This question involves only APD. However, the first thing to consider is whether all aspects of your child’s listening difficulties were evaluated and considered holistically. Research has shown that, in most cases, APD occurs concomitantly with other conditions involving aspects such as language (King et al., 2003; Sharma et al., 2009), cognition (Riccio et al., 1996; Ferguson et al., 2011; Ahmmed et al., 2014) and social communication (Ferguson et al., 2011; Schafer et al., 2020). There are even studies discussing the hypothesis that APD might be a listening symptom of those other conditions instead of a distinct and independent disorder (de Wit et al., 2018) or only one marker of a more general neurodevelopmental syndrome (Moore & Huter, 2013). Regardless of the correct hypothesis, when it comes to the clinical world, the main message is the consensus that all those aspects can simultaneously contribute to the child’s listening difficulties in different proportions and patterns, leading to a unique listening profile. Therefore, a 360° view is essential to guarantee that nothing has been missed when evaluating and ameliorating all impaired aspects, an approach that would require a multidisciplinary team. Thus, if your child has been advised to have any other additional assessment, please consider it.
The results of the Auditory Processing Assessment must not only confirm the presence of APD but also identify the specific type of auditory processing difficulties they are facing. This information is crucial as it guides the type of APD intervention that will be most effective for your child. For instance, if your child struggles with speech perception in noisy environments, they might benefit from using an assistive listening device in the classroom. On the other hand, if their difficulties are related to auditory memory or processing spoken information, the focus might be on providing clear written instructions and visual aids in the classroom. These examples highlight the individualised nature of the intervention plan, ensuring that your child's unique needs are being met effectively.
Overall, the intervention plan usually considers three different aspects (BSA, 2018).
The first one is focused on acoustic environmental changes, which include implementations to improve the signal (teacher’s voice, for instance) and reduce the background noise, obtaining a more positive signal-to-noise ratio. Examples are acoustic treatment measures, preferential seating, changes in the way the lessons are delivered and the use of assistive listening devices.
The second aspect is deficit-specific auditory training, which means focusing specifically on the impaired skills detected through the assessment. It involves exercises and activities with a gradual increase in difficulty level to promote smooth learning. Research has shown positive results in improving those specific auditory processing skills following intense and challenging training (for more information and references, check https://www.theapdclinic.co.uk/post/auditory-training).
The third aspect is related to the use of compensatory strategies. This aspect is based on using the child’s strengths to implement daily adaptations, making the child’s life easier and promoting well-being. The strategies are completely functional and are considered after mapping out all the challenging daily situations the child faces regarding listening.
While those specific aspects of APD intervention are crucial, it's equally important to consider your child's mental health. Mental health issues are often observed as a consequence of late diagnosis and lack of support. By prioritising mental health, you can help foster healthy mental and emotional development in your child, making them feel supported and cared for.
For more information about APD intervention, please check:
References:
Ahmmed AU, Ahmmed AA, Bath JR, Ferguson MA, Plack CJ, Moore DR. Assessment of children with suspected auditory processing disorder: a factor analysis study. Ear Hear. 2014 May-Jun;35(3):295-305.
Ferguson, M. A., Hall, R. L., Riley, A., et al. (2011). Communication, lis tening, cognitive and speech perception skills in children with auditory processing disorder (APD) or Specific Language Impairment (SLI). J Speech Lang Hear Res, 54, 211–227.
King WM, Lombardino LJ, Crandell CC, Leonard CM. Comorbid auditory processing disorder in developmental dyslexia. Ear Hear. 2003 Oct;24(5):448-56.
Moore, D. R., & Hunter, L. L. (2013). Auditory processing disorder (APD) in children: A marker of neurodevelopmental syndrome. Hearing, Balance and Communication, 11(3), 160–167.
Riccio, C. A., Cohen, M. J., Hynd, G. W., et al. (1996). Validity of the Auditory Continuous Performance Test in differentiating central pro cessing auditory disorders with and without ADHD. J Learn Disabil, 29, 561–566.
Schafer EC, Mathews L, Gopal K, Canale E, Creech A, Manning J, Kaiser K. Behavioral Auditory Processing in Children and Young Adults with Autism Spectrum Disorder. J Am Acad Audiol. 2020 Oct;31(9):680-689.
Sharma M, Purdy SC, Kelly AS. Comorbidity of auditory processing, language, and reading disorders. J Speech Lang Hear Res. 2009 Jun;52(3):706-22. doi: 10.1044/1092-4388(2008/07-0226). Epub 2008 Dec 8. PMID: 19064904.
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