Auditory Processing Disorder will not present the same way in every child, though it is rare to find a child who only suffers in one of the listed areas. APD usually exists as a blend of difficulties - however, one issue may be more dominant than the others. The main types of APD identified in children are:
Associative
deficit
An
associative deficit is a problem in associating sounds with their written
language. It is possible for a person with an associative deficit to have good
sound discrimination but a poor ability to recognise whole words. Although
someone with this problem may be able to repeat verbal directions verbatim, they
may not have comprehended the message at all. Also, complex sentences are often
poorly understood [41]
Auditory
decoding deficit
This
is the most common problem in children who suffer from APD. Information is
processed inaccurately and slowly, and these children are often wrongly
described as having a hearing deficiency. Words may be misheard or confused (eg.
'maths' and 'mass'), and rules for grammar and tense are poorly remembered. Many
children with this form of APD have poor spelling and reading skills [49] and tend to tire more quickly than most children of the same age [41].
Auditory
decoding deficit may occur in either of the two hemispheres of the brain. A
problem in the left hemisphere, the language centre of the brain, causes a child
to have trouble distinguishing the difference between similar sounds - for
example, 'p' and 'd'. A problem in the right hemisphere causes difficulties in
identifying the tone in which a message is given - for example, if the speaker
is angry, excited or being ironic [20].
Auditory
integration deficit
Children
with this type of APD find it very hard to combine information that is given in
more than one medium. This may translate as a problem when a child has to listen
to directions and then perform a physical task, such as in a physical education
class. It would be easier for someone with this type of APD to watch another
person complete the activity and mimic it in that way [49]. These
children tend to wait for others to begin a task so they can gauge how to do it
themselves [41].
These
children also have problems understanding words as a whole and this leads to
poor spelling and word-recognition. Auditory integration deficit describes what
happens when the left and right hemispheres of the brain do not communicate well
with each other so the relationship between different pieces of information
cannot be recognised [20].
Organisational
deficit
The
primary problem for children with this type of APD is with sequenced
information. Such information usually comes in the form of step-by-step tasks or
directions. Auditory signals are successfully received but are not organised in
a meaningful way to enable an appropriate response. This extends to physical
organisation such as keeping study notes in order. Tasks that require planning
are particularly difficult, and these children also seem to have trouble
expressing themselves [49]. An organisational deficit also affects a child's
ability to generate a response to information that is given verbally [20].
Prosodic
deficit
This
problem may be more outwardly apparent than any of the others. Children with a
prosodic deficit will not modulate their voices to reflect rhythm, tone or
stress. Likewise, they are unable to recognise such modulations in other
people's voices. This is a fundamental skill for good communication so this
type of APD is commonly accompanied by social problems. Children with this
problem also have little understanding or skill in the area of music [49].
Auditory
hypersensitivity
Auditory
hypersensitivity (or tolerance-fading memory) describes a feature of APD where
background sounds cannot be selectively ignored [18]. A child without
APD would be able to listen to a teacher even when people are whispering around
him or her. Children with auditory hypersensitivity, however, would be unable to
discriminate between the many sources of sound. To put it simply, each sound in
the child's environment is accepted with equal weighting and the child is unable
to attend to the desired message.
This
becomes especially problematic in school situations where individual differences
in receiving messages cannot be attended to as all students receive one set of
instructions at the same time. Children with APD will often appear to have
ignored the teacher or misunderstood directions and this becomes harder as
teachers start giving multiple instructions within the one sentence. Auditory
hypersensitivity is diagnosed through a dichotic listening test especially
designed to identify this problem [49]. The ability to selectively listen to one
source of sound in a busy environment is sometimes referred to as auditory
figure-ground awareness [42].
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