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Hard of Hearing or Something More? Auditory Processing Disorder in Children

Blog Hard of Hearing or Something More? Auditory Processing Disorder in Children

“When we think of hearing, we think of hearing with our ears,” says Teri Bellis, Ph.D., a spokesman for the American Speech-Language-Hearing Association (ASHA). “But the ears work together with the brain and the central auditory pathways that process what’s coming in. If there’s a deficit in this system, the brain will misinterpret what the ears are hearing.”


Your child seems to have trouble understanding what you say to her, but a hearing test comes back normal. Is she simply not listening to you? Maybe. Kids can be good at hearing only what they want to hear sometimes. But the problem could also be a condition called auditory processing disorder, or APD, in which the ears function just fine, but the brain isn’t able to “get” what’s being heard.

“When we think of hearing, we think of hearing with our ears,” says Teri Bellis, Ph.D., a spokesman for the American Speech-Language-Hearing Association (ASHA). “But the ears work together with the brain and the central auditory pathways that process what’s coming in. If there’s a deficit in this system, the brain will misinterpret what the ears are hearing.”

Because ADP manifests in so many ways, symptoms of the disorder are hard to pin down. “They can vary widely from kid to kid depending on what region of the brain is affected,” explains Bellis. Not only that, ADP can lead to misdiagnosis of other conditions, such as attention deficit disorder. “It may seem a child has trouble paying attention, when really she isn’t hearing what’s going on properly,” Bellis says.

It’s nearly impossible to pin down how many children are affected by ADP, Bellis says. (Adults can suffer from the disorder, but it typically is a side affect of an illness or injury.) What is known is kids can’t be officially diagnosed until they’re school age, 7 or 8, when they begin learning to read, spell, work math problems, and so on.

However, there are a few red flags among younger children. “One is when a little kid who’s learning to talk often mixes up “D”s and “G”s” says Bellis. Lisping is not associated with ADP, she adds.

Even though ADP is difficult to diagnose, it’s usually not hard to treat once it’s clear what’s going on. Bellis says there are three ways to help a child overcome APD:

  1. Environmental modification — changing the way a child is taught so that he’s better able to obtain the information he needs to grasp.
  2. Central resources training — strengthening skills such as memory and language to help support what a child needs to hear.
  3. Dichotic listening therapy — a direct treatment that Bellis has found works in 6 to 8 weeks for the majority of patients. “The approach is akin to exercising a muscle,” she explains. “Usually the auditory pathways to the brain are weaker in one ear or the other. Dichotic listening therapy uses sounds to stimulate and strengthen the weaker pathway.” Bellis has found the majority of children are cured within 6 to 8 weeks.

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