The Auditory System Explained
What is the Auditory System?
The auditory system is a part of the sensory system that is responsible for our sense of hearing. The auditory system and the vestibular system work closely together to control balance, coordination and movement.
There are two components of the auditory system:
1.) The first component of our auditory system to develop is called the defensive component. Newborns get startled when they hear loud noises. Over time, our brains learn that not all loud sounds are threats. This knowledge is a precursor for the future development of comprehension skills. Truly understanding the meaning of the sounds that we help our sensory systems to become fully integrated.
2.) The second component of our auditory systems is discrimination. Auditory discrimination allows us to comprehend more details about what we hear such as sound location, ability to filter out background noise, associating sounds with prior experiences and remembering verbal instructions.
When the two auditory system components are functioning properly, our bodies react appropriately to auditory input we encounter in our surroundings. However, if the two systems are not working well together, our brains misfire and interfere with our ability to regulate our reactions. Malfunctioning auditory system components reduce our ability to fulfill even daily living functions and untreated will negatively impact our standard of living.
Auditory Processing Disorder:
As discussed above, when the components of the auditory system are not working properly, the next step is to consider consulting with a physician. Advocating your desire to get your loved evaluated for auditory processing disorder (APD). APD is the medical terminology used when referring to the brain struggling to comprehend speech or increasing or reducing how we percieve what we hear.
APD can impact individuals at any age and presents differently from one person to another. It is also important to note that APD has nothing to do with intelligence or the ability to hear sound. No matter how loud a person speaks, the individual with APD will sometimes have difficulty understanding what they are being told. They often need extra time to process what they hear.
In general, we can over respond, under respond or seek out auditory input:
Over responsiveness to auditory input will result in a person wanting to avoid hearing loud noises. It also results in the person becoming distracted easily by noises in their surroundings.
Under responsiveness to auditory input presents itself as a general lack of awareness to sounds that other people are aware of. They consistently do not hear their name being called. They often ask for things to be repeated and struggle to remember verbal instructions
For the individuals who seek out auditory input, it presents with the person speaking at a much higher volume than those around them no matter what environment they are in. They love noisy environments, loud music or having their volume high on the TV.
Symptoms of Auditory Processing Disorder:
Auditory Processing Disorder presents differently from person to person. Many of these symptoms overlap with symptoms associated with other disorders, such as ADD/ADHD, Autism Spectrum Disorder and speech and/or language disorders. Only about three to four percent of people are diagnosed with APD. Due to it being relatively rare, APD is not fully understood. What is known, people with an APD diagnosis often appear to have a combination of multiple symptoms.
Some of the most frequently reported symptoms of APD include:
Significant difficulty understanding speech, appearing predominately when paired in a setting with background noise
Difficulty following verbal multi-step instructions
Easily distracted
Difficulty staying on task in settings where required to listen to someone speak for long periods of time without a break
Difficulty comprehending and remembering information they receive verbally
Consistently performs below grade level in reading, writing and spelling
Trouble following abstract thoughts or ideas
Misunderstanding of jokes, idioms, and figurative language
Advice For Caregivers:
First and foremost, be patient and understanding. Always try to keep in mind that their responses are directly related to the traffic controller in their brain. Their responses to auditory input can sometimes come across as difficult behavior or poor listening skills. They just have a difficult time processing what they hear.
Noise cancelling headphones or ear plugs are extremely helpful for children (and maybe adults) who are going to be loud environments.
A person with APD is going to need extra time between instructions as well as a small break before you repeat any verbal instructions to avoid a sensory overload.
Reducing sound distractions in environments where they need to stay on task and focused.
Continue teaching coping skills and support their overall sensory regulation and mental wellness each day.
Ideas that are specific to those struggling with over responsiveness, under responsiveness and someone auditory seeking:
Over Responsive:
Always try to prepare your child in advance whenever they will be in loud environments or will be experiencing sudden loud noises such as fireworks or even a loud flushing toilet at a store.
Under Responsive:
Try to fill in whatever gaps they may experience from verbal auditory input by providing them with a written or verbal copy.
Auditory Seeking:
For those seeking auditory input, encouraging them to play an instrument or listen to music while they are doing their homework can help give them the auditory stimuli they are after.
How is it Tested?
Due to the complex factors associated with APD, there are several testing criteria that is REQUIRED before the child is eligible for testing.
A child must:
Be at least 7 years old
Have normal hearing
Normal speech and language skills
Not have an intellectual disability
In addition, there are some co-occurring conditions that prevent a child from qualifying for testing.
Common reasons that a child may not be eligible for APD testing include:
Autism Spectrum Disorder (ASD)
Down Syndrome
Developmental delays
Below average IQ level
Significant speech/language disorders, such as apraxia of speech, stuttering, etc.
Hearing loss
The diagnostic procedure for APD requires a very comprehensive review of the child’s past medical, educational, and developmental history. The test is several hours long, and the child is required to participate in listening test that assess different areas of their auditory system. Since the test is so in depth. the results typically are not available that day. The physician has to score the assessments, review the history and whatever notes they took during their interaction with your child.
My youngest daughter has been diagnosed with APD and our particular diagnostic process was a three-appointment ordeal. Each appointment lasted about 3 1/2 hours. The audiologist wanted to screen my daughters hearing, do a physical exam, send assessments home for teachers and caregivers and then perform the in-person assessment.
In our experience, there was a two weeklong wait before we had our follow up appointment. The wait was worth it. We received a very detailed report of what the diagnosis was, how she met the criteria and how teachers and parents can encourage the development of the auditory system moving forward. It was such a thorough and informative appointment and we left there with a game plan on how to support her in the most beneficial way.
Students who struggle with auditory processing can have difficulty with speech and language development and conversational skills. Since the auditory and vestibular systems are so closely related, incorporating movement into their everyday activities can encourage the development of their language skills.
How is it Treated?
Auditory Processing Disorder is not something to treat without the help from an audiologist. Depending on your families’ particular circumstances, the audiologist will come up with a customized treatment plan. If you think that your loved one may be struggling with symptoms of APD it is important to have them evaluated. If they indeed are diagnosed with APD, the diagnosis will be extremely important and beneficial to their education.
Since APD is considered a learning disability, it would qualify your child for an individualized education plan (IEP). An IEP is your tool to advocate for your child’s needs so they can qualify for and receive proper accommodations. The accommodations vary but some examples include extra test taking time, written and visual instructions to coincide with verbal instructions and if appropriate an IEP may significantly decrease the amount of work sent home with them.
Is there a cure for APD?
The answer to this question is a bit controversial. The areas of the brain that are responsible for auditory processing abilities continue developing until around thirteen years old. That is the average age the auditory system is considered to be mature. Due to the gradual rate of development, children diagnosed before their auditory system had finished maturing could “grow out of it.” Especially if they were receiving therapy and other services from a young age to improve their auditory processing skills.
For these reasons, it is recommended that children diagnosed with APD before age 13 be re-tested every 1-2 years until after their 13th birthday to monitor for any changes or improvements with their auditory processing skills. It may seem like an inconvenience, and you may wonder what the point would be to keep testing them instead of just waiting for the child’s auditory processing skills to improve?
Ever heard of the phrase early intervention? That definitely applies in this situation. The sooner they get diagnosed the sooner they can start learning coping skills, utilizing accommodations for their education and participating in therapy and other resources. There is no number of inconveniences that I would not happily endure to make sure my child is best set up for their future. It definitely is NOT a waste of time.
