Auditory Processing Disorder (APD) may be diagnosed when a child has trouble listening, following directions, expressing herself verbally, reading, and/or locating sounds. ADP can present on its own or as a component of other cognitive disorders, such as autism spectrum disorder, apraxia, or ADHD. If a child is unable to process sound well, their social skills and school work suffer accordingly. As they progress in their course of APD, parents report improvements in socialization, academics, executive function and motor skills.
To diagnose Auditory Processing Disorder, a therapist administers specialized hearing tests that measure the child’s ability to discriminate between sounds, detect sound patterns, locate sounds, and identify when sounds are minimized or amplified.
From these results, the specialist may prescribe a course of auditory processing therapy. Most programs are administered in the clinical setting; however, there are some that can be administered at home once parents have undergone training.
In an article on the website In Pursuit of Research, speech therapist Kellie Hetzel, describes auditory processing treatment programs:
“At the core of all of these programs is a claim that they work to strengthen the ‘foundational’ aspects of a child’s neurological functioning, including auditory processing and attention,” says Kellie Hetzel, a speech therapist with Aurora Strategies.
Hetzel describes an analogy between a house with a crack in its foundation and the neurological processes that various listening programs address.
“If auditory processing and attention, along with the other sensory areas involving movement, touch and vision are located in the foundation of the house or the brain, and if there is a weakness in that area, then it’s difficult to support the various floors of the house, which are the acquisition of math, reading, science and other subjects,” Hetzel says.
Auditory processing therapies are often effective with children on the autism spectrum. According to the website Very Well Health, reasons why autistic children struggle with auditory processing are unknown, but “one theory holds that the brain's hippocampus, which is responsible for processing auditory information, may be "immature" in people with autism. Another possibility, according to researchers at The Children's Hospital of Philadelphia, is that children with autism are hearing normally, but are processing sound more slowly than non-autistic children.”
Because of auditory processing therapies enhance a variety of integrated developmental skills, anecdotal reports and clinical studies have shown their effectiveness in helping children with dyslexia, ADHD, sensory processing disorders, developmental delays, speech and language disorders, and challenges with motor skills.
How It Works
Each program has its strengths and target patients. Below are short summaries of several popular auditory processing therapy programs. Consult with your child’s speech or occupational therapist to find the best match for their needs, your budget and your preference for in-home or in-office treatment.
French Ear, Nose and Throat specialist Dr. Guy Berard developed AIT using the foundations of ADP pioneer Dr. Alfred Tomatis. Dr. Berard hypothesized that behavioral and cognitive problems develop when individuals actually perceive certain sounds “too accurately.” During treatment, specially modulated and filtered sounds are played through high-quality headphones. By tracking the sounds, the lister’s auditory system is retrained to integrate frequencies at the level heard by most of the population.
Interactive Metronome is a tool designed to help children synchronize their body clock and temporal processing. According to the company, IM provides “a structured, goal-oriented process that challenges the patient to synchronize a range of hand and foot exercises to precise computer-generated reference tones that are heard through headphones. The patient attempts to match the rhythmic beat, using repetitive motor actions. IM uses a patented auditory visual guidance system that offers immediate feedback, measured in milliseconds.”
IM has shown to improve motor skills, response time and executive function in children and adults. You can read summaries of recently published studies on it here, including one that documents improvements in literacy.
Scientific Learning Corporation offers nine language and reading programs under the Fast ForWord umbrella, the most popular of which is Fast ForWord Language. FastForWord Language is a series of seven interactive games which work to improve a child’s processing skills, sequencing abilities, memory and attention span. The program is intense, requiring at least an hour of work each weekday, but it is flexible. Therapist Kellie Hetzel, who uses it with her young patients, describes its implementation. “The program can be administered at home, at school or in a clinic setting. Children spend between 50 and 100 minutes five days per week on the program for a period of four to 12 weeks.”
This program includes over 40 recordings (many are nature sounds and classical music) developed by German sound engineer Ingo Steinbach. The higher-frequency sounds are emphasized in the recordings, which are said to require extra focus and attention from the listener, thereby training them to hear with more range and sensitivity. Parents can be trained by a speech or occupational therapist to implement the sessions at home. Typical courses of treatment include daily or twice-daily sessions for the three to six months.
This is described as an “approach” rather than a set program. A multisensory method of learning reading, it increases fluency through helping students connect language with words. The Approach has become a cornerstone of teaching dyslexic learners reading skills. The website Understood describes the Orton-Gillingham Approach thus:
This approach uses multiple pathways to help kids learn. For example, students might learn the letter “s” by seeing it, saying its name and sounding it out while writing it with their fingers in shaving cream.
Orton–Gillingham also puts a strong emphasis on understanding the “how” and “why” behind reading. Students may explore why the letter “s” sounds one way in the word plays, and another way in the word snake. Once they know consistent rules and patterns, they’re better able to decode words on their own.
These are just a few of many APD therapy programs available. Other established programs include Tomatis, Therapeutic Listening, and the Listening Program.
Because children in need of ADP are presenting with auditory problems due to another diagnosis, it has been challenging for the medical establishment to study APD therapies. Smart Speech Therapy describes the results of a 2016 review of APD studies and concludes: “…none of the reviewed studies had conclusively proven that APD was a distinct clinical disorder. Instead, these studies showed that the children diagnosed with APD exhibited language-based deficits. In other words, the diagnosis of APD did not reveal any new information regarding the child beyond the fact that s/he is in great need of a comprehensive language assessment in order to determine which language-based interventions would offer optimal benefits.
Things to Consider
Clearly, a wide variety of well-tested APD therapy programs are on the market. Weighing your budget, your child’s therapist’s recommendations and experience with a particular program, and your child’s optimal learning environment (home, school, or office setting), the right direction should become clear.