing the app, a person could place their phone on the desk of the instructor or on the table at the restaurant near the person speaking, and their voice will be amplified in your ears. This part is especially helpful in hearing conversation in noisy and crowded environments. I have not personally utilized this product, but it sounds interesting.
FM systems for amplification in the classroom environments. ALS Auditory Listening Systems. The speaker wears a headset microphone and the listener wears coordinating headphones. Some examples are made by Pro Acoustics.
Separate, quiet environment for all test taking. (Use of headphones during testing is also helpful.)
Written instructions for assignments, work tasks, home chores. Avoid multiple-step spoken instructions and questions.
Permission to receive a copy of class notes or access to a classmate’s notes. Background noise can making taking notes more difficult.
Include visual and hands-on components to the auditory learning as much as possible.
Sound breaks in a quiet place throughout the day, a quiet lunch environment. Opportunities to rest from the auditory fatigue of working hard to listen. As an adult, I take breaks at parties. I slip outside and take a walk. I try to encourage meetups with friends to take place outdoors or at venues where the volume isn’t super loud. If we end up at a noisy restaurant, I may slip into the restroom to take a break, and I try to give myself grace when I can’t follow the conversation. In noisy social environments, it really is ok to take a pretend phone call if you need a break but also need a polite excuse to step away. When I get home from a loud restaurant, I retreat to my bedroom and immerse myself in quiet before I rejoin the family, or spend a little time outdoors with my horse.
Written schedule or notice, or verbal reminders of changes or important events before they occur.
Opportunity to preview new vocabulary and ideas before a formal presentation of material. A follow-up after presentation of material is also helpful.
Written content and visual cues are very important for learning a foreign language. *In my personal opinion, American Sign Language may be an excellent language choice, and flexibility on some of the grading based on auditory listening could also be helpful.*
Classes with heavy listening should be in the first part of the day, due to auditory fatigue as the day progresses. With this in mind, priority registration for courses is recommended. Another benefit to priority registration is that classes with teachers who are collaborative, structured and understanding to needs will be a better fit.
A teacher or speaker should seek visual cues (call the person’s name, lightly tap the shoulder) to ensure they are picking up important auditory information. A speaker can check in and repeat/rephrase information if it was not understood.
The optimal study environment is a quiet, low-activity room. I think this is part of why homeschooling has been so successful for my family.
White noise may be helpful to avoid sleep interruptions at night.
My final thoughts- New diagnoses can be scary and overwhelming, especially when they are for our kids. If you suspect or are discovering a new diagnosis, give yourself loads of compassion. I used to be so scared of the possibility of new labels. Resisting them didn’t make disabilities go away, it just left the information unconfirmed. While diagnoses can be frightening, they can also be empowering and affirming. Both sides can be true at the exact same time. No diagnosis defines you; it is information to help you advocate. You and your kids are wonderful, and I don’t say that lightly. If you want to read more about new diagnoses- hop on to my past blog here.
Warmly, Christina
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