Auditory processing disorders (APD) can be observed in both children and adults. Simply put, these are disorders in which the person appears as if they have a peripheral hearing loss but have normal hearing on the audiogram, or pure tone test. People with auditory processing disorders may have deficits in processing of auditory information in a number of ways: they may have difficulty listening when background noise is present, difficulty with “filling in” missing auditory information, problems with combining information between the two ears (called dichotic listening), and issues with the timing of auditory information, just to provide a few examples. These types of problems may result in the listener struggling to hear in less than optimal situations, not being able to understand non-native speakers of their language, and struggling with people who speak rapidly, among other deficits. Auditory processing disorders can be the result of a developmental delay, a disorder of the central auditory nervous system (e.g. related to a head injury or illness), or a “wiring” issue thought to have a genetic component.
Auditory processing disorders are assessed by audiologists as part of an interdisciplinary team approach. The diagnosis of auditory processing disorder is under the scope of practice of the profession of audiology. It is a low-incidence diagnosis and other types of causes for the suspected auditory difficulties should be ruled out prior to implementing an auditory processing evaluation. In children, testing is most effective at age 7 or older. Prior to testing, peripheral hearing loss should be ruled out. In addition, children that have been identified as being on the autism spectrum are not appropriate for this type of testing. Normal cognitive functioning should be established prior to seeking an auditory processing assessment.
The auditory processing assessment is done to determine if an auditory processing disorder is present, and if so, to determine the parameters of the disorder in order to guide management. Case history information provided by referral sources, school, and family all contribute to the assessment. The assessment is designed to “tax” the auditory system in order to make it work under less than optimal conditions and to determine the ability of the auditory system to be flexible under these conditions. The assessment takes about 2 hours and provides insight into the types of auditory processing deficits present and the impact of these deficits on academics or the work environment. Recommendations are generated from the assessment that helps to link the diagnosis to treatment and management. The management of auditory processing disorders can be categorized in three areas: modification of the listening environment, often with the use of assistive listening technology; direct treatment for the disorder; and development of compensatory strategies and techniques.
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