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There is at least one child per classroom in New Zealand struggling with auditory processing difficulties and many teachers and parents are not aware of the serious impact this could have on a childs learning.

Auditory Processing Disorder (APD) is a hearing disorder in which the ears process sound normally but the brain cannot always understand or hear. Children with APD may exhibit signs of hearing loss, especially when there are competing sounds at even moderate levels, yet they pass standard hearing tests conducted in quiet. Despite having normal intelligence they may need instructions repeated and may have difficulty following directions in the classroom. In particular they may not respond appropriately to instructions that are lengthy or that include more than one task. Audiologist and CEO of APD specialist clinic, SoundSkills, Dr Bill Keith, says a child who has difficulty understanding verbal instructions and who struggles with reading and spelling could have an auditory processing disorder.

APD affects an estimated 3-15% of children more boys than girls and most go undiagnosed. In the past year weve identifi d close to 100 cases, primarily in Auckland, says Dr Keith. APD can present as a learning or behaviour problem and can cause under-achievement because these children are missing out on vital information says Dr Keith. The problem lies in the hearing pathways and centres in the brain. Children are unable to extract the message that they need to from all the sound and noise around them. Or they have trouble retaining auditory information unless it is brief.

Causes of APD include birth trauma, early history of otitis media (glue ear) and hereditary factors. The condition often occurs in conjunction with other areas of difficulty such as Attention Deficit Disorder (ADD), language and speech sound problems, and reading disorders. It can be the underlying cause of language, spelling, reading and learning disorders. The underlying auditory problem should be addressed before trying to remedy the language, spelling, reading or learning difficulty.

The condition requires specialised testing and assessment, and individualised treatment. A multi-disciplinary team approach is necessary. But, says Dr Keith, the good news is that there is now robust evidence for the effectiveness of a number of interventions including hearing training to improve listening skills, language therapy to improve understanding and wearing a personal FM listening device in the classroom to transmit the voice of the teacher clearly, and lessen the impact of background noise.

Professor Suzanne Purdy, Head of Speech Science and senior researcher in the Centre for Brain Research at the University of Auckland has recently concluded research showing that FM usage delivers a double benefit for children with APD. Firstly it provides immediate assistance with hearing, but over time FM usage also can lead to an improvement in auditory skills so that use of the FM system may not be permanently necessary. Professor Purdy notes that APD is often overlooked or mistaken for another condition that affects learning and behaviour. Her research with colleagues at the University of Auckland and Macquarie University in Sydney has shown that APD often is associated with literacy and language difficulties. It is important that children who appear to have poor classroom listening skills and who are struggling with literacy in particular be assessed by an audiologist to determine whether APD is an underlying factor, says Professor Purdy.

SoundSkills is dedicated to diagnosing and treating APD. SoundSkills audiologists, speech therapists and education adviser provide specialised testing and individually tailored remediation programmes.

Vibrations Autumn 2011
Magazine of the National Foundation for the Deaf