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What Causes APD?

There are events that can cause an auditory processing disorder (APD). These events may  result in the disruption of a clear and timely message being sent to the brain. The most common cause of APD is genetic, meaning it was inherited. Some other possible issues include:

  • oxygen deprivation ( ex: traumatic birth; near drowning; excess cigarette smoking)

  • significantly high billirubin levels soon after birth

  • head injuries

  • chronic middle ear fluid within the first few months of life that resulted in a temporary hearing loss for an extended period of time

  • surgical compromise

  • viral infections

  • chemo treatment (I have seen a few patients who acquired an auditory processing disorder following treatment)

In most cases, the cause of the APD is not known.  Fortunately, most APD issues respond well to auditory training. After the therapy process is completed, an improvement is seen in ability to communicate and learn through the auditory system.

Symptoms of APD

Auditory processing is complex and there are different types of auditory processing disorders, so symptoms vary and are many.  In addition, ADD (Attention Deficit Disorder) and Dyslexia share some of the same symptoms.  It is easy to see why it is impossible to determine the cause of a listening problem by looking at symptoms alone.


An auditory processing disorder, or APD, may manifest itself in several ways. This includes the following:

Difficulty understanding speech in noisy situations, difficulty learning to read, poor reading comprehension, poor spelling ability, misunderstanding a verbal message on more than one occasion, difficulty following multiple directions, an unusual sensitivity to loud sound, saying “huh” or “what” a lot, withdrawing from a conversation, dominating a conversation so that one does not have to listen, appearing to hear but not understand, and difficulty remembering what was said.  A person with APD may not have all of these symptoms, but they will have quite a few of them.


Often the person with APD does not realize that it's their listening skills that are causing them difficulty with communication and learning.  Often the parent or spouse does not realize it either. A listener with undiagnosed APD can believe that they aren't as smart as others or that they cannot be as attentive as their parents or spouse may want them to be.  This is why it is imperative to diagnose APD in childhood, in order to avoid growing up with a deficit that is not understood or treated. 


The disorders of ADD and APD share many of the same symptoms, but are separate entities.  Both can cause difficulty with understanding the spoken message. However the problem arises from different areas of the brain. While the difficulty hearing directions for the ADD child comes from an inability to focus, the listener with APD has a deficit in the auditory system, which causes the message to be processed in a less efficient manner. Therefore it can be misunderstood or the response can be delayed.


Treatment differs greatly between these two disorders, but the goal is the same, which is a better understanding of speech and an easier time learning in the classroom or workplace. Sometimes these two disorders coexist within in an individual.  If an adult or child has ADD, it is important to assess the auditory processing abilities for weaknesses, particularly if medication has not been successful. 

Is APD Treatable?

This is the question that's on every parent’s mind and is my favorite one because auditory training is so amazing!  The answer is Yes! Auditory processing weaknesses are treatable. Whether it can be completely eliminated depends on the type of auditory processing disorder, and if there are any other conditions present, including ADHD, learning disabilities, autism spectrum disorder, sensory integration disorder or cognitive disability. It is also dependent on the motivation of the child or adult to complete the auditory training exercises. For most persons with auditory processing weaknesses, improvement in hearing can be accomplished.


There was a wonderful study done back in 1991 when functional MRIs first became available.  An MRI was taken of an adult monkey's brain to determine which areas were being activated. These researchers mapped out the areas of the brain that responded to low frequency sounds, mid frequency sounds, and high-frequency sounds.  Next, they surgically destroyed inner ear  high-frequency sound receptors so that the brain was no longer receiving that type of stimulation. Then they waited for 10 months. Their hypothesis was that the area of the brain that previously received high frequency sounds would become weak, atrophic, or diminish in size. But when they repeated the MRI, they found that this area of the brain that responded to high-frequency sounds had reorganized to respond to low and mid frequency sounds. No wasted brain tissue, just reorganization!  The brain actually changed in response to the stimulation it was receiving. This phenomenon is called brain plasticity, which demonstrates that the brain can change, and reorganize. This amazing study  was a very significant one for the area of auditory training.

What is Audtitory Training like?

There are many options for auditory processing therapy. The most important first step is a thorough auditory processing evaluation that incorporates a battery of tests to evaluate all the different areas of the auditory system. This evaluation should be performed by an Audiologist. Reults of the test battery will diagnose strengths and weaknesses in the auditory system, which will guide the appropriate approach to therapeutic intervention.


Auditory training is very different from training other sensory systems. The training has to take place in the auditory system without allowing the cognitive realm to assist. Therefore, specific training materials and a tailored therapy approach are so important for success.


Over the years, I have incorporated these  “Golden Rules” for  auditory processing training:


1) “You hear what you hear”. You cannot correct the listener when he or she does not hear the correct message. Instead, the message must be presented in a way so that a clear difference is heard.


2) “The child / adult owns the ears and therefore owns the therapy”.  The training has to be a joint effort with equal input from the therapist and listener.


3)  “Focus on the strong areas as much as the weaker ones”. This helps to improve compensatory techniques, but more importantly, it fosters self esteem.


4) “Be able to change directions or gears on a dime" and "think on your feet". A quality therapist needs to be adaptable. As the auditory system is trained, it changes. As we proceed in therapy, we may discover new issues, or uncover a better method or direction for intervention.


5) "Daily does it!" Daily practice, even for just 10 minutes, is imperative. This daily training is completed at home. In order to have real changes to occur in the reorganization of the auditory system, there MUST  be consistent input!

What Makes our Clinic Different

Our  Auditory Processing and Therapy clinic was created because we have a passion for the field of auditory processing. We are different from other clinics in many ways.


First, diagnosis and treatment of an Auditory Processing Disorder is our only offering. We are highly specialized and I have been in practice for over 25 years.


Secondly. we provide a separate follow up session after the evaluation to discuss the results and to educate clients about their disorder, instead of sharing the information immediately after the evaluation. I feel it is very important for the child and family to completely understand auditory processing, and to comprehend both their auditory strengths as well as weaknesses. The findings are presented in a fun, interactive and positive way. Discussion also includes how the auditory processing test results relate to any other testing that may have been previously completed. A therapy plan is created, which can be implemented at our facility or at another treatment location.  What is best for the child and the family is always foremost on our minds. 


At our clinic, we individualize each treatment program based on the client's needs. We do not promote just one single method of treatment. Auditory processing is far too complex for one method to work with all of the possible auditory processing disorders. Our therapy methods are based on which areas of the auditory system are found to be weak and which programs are appropriate for the age of our client.

If you are in need of an auditory processing evaluation, please come check us out!  You will receive a top notch evaluation and treatment program designed just for you!

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