Familiar with Auditory Processing Disorder? Please read and help

[LargeLatte]

Long sorry - but I am sure a mumsnetter will read this and understand our situation.

DS1 (5y 10m) has already been assessed for autsim (when 4) but doesn't tick the right boxes.

Last night I stumbled on some information about auditory processing disorder and it made a lot of sense.

Many of the problems we have with Ds1 centre around communication, instructions and understanding.

For example on the way home in car today dh asked kids 'what so you want for lunch, pancakes, tuna sandwich, or something else' - ds2 (4) very quick to shout 'pancakes'. Ds1's response it 'what'. And that is the response we get to pretty much every question. 'What shoes', even though they are right in front of him. 'Shreddies or cornflakes?' - ds will respond 'what cornflakes', or even 'I not understand'.

If I want to get him to make a choice, I hold up the options and he points to it. If I need him to put on his shoes, coat etc I just hand him the item wordlessly and he does it.

It is only once you introduce words that life gets confusing for him.

But I am sure its not hearing because he and his dad are right now having a great conversation over the top of the noisy Star Wars theme music.

So in summary - talks fine, can hold a conversation, make himself understood, hear me when he can't be lip reading - but making choices, or following instructions are really a total non-starter.

At parent's evening teacher pointed out he was relauctant to follow instruction but if someone sat with him and showed him what to do he was capable. As a result he is starting to fall behind.

Sound familiar?

Should probably also mention that he has an extremely heightened sense of smell so hopefully has a great career ahead of him as wine / chocolate taster :)

I'm not sure if this relates directly to your DS's disorder, but I came across this as a result of something I heard on Radio4 recently. Someone was talking about using this method to help children with various difficulties. it resonated with me as I'm left ear dominant, although I'd always assumed I just had slightly weaker hearing in the right ear.

Haven't looked into it thoroughly, so pardon me if it's completely irrelevant.

Looks interesting.

It just surprises me how selective the problem is. It really only seems to affect him if he needs to make a decision or follow and instruction.

Might hunt down ane extensive library of those little pictures. They worked a dream when we were explaining about acceptable behaviour.

My dd2 is 5.7. She has mild/moderate hearing loss plus an additional SLI (not the speech bit, that's perfect, but the language). A least we think she has SLI but it's all really confusing as she can talk in sentances but can't hold a conversation, appears to understand but often gives unrelated answers to questions, word retrieval problems, possibly auditory memory problems...who knows. It's all an enigma and not typical of language difficulties caused by her level of hearing loss.

The reason I'm posting OP is that some of what you've said is like dd2: choices (unless shown), instructions (have to be very simplistic), and that heightened sense of smell. And yes, I've considered AS/ASD but she doesn't tick all the boxes.

Dd2 had an observation with an Ed Pysch last week, a very perceptive and lovely woman who is going to come into school regularly to assess and monitor dd2 to work out what exactly her problems are so that we can better understand how to help dd2 in class.

IMO it is worth getting your ds's hearing checked anyway (just to rule that bit out). APD is, I believe, more difficult to assess - you need Dolfrog to talk to about that as he's the authority on APD on here.

Thanks kissingfrogs - very helpful.

We had a play with an Otovent tonight which helps clear glue ear and he said his ear clicked and then it sounded like a microphone so there may be some hearing issues there.

The other thing that makes communication difficult with him is that he will pick a totally inappropriate volume to speak at. If it there is a lot of background noise he will actually speak quieter - like he has no instinct for making himelf heard.

How do I get Dolfrog's attention? Can I buy him a virtual pint?

Sorry, I know very little about APD, but I can help you on how to contact dolfrog.

Click on inbox at the very top of the page and you can PM (private message) them. They will also get an email from MNHQ letting them know they have a message waiting in their MN inbox.

Dolfrog is the expert. I'm sure he'll be along soon. But it does Sound like ADP

There are loads of therapies based around the Tomatis method. But I recommend a slightly different treatment Auditory Integration Training. I have done it (at the sound learning centre in London) with both DS and DD.

They take audiograms before and after the treatment, and the diff in the audiograms is jaw dropping. The diff in the kids has also been amazing.

It's not a cure for ADP, but it is a cure for a number of other underlying hearing problems (hypersensitive hearing, auditory discrimination problems and auditory processing delay) which your DS probably also has.

So you are best, if you can, to start with this and a then see what hearing problems you have left.

It may be APD. Have you had his language skills assessed by a Speech and Language Therapist (SLT)?

Afternoon all, thanks for your replies.

He was assessed by paedatrician for ASD when he was 4.

Last year he failed the routine hearing test at school but was retested a few months later and passed.

He hasn't seen anyone since as it just literally hadn't occured to me that the problem was anything other than a feisty personality, and now I am not sure where to begin, especially as I'mnot totally sure I can rule out a hearing issue altogether.

I suppose a chat with the school SENCO would be a good place to start?

I am just a bit bamboozled as ds2 has hearing and touch sensitivity issues that his preschool are starting to flag too, so I an feeling a bit overwhelmed by it and not sure what to do first. DS2 does have hearing problems caused by glue ear and repeate ear perforations although he is much more likely to complain something is too loud than too quiet.

Ahhhh - head spinning.

Bump

Hi LargeLatte,

My Son is 10 and since the age of 4 has been seeing a SLT for speech & language delay and auditory memory delay and is under SENCO school action plus, but only recently APD has been mentioned in his DX (However you speak to his school, SENCO, GP etc they don't know what it is, this is what I have found anyway). What you describe in your post is how my son is, he answers everything with "What" and then we have to go through the process of asking the same question again and again sometimes. If he asks us a question and we do our best to explain in a way he will understand, he answers back "What I don't understand". His hearing has been tested and he's passed all tests, he's been signed off a year ago by the peadatrician on medical grounds with ASD being ruled out. My son is falling way behind his peers because of the above so your post does sound all to familar. We are currently researching APD and hoping we can help him as secondary school is only a year away, we are hoping to get refered to an Audiologist prefably at Great Ormond Street, but like most things I am sure this will take a long time, alot of follow up and stress on my part aahhh. I suggest you do speak to your school SENCO, my son had alot of ear infections as a baby/toddler and this has been linked to his speech and memory delays. I agree with the head spinning. Good Luck

Thanks nikiminiink - very helpful. They do sound similar. Ds gets upset and says 'what you say' over and over when he doesn't understand. He also explains things in a really complicated way - he once refered to his brother as 'that [insert name] that lives with us in our house] - so sometimes it is very hard to understand him.

Mrs F (school SENCO) here I come.

I'd suggest GP to get a referal to audiology. If he's prone to glue ear and has had perforated drums it is very worthwhile getting his hearing checked. I don't want you to get all worried though, I myself had repeated glue/perforations as a child and it didn't effect my hearing.

My dd2 is also sensitive to loud noises, and that's WITHOUT her hearing aids in. Doesn't make sense really as logically you'd expect the opposite.

Keep us posted.

LargeLatte
Sorry for the late reply took an computer break lol.

Auditory Processing Disorder (APD) is a listening disability, or not being able to process what you hear. APD has only been officially recognised in the UK since 2004, when the Medical Research Council published its first APD pamphlet They have known about APD for over 30 years in the USA so here in the UK we are to some extent playing catch up.
The best online description of APD is by Jack Katz , who was one of audiologist who first identified APD.
APD Evaluation to Therapy: The Buffalo Model

Those who have APD have problems processing all sound based information, which includes speech, so we have problems following conversations and following verbal instructions. Young APDs have problems with new words, as do adult APDs until we have created a memory assocaiation for the new word. Awe have problems saying new words, we are not able to sound them out, we have problems processing the gaps between the sounds that can make up a word, as result we can only learn the whole sound of a word. So phonics is completely useless for us. Id people speak to fast then we are notable to process the gap between the words and this will mean that we are not able to process what that person may have said.

Living with APD is about anticipating waht will happen tomorrow so that we can prepare our answers and hope that our coping strategies will be in place when we need them, so that we can best guess the bits we miss due to our APD. we tend to use visual coping strategies such as lip reading, and reading body language.

APD can be of gentic origin or acquired via a severe ear infections such as Otitis Media with Effusion (Glue Ear), APD is one of many cognitive subtypes or underlying causes of Dyslexia, and one of the many co -morbid issues which can combine to cause the many problems that exist on the autistic spectrum. Many APD have been miss diagnosed as having Aspegers Syndrome, this is because when we have to run our coping strategies to enable us to talk or speak our working memory (short term memory) has to close sown our other sensory information processing abilities whioch help us process how others are responding to waht we are saying. Once we have finished or stoppd talking our visual coping strategies are able to run again, and we become probably more understanding of the reactions of others than non APDs.

Working Memory is much like the RAM of a comnputer with limited capacity, if overload it will crash. We priorities how we use our working memories sub-consciously. WE access and run the cognitive processes we require to perform all tasks we perform in the working memory. If you have to run a coping strategy or alternative cognitive process to work around a cognitive deficit or disorder, then something has to make way, usually our self organisation skills. And if we are stressed or ill then our coping strategies will have to make way as we cope with the illness or stress. The more coping strategies we have to run to survive the more other less important cognitive abilities or skills have to be switched off, to enable us to cope with the task in hand.

We have tried to provide some useful information on the APDUK web site the multi coloured text is how APDs prefer text to be presented, and extra spacing. (Can be done on any word processor to any text) Some APD children sometimes like nouns and verbs etc to be different colours, and then phrases and eventually sentences as on the web site.
We have some hand outs in the resources section The NHS use our combined handout pdf download to help explain APD. You nay aso find The Power of Visual Thinking of some interest. and there are 7 Newsletters which can be downlaoded and the research articles in No.1 and No.2 can be useful when cliaming Disaiblity Living Allowance

I hope this helps

Wow dolfrog - they weren't kidding when they said you were the expert.

Your response has actually made me quite tearful because so much of what you said applies to ds1, but also ds2.

I have just had yet another meeting about ds2's biting at preschool - even though he has very strong speech and vocab skills, he struggles to communicate quickly (eg if a child hits him or takes something from him) and he reacts by biting.

Thanks so much for taking the time to give me such a comprehensive reply.

I will read the resources you have linked to before I ask any more questions.

Thanks again.