EDUDEAF: Auditory Processing Disorders

Key Words: Deaf Education Information, Deafness Related Issues, Additional Disorders

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Date: Fri, 13 Dec 1996 18:07:44 -0500
Reply-To: A Practical Discussion List Regarding Deaf Education
Sender: A Practical Discussion List Regarding Deaf Education
From: Tina Davis
Subject: Auditory Processing Disorders

To: Multiple recipients of list EDUDEAF

Hello everyone. I have a question about auditory processing disorders. A parent contacted me about her child and I didn't have a lot to share with her. I was hoping that someone on the list has had some experience with this. There is a child who is in 3rd grade and has just had some testing done. The SPL that tested her said that she seems to have a problem with filtering out background noises. The test she gave her consisted of the child wearing headphones and being presented with a sentence and also some background noise (ie. children laughing etc.) When the background noise was presented the child could not repeat one word/phrase/sentence correctly. However, without the noise she repeated 100%. Is this test called "The SCAN"?

Is there any other tests that can be done? Would this child be a candidate for an ABR? I guess the child has an appointment with an auditory pathologist. Should the child's hearing be tested or will the auditory pathologist do it? What is an auditory pathologist? Is it the same as an audiologist?

Beyond the testing what sort of therapy is out there to mediate the problem? I realize that if she does have an APD then she will never be cured but isn't there a way to "deal" with it? Who is the best person for the job? I have heard of children with APD wearing an FM system. Is this a good step?

I would appreciate any help anyone can give. I realize that right now is a bad time to ask as Holiday shopping time is clinching down, but the child's CSE meeting is on Wed. I would like to give the mother some sort of info/ encouragement.

Thank you,
Tina Davis

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Subj: Re: Auditory Processing Disorders
Date: 97-01-03 10:26:24 EST
From: dr.j@RDZ.STJOHNS.EDU (Jay Lucker)
Sender: EDUDEAF@LSV.UKY.EDU (A Practical Discussion List Regarding Deaf Education)
Reply-to: EDUDEAF@LSV.UKY.EDU (A Practical Discussion List Regarding Deaf Education)

To: EDUDEAF@LSV.UKY.EDU (Multiple recipients of list EDUDEAF)

Dear Tina,

Yes, what you are describing sounds like a child who *may* have a central auditory processing problem.

You asked who is the best person to further evaluate the child and work with the child? The answer is easy. Who do you know who really understands CAPD and can provide a thorough, useful CAPD evaluation? In some places, the person is an audiologist. In some places the person is a speech-language pathologist, in some places the person is a neuropsychologist. Since CAPD is such a wide and varied problem, it really depends on your approach. And the worse approach is a shotgun approach, which is what is too often the case.

Since CAPD is an area in which I specialize, I have very strong convictions in this area. But, the bottom line is, who do you trust, who has the right knowledge in this area, and how will this knowledge help the child.

Also, the SCAN is one of the many tests which can be used in evaluating CAPD. The subtest of the SCAN you describe presented monosyllabic words in the presence of cafeteria noise. What is important is not that the child obviously scored below the norms for her age, but, was the test presented in a calibrated and controlled fashion? That is, was the signal presented through earphones at a controlled level of listening (such as the child's MCL or at a normal conversational speech level). If the signal was too loud, the child may have performed poorly because the stimulus was uncomfortable, and she was trying to tune out this annoying stimulus. A similar idea with too soft a signal - child straining to hear the speech. Thus, in these cases, the problems would not be due to the background noise but to the improper intensity of the signal.

Now, you said that the SLP stated the child di poorly for the "sentences" (If the SCAN it would have been words) presented with the noise (cafeteria noise), *but* the child did OK for the words in quiet ! That's most interesting since the SCAN test does not present the words in quiet - so no comparison can be made. (BTW, your comparison is for me one of the most appropriate ways to *truly* tell if the problem is due to background noise - but few tests of speech in noise make this comparison.)

So, now we don't know if it was the presence of the noise, the child's inability to know to what she must attend, the intensity level of the speech, or familiarity with the test words which caused this child to fall down on the speech-in-noise (or auditory figure-ground) test of the SCAN (assuming as you said it was the SCAN).

So, a differential diagnostic test battery is needed to determine what factor or factors are actually interfering with the child's auditory processing.

Now, the real bottom line.....so what can be done about it ? Depending on what factors are causing the problems, you can:

So, we can provide a great deal of help.

If you'd like to learn more about CAPD or keep up to date on this specific topic, there is a CAPD listserve just for this area.

Send email to: listsev@sjuvm.stjohns.edu Message: subscribe CAPD (just substitute you real name for and leave out the <> marks)

Hope this was helpful, Tina.
dr.j!

Uploaded by: B.J. Lawrence/Kent State University/Deaf Education Major