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Why Auditory Processing Issues are so Hard to Notice by Olga Lis

By February 24, 2014Blog

It is a regular Monday morning, and you are trying to get out of the house in your usual somewhat efficient manner. You ask your child to do something simple, and he or she says, huh For example, you might say something like, Jack, time to get ready for school: go upstairs, get your shoes, grab your coat and hat, and shut off the lights in your room. He heads upstairs and half way up asks you what you said. Your child acts as though he didn't hear a word or heard half of what you said.

Often teachers describe a child like this as having poor listening skills because the same thing will happen in class except that in school the child misses important assignments, fails to follow instructions on tests, or is unable to learn information when it is presented orally. What is going on here

Parents or teachers may assume that a child is deliberately ignoring them or simply cannot focus on a task at hand. But audiologists, who are specialists in hearing, have identified a specific reason for these listening problems. They refer to them as auditory processing disorders, or APD for short.

The difference between hearing and listening is:

APD is not a hearing loss and not an attentional problem, although it can often seem as though the child is not paying attention. Rather, with APD a child has trouble figuring out what was said, although it sounds loud enough. All of us suffer from this problem when we are trying to listen to someone talk in a very noisy room, like at a party where a band is playing very loudly. We know the person is speaking we can hear their voice but we can't easily discern what they are saying. Sometimes we try to read the person's lips to figure out what they are talking about. But after a while it gets so hard to listen we just tune out or leave the situation. Now, imagine you are a child and speech always sounds muddled like that. The child's natural instinct, just like yours, is just to stop listening. As a result, children with APD often achieve way under their potential despite being very bright. And in some cases, the children may have speech and/or language problems as well.


Audiologists have been able to diagnose auditory processing problems for many years. However, there are different philosophies when it comes to APD. When parents come to me for help, I explain that the purpose of our evaluation is to find out specifically what kind of auditory processing issues their child is dealing with so that we devise an appropriate intervention plan. Our evaluation focuses on various aspects of auditory processing, such as auditory memory, temporal processing, sequencing, organization, and integration of auditory information, as well as listening to degraded speech signal, compromised by noise or poor acoustics. Once the evaluation is completed we work with the child's speech pathologist to implement deficit-based intervention.

Most of our referrals come from teachers and speech-language pathologists. The best way to explain to the parents what the APD evaluation assesses is the following. I know that your child can hear. What I don't know is whether or not the information he or she hears gets from the ears to the brain in exactly the same shape that it leaves the ears, or does something happen on the way to make them misunderstand the message The APD testing looks at what we do with what we hear. Children with auditory processing issues often function like the hearing-impaired children. They frequently ask for repetition, get easily distracted, and frustrated by background noises, have trouble following multi-step directions. Research demonstrates that children with ADD, ADHD, specific language impairment, etc. share the same symptoms. Although it's true, it is essential to determine which auditory processing issues arise from inattention so that necessary auditory training can me devised. Most of the children with APD do well in structured, one-on-one listening environments and fall apart whenever the listening situation is less than ideal, like a typical classroom.

Olga Lis, MS, CCC-A is a senior clinical audiologist at Audiology Central in Brooklyn. She had been with the team, lead by Dr. Shirley Pollak, since 2008. She received a Master of Science degree from Brooklyn College CUNY in 1998. Olga specializes primarily in pediatric audiology. She spent two years as part of the Cochlear Implant Team at Lenox Hill Hospital and eight years as the coordinator of the Cochlear Implant Program in Long Island College Hospital. Olga s areas of expertise include pediatric audiology, including diagnosis and management of hearing loss, auditory processing testing for both children and adults, and cochlear implant evaluations and programming. She has been a certified provider of the Fast ForWord program since 2001. Olga currently performs diagnostic and rehabilitative services, including hearing aid evaluations and dispensing for all clinical populations, from infants to geriatric. Audiology Central is located at 209 Avenue P (entrance on West 6th street), Brooklyn, NY 11204. You can contact Audiology Central at 718-421-2782, online at www., or on facebook at Listen Up Brooklyn.

Craig Selinger

Author Craig Selinger

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