AUDITORY PROCESSING DISORDER

1
AUDITORY PROCESSING DISORDER

• WHAT WE WILL COVER
• Causes of APD
• Definition
• Behavioural Characteristics
• Assessment
• Management and Treatment

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DEFINITION OF APD

• What we do with what we hear
• Difficulty processing and interpreting auditory
  info in less than optimal environment
• Inability to attend, discriminate, comprehend
  message
• Have to work harder to perceive msg

3
DEFINITION OF APD

• Chermack Muziek estimated prevalence 3
• More in males
• Co-exists with other disabilities
• Speech and language
• Learning disabilities
• ADD ADHD
• Autism and Autism spectrum

4
DEFINITION OF APD

• APD is mild compared to other disabilities but
  can have a large impact on listening and
  analysing what we hear
• Often find that psychological, medical and
  neurological examinations are unremarkable

5
AUDITORY PROCESSES

• Mechanisms responsible for following phenomena
• Sound localization and lateralisation
• Auditory discrimination
• Temporal aspects of audition
• Performance with competing signals
• Performance with degraded signals

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AUDITORY PROCESSES

• What happens when we hear?
• Brain identifies sound by distinguishing
  characteristics (freq, intensity, temporal)
• Constructs an image of the sound
• Compares image with existing image
• If matching we understand

7
CAUSES OF APD

• No one cause
• Research often states as unknown
• Maturational delays
• Neurological problems
• Trauma and Tumors
• Degenerative disorders
• Surgical compromise
• Auditory deprivation (GLUE EAR)

8
BEHAVIOURAL CHARACTERISTICS

• Not unique to APD thus not indicative
• Should be considered at risk
• Short attention span
• Difficulty following long conversations
• Difficulty learning new vocab
• Delayed responses
• Says huh or what a lot
• Easily distractible

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BEHAVIOURAL CHARACTERISTICS

• Impulsive
• Difficulty starting or completing tasks
• Easily flustered in noisy situations
• Sensitive to loud sounds
• Difficulty reading and writing
• Performing below potential
• Perceived as naughty
• Behavioural problems

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EFFECTS OF APD ON INDIVIDUAL

• Hinders academic performance
• School drop outs
• Work accuracy and efficiency
• Unemployment
• Social and emotional status
• Emotional upheavals
• Over all well being

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ASSESSMENT OF APD

• UNDERSTANDING THE CANS
• Senses has special areas of representation in
  the brain
• Auditory NB provides with means of
  communication
• Brain blocks out undesirable stimuli

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• Prevents listening chaos
• CANS functions at adult level at 10/11 yrs

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AUDITORY PATHWAY

• Route of of signal is complex
• Sound strikes eardrum
• Sound transformed into neural signal
• Travels through neural networks to various parts
  of brain
• Analysis, recognition and comprehension

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ASSESSMENT CONTINIOUS

• Multi-disciplinary approach
• Professionals involved
• Teacher
• Paediatrician
• Mental Health Professional
• OT
• ENT
• Audiologist
• SALT

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AUDIOLOGICAL EVALUATION OF APD

• Background History
• Pure tone Audiometry
• Tympanometry
• OAE
• Central tests

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CENTRAL TESTS

• Involves speech stimuli modified to make
  understanding more challenging
• Goal is to stress functioning of auditory
  mechanism at various levels of CANS functioning
  to identify inefficient functioning
• Decades of research to confirm accuracy

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CENTRAL TESTS CONT.

• Two major categories
• Electrophysiological testing
• Behavioural testing

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BEHAVIOURAL TESTING

• Fall into 4 categories
• Monotonic tests
• Dichotic tests
• Temporal patterning tests
• Binaural Interaction tests

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ELECTROPHYSIOLOGICAL TESTS

• Objectively measures physiological response and
  includes
• ABR
• MLL
• LLR

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SCAN TEST

• Aim is to demonstrate challenging listening
  situations
• Age 5 to 11. Adult test available
• 4 Subtests
• Filtered speech
• Auditory figure ground
• Competing words
• Competing sentences

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SCAN TEST

• DISADVANTAGES
• 20 min without break
• American accent
• Vocabulary sometimes unknown
• Not testing all auditory skills (memory,
  sequencing)

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MANAGEMENT AND TREATMENT

• Fall into 3 categories
• Enhancing APD skills
• Enhancing language and cognitive resources
• Improving quality of auditory signals

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M T cont.

• Strategies depend on
• Exact nature of APD
• Age of child
• Co-existence of other disabilities

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ENHANCING APD SKILLS

• Therapy aimed at
• Memory
• Discrimination
• Analysis
• Synthesis
• Closure
• Cohesion

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ENHANCING APD SKILLS

• Nature of treatment Two types
• Sound Therapy
• AIT
• Earobics
• Listening Program
• Bodyworks
• OT (Braingym)
• Cognitive Programmes (PACE/ Audiblox)

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ENHANCING APD SKILLS

• Programmes
• Auditory visual approach
• Pendulum
• CAPD kit
• DASL

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ENHANCING COGNITIVE AND LANGUAGE RESOURCES

• SALT therapy
• Bodyworks

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IMPROVING AUDITORY SIGNAL

• Classroom alterations
• (to be covered by Nerrys)

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APDIntroduction

• LIZEL LEMMER
• AUDIOLOGIST/SPEECH THERAPIST
• KING EDWARD VII