Auditory Memory / Auditory Processing.......

[nickminiink]

Hi, Can anyone explain what the difference is between Auditory Memory and Auditory Processing. My son is 10 years old and has been under SENCO / SA plus since he started school. Originally we were told he has Speech and language difficulties and has been under a SLT since the age of 4 years old. However his progress at school has been very slow and he is still 3 and in some areas 5 years behind his peers. He has seen paediatricians and 2 years ago an EP, who has ruled out ASD but we were never given any kind of DX, just to continue seeing the SLT. Surely after 5 years we would be seeing some kind of progress. Due to Government cutbacks they stopped his SLT and after alot of arguing we have now managed to get a locum assigned to him for how long who know's. However in the meantime we privately hired a SLT and she assessed him to have Auditory / working memory disorder where after testing his age equivalent score was 5 years 5 months, word finding was 4 years and 11 months. Then the locum thinks he may have an Auditory Processing disorder, I have left messages for an explaination as this was in a report. I am confused as when you research both there are differencies and I do not want to spend alot of money on therapies / programmes for APD such as Johansen IA etc if I should be going down another route. I am so confused as what to do as 5 years on we haven't really had a proper DX and we just plod along hoping one day everything clicks into place for him. I am worried about his move next year to secondary school as he is so far behind his peers in the classroom, except for maths (not written equations though). I just wish someone could just tell me what's the matter with him so I can help, I am now going down the route of him seeing the paed / EP again through referals from the school armed with this new information. Can an audiologist give me a more confirmed DX and rule out APD for example.
Sorry to ramble on.
Thanks for reading.

Well I can tell you that auditory integration training has been the best thing we have ever done for DD. She had auditory memory problems, auditory discrimnation problems, auditory processing delay and hypersensitive hearing.

The audiologist said there was nothing wrong with her hearing!

And I say had because it has all been cured now. AIT is absolutely amazing.

Hi, I am a mum and an independent speech and language therapist. Auditory processing disorder is a disorder where although a child can physically hear (and so will pass a standard hearing test), however the brain does not process what it hears accurately. A child with auditory processing disorder may have difficulty understanding what is said to them above background noise, or when having to listen to somebody speaking while others around them are also speaking. This can affect their vocabulary understanding and use, and their general language comprehension. Working memory is the brain's ability to store, retrieve and manipulate short term information (of all types) and is not necessarily affected by having APD. Auditory memory is the brain's ability to store, retrieve and manipulate spoken information that they have heard, and so could be affected by APD.

There is an assessment called SCAN-C that some Speech and Language Therapists or some Audiologists have that can diagnose APD. If APD is diagnosed then therapies such as The Listening Program or Johansen AIT may well be of help.

I hope this helps and hasn't confused you further, please let me know if you need any further information.

Eleanor Harris

Your advertising of your services isn't appropriate here, Eleanor.
If you want to tout for business, there is a section where you pay to do so.

Moondog - a bit unfair. She wasn't touting, but was explaining APD which the OP asked about.

That's great, Indigo,yes. Very helpful.
Why does she need to give her full name? Have you noted that she points out that she is an independent SLT? That means she's looking for business. That's fine, but this isn't the place to do it.

nickminiink

I founded APDUK in 2002, all of my 3 sons have a clinical dianosis of APD as so I and my partner.
Currently in the UK the only APD diagnostic Centre for children is Great Ormond Street Hospital, for which you will require a GP referral, and a the results of a hearing test.

The new Battery of APD diagnostic tests used in the by the Medical Research Council will soon become available to regional APD diagnostic centres.

APD can only be diagnosed by an audiologist trained to use the full battery of diagnsotic tests which can include Scan C, which is from the USA.

Auditory Processing Disorder is a listening disability, and most who have APD have a poor auditory memory. They are all part of the same diagnostic process.

There needs to be a multi discipline assessment procedure, an audiologist to daignose the APD, a Speech and Langauge Pathologist to assess the language problems, and a psychologist to assess how living with APD has affected your child. This is the recommendation of the<a class="break-all" href="https://docs.google.com/viewer?url=www.thebsa.org.uk/apd/BSA_APD_Position_statement_Final_Draft_Feb_2007.doc&pli=1" rel="nofollow" target="_blank">UK APD Steering Committee.

There are many so called remedial programs which are only able to provide a basic set of coping strategies or work arounds, which may not match the work arounds or strategies your son may have already begun to develop.

APD has a genetic origin , although i can be acquired as a result of a severe Easr infection such as Otitis Media with Effusion or Glue Ear.

nickminiink

Sorry for the spelling mistakes and missing words etc having a bad APD day.

Living with APD is about understanding the nature of your own personal Auditory Processing Problem, which vary from one APD to another, and also being able to understand your cognitive strengths that you can use or develop as an alternative to work around those problems. APD is about not being able to process waht you hear, or not processing bitis or all that you hear, so we develop coping strategies to best guess the bits we miss. using lip reading, and body language etc.

Working memory or short term memory is like the RAM of a computer and has limited capacity, and we use our working memories to carry out every tasks we perform during the day. If you have to run coping strategies to work around a cognitive disability like APD then you will have to run that coping strategy in the working memory, and some other task will have to make way to enable you to run the coping strategy you need to survive. Usually it is our self organisation skill that make way. We priorities how we use our working memories subconsciously, so you can not switch coping strategies on and off when you need them. And our coping strategies have to make way when our bodies need to cope with illness or stress.

APDs need to prepare or anticipate what will happem tomorrow so that we can prepare the answers to the questions or situation we expect to find ourselves facing. It is the unexpected which causes problems, we can not be sure we will have the correct coping strategies available when needed or know whether we need to develop new coping strategies.

I am still having a bad APD day so hopefully I have covered most of your questions

Dear Moondog. I wrote that I am an independent SLT because that's how I automatically write my job, and I gave my full name in case they wanted to contact me. I was just trying to be helpful as a fellow mum, giving out advice for free that I normally charge for. Your comment has made me think twice about giving out any speech therapy advice on here ever again.

Eleanor - please stay, we have a couple of other SLTs who contribute to the board, and their advice is very appreciated.

Most people on here like to stay anonymous, that's all.....

Your post was helpful. Please stay.

EleanorSLT
I think you were correct to state or declare your area of specific interest, as it helps all who read this, as to where you are coming from. And you did list three very different potential support programs, the only missing ones were Fast ForWord and Earobics. So you were not really advertising your services as has been suggested.
I am fortunate in that if you put my name into any search engine it will bring up my APD internet history over some 10 years or more.

Just for the record Moondog, so that you are clear that I am not touting for business, the reason that I use Mumsnet is that my 10 month old baby boy has hearing loss in both ears and wears hearing aids. I find it a valuable place for information and so if I think I can be of help to others then I will help if possible. There, got if off my chest, sorry! :)

bdaonion

The age of maturation is between 7 - 8 years of age, and that is when children stop growing out of developmental problems.
APD is one of the most difficult conditions to diagnose as it can mimic many others, such as ADD, And is an underlying or contributory cause of issues such as dyslexia and issues on the autistic spectrum.

Until there are more regional APD diagnostic centres (hopefully in the4 very near future) then Great Ormond Street is currently the APD diagnostic Centre in the UK for children, and the National Hospital for Neurology and Neurosurgery for adult assessments.

One of the problems is the cost of the sound proofed cubicals required to carry out an APD assessment, and there will probably require a few of these cubicals set up for the different tests which make up that APD diagnostic battery of tests.

APD is just one of many issues which can cause speech and language problems. Those who have APD tend to have word recall problems, finding the right word when we need it, and poor sequencing skill, getting the letters of a word in the right order.
We have problems with low levels of background noise, identifying specific sounds, problems processing the gaps between sounds, especially the gaps between the sounds which can make up a word, or between words if some speaks too fast for us to process what they are saying.

APD is about having problems processing all sound based information which does include speech, but also includes all other sound based information alarms, bells, any form of sound. APDs have problems following conversations, and following verbal instructions.

sorry if i have repeated anything but i am having a bad APD day today it happens lol

Thanks for all your comments very much appreciated. I have done so much research over the last few months that I struggle to know what to do for my son as I have not had any form of DX. So I research the contents of the reports from the SLT's who say my son has an Auditory Memory problem, he struggles to remember simple instructions and now we have to send him school with notes in his pockets just so he can remember his homework, but then he forgets to read the notes. I am at a loss to which professionals I should be seeing as he has been under SLT's for 5 years and yet his progress has been very slow, but they say he is doing fine. I don't call 5 years behind your peers in word finding is fine.
Dolfrog thank you for your replies very imformative.
and for the record EleanorSLT I never thought for one minute you was touting for business I never read your message like that, I thought it was very imformative and your advice really matters so thank you for taking the time to give advice. Please stay around.

nickminiink

What you have been describing are the symptoms of Auditory Processing Disorder (APD).
You listed

my son has an Auditory Memory problem
he struggles to remember simple instructions
he can remember his homework
he forgets to read the notes
5 years behind your peers in word finding
___

All of which are typical of child who has APD like any of my three APD sons.
These are also typical of the symptoms mentioned by parents when the contact the APDUK helpline

According to the Medical Research Council 10% of children have some degree of APD, and when this is projected to the whole UK population this means that some 6 million people in the UK have some degree of APD, but at this point in time most do not even know what APD is, let alone that they may have APD. (The figure is higher when you include those who acquire APD a result of a stroke or progessive illness, as part of Aphasia.)

So you should be seeking a GP referral to Great Ormond Street Hospital for an APD assessment. Preferably their new Multi - Discipline report (Audiologist, Speech and Language, and Psychologist) assessment, which may require multiple visits, but will provide a overall assessment, which the local SLTs should understand and advise the school as to the real nature of your sons issues.

There is no cure for APD, living with APD is about finding out how you can best cope with the issues that cause your APD problems

When i was diagnosed as having APD in 2003, when i was in my late 40s i discovered that i have the sequencing skills of the average 4 year old. I wish i had known earlier, so that i could have understood the full nature of my disability, and been more able to self advocate regarding my deficits.
(You may have noticed that i am having a good APD day today)

Hi Dolfrog, thanks again for replying to my thread. I had only heard of APD 3 months ago so decided to research it. I have approached the school, SLT and my GP and all 3 didn't really know anything about this disorder. I went to my GP for a referral, he said it would be best to go through the school nurse to get referred to our community Paed who discharged my son a year ago. So back to square one I guess. I am guessing because my son is so far behind he is not coping very well, so this is where I get confused to what I can do to help, apart from talking to the professionals on a regular basis who probably now think I am a troublesome parent. GOSH looks the way to go, everything takes so long though.
Did your sons attend a main stream school, as my son is a year away from secondary school which worries me as he struggles to cope with the little amount of homework he gets now, which takes hours with me helping.
Just one last thing I was told by the SLT after his last assessment under the test of Steady Beat Competency, he was excellent at imitating different rhythms and length of rhythms, indicating he has no problem with steady beat and demonstrated excellent attention and listening skills. With APD I would expect this would be a weak area.
Thanks again

nickminiink

Your GP needs to be informed about APD which is a medical condition, so to correct your GPs ignorance download a copy of the UK Medical Research Councils (MRC) 2004 APD pamphlet which can be downloaded from the MRC or the APDUKweb site.
The MRC determine waht is and what is not a medical condition and it is your GPs professional responsibility to keep up to date with the the MRC, APD was officially recognised in the UK back in 2004 which is 7 years ago.

APD is a medical disability which has implications in education. The first UK APD clinic was run by an SLT at Sheffield University, as part of her NHS funded APD research, the some of the results can be found at Management of Auditory Processing Disorder
There has been a great deal od research with regard to APD and music in the USA in recent years , especially by Nina Kraus and her colleagues, you can find more of her research papers in theCiteULike Audiology and Auditory Processing Disorder group - library 265 articles (I have sorted the library by author as one of her colleagues names begins with an A).

All of My 3 sons have APD, all different, all attended or attend mainstream schools. Our youngest has just started Secondary school, and has one of the new Great Ormond Street Hospital (GOSH) Multi discipline assessments, which the school have found useful as have the SLT team, who have actually kept in contact with GOSH.
The schools need to be able to understand his learning deficits and more importantly his learning strengths. Most of the education system is not that education friendly, especially now that the government has become the marketing centre for phonics teaching programs, which APDs can not use.

my DD has APD I am sure. A recent multi disciplinary assessment found her to have severe word finding difficulties and memory problems related to language. Her cognitive ability when it comes to pictures etc is normal for her age but understanding of language is less tha half her age (she's four and a half).

I am very interested in the Great Ormond st thing although maybe she is too young, the ed psych at the assessment said I won't know how long term her difficulties are till she is around 8 or 9 but that because of how severe her issues are she may well have long lasting probkems and will need to be given startegies to cope with it. We use signing and pictures. Like others here she hears things wrong and confuses words. She had gue ear on and off for two years which I had thought was the problem to start with. It makes me really sad to think that could have caused this long term difficulty.

Hi dolfrog

Another SLT here. I am pretty convinced one of my clients with ASD has APD. We have been trying out some of the strategies on your site (he is a secondary student) and have adapted texts etc, and he reports it is helpful and is doing quite well.. the teacher in the setting has done certification in The Listening Program in the past and it is available on site but we haven't started it as he hasn't a proper diagnosis.

Not sure what the proper route to diagnosis is - I've had one client sent out of area to GOSH for testing but I don't think that we'll get funding for this student in the current climate.

I am a bit wary because he needs a proper dx but I don't know what to do to get him one and though I think the Listening Program might help I don't want to do anything that might be harmful. ASHA are very anti-AIT as you may know so I never learned much about it but I do know people report good results and I don't want him to miss out either. A dilemma!

Any thoughts on how to take it further?

Thanks!

working9while5

The first APD clinic in the UK was run by an SLT at Sheffield University as part of her NHS funded research, before the Medical Research Council won their government funding for their first 5 year APD research program in 2004. And we have some of the notes from one of her presentations on the APDUK web site.

When our youngest was officially diagnosed last year at GOSH, during his Speech and Language assessment there were also 3 trainee observers, and others SLTs participating in the assessment process. The UK APD Steering Committee has also expanded to include more SLT and Psychology participation.

Since the late 1990s there have been issues with many of the program providers for a wide range of reasons. Basically there are many causes of APD, when i first started to research APD to help my son, 1999, in the USA the leading researchers were talking about 4 models or subtypes of APD, some 12 years later the leading researchers have further broken that down to 12 or 13 different subtypes. The problem with these programs is that they are not able to identify which subgroups they can help, which subgroups they can not help, and which subgroups they may harm.

All APDs have different subtypes of APD, different severities, and more importantly different alternative cognitive skills they have developed to work around their deficits, from the time onset of APD, which for many is from birth. All of my three sons have some degree of APD, as do my partner and I so we are a family of 5 APDs. We all have different degrees of APD, and different ways of coping with it. Most of the programs only provide a one form of support or set of coping strategies , and only at a very basic level. So you need to identify the coping strategies each APD has already developed, and then try to identify a program which can help develop those same coping strategies. Because after the program has been completed each APD has to revet back to their own coping strategy development as they face new life challenges and they need to develop new or adapt existing coping strategies on a daily basis.

So unless the coping strategies included in any program match the existing and future coping strategies each APD is cognitively able to develop, it will be a waste of money, and it could actually cause some psychological harm. Back in the 1990s one program was marketed as the cure for APD, which research has long since been disproved. As you say ASHA is not a fan of AIT, and a couple of years back banned its members from using AIT. (I was too busy doing other things to discover the actual reasons)

I have tried one of the programs which are frequently recommended, and has proved to provide some help for many. We had the three members of the family who were diagnosed as having APD (at that time) using the program, one complained ear pain, the teenager lost interest, and it began to muck up my existing coping strategies. So we stopped using the program. Another family we know, paid some £2000 plus for another program and their child gained no benefit at all.

This why APDUK does not promote or endorse any program which may help some who have APD. And why we talk about identifying and developing the alternative cognitive skills each APD will have to work around their own specific APD problems.

The biggest language problem that APDs have is not being able to process the gaps between sounds, especially the gaps between sounds that can make up words, or even between words when some one is talking very fast. This tends to mean that we have some form of speech development delay, as we are only able to reproduce the sound of the whole word. Most APDs are natural Visual learners or become self taught visual learners to work around their auditory deficits. So we tend to think in pictures, and not words. We use lipreading, and reading body language to help fill in the auditory processing gaps we experience when listening to others. APDs will have a poor auditory memory, and when listening, or talking will have poor working memories for other information processing tasks, which means we can temporarily appear to be "Aspergerish"

At some point in our development we develop our long term memories to act like video recorders for conversations, classes, lectures etc, and then play back the long term memory to help us understand what was said at some point in the future, and this also means we can have the long term memory of an elephant, and can recall lots of sometimes useless information. When an APD has developed this ability then they need to have some quiet time each day to allow this recall to happen (i can spend hours in the bath just recalling the events of the day, or trying to anticipate what will happen tomorrow.)

I hope this provides some help, you can always contact me via the APDUK help line if you have any questions

My DS has APD - he is 11 now. I fought against a diagnosis of ASD since he was 3 because I just knew it wasn't that.

I was so frustrated that I applied to a local charity for the funding for and independent Ed Psych exam. I then forced a statement. And then got legal aid to employ Maxwell Gillott to get our LEA to re-jig his statement and get him into the Moat School which is an independent dyslexia school. You may think, dyslexia? But it is that barrell of biscuits and well as the ASD barrell of biscuits. You need a statement - and pretty quick before he goes to secondary.

Fight the system and look around you for educational charities.

dolfrog, that is so helpful -my dad was talking to a friend about my dd who I am certain has APD and my dad has got books on since our assessment. I would like a diagnosis so at our paed appointment next week will ask about a referral in the future- when she is 7? but in the mean time am going to carry on with pictures etc. We are seeing some behavioural issues now whereas previously she has been almost too laid back.

We have an inclusion teacher who, before the assessment said DD had delays in all areas and had we not had the assessment that showed she had normal cognitive ability she would have been treated as a child with GDD I suspect.

Anyway sorry back to my dad's friend, he was talking about DD and the friend said his DD who is 20 has had a terrible time at school and describes listening to people talk as if its through a radio with poor signal. She also has speech sound problems which led to bullying and has tried to muddle through but they feel hasn't met her potential so she is now having speech therapy after years of the parents trying to get help for her, having various tests that showed nothing.

I wonder if I should mention the APD website? She now feels she would like a diagnosis I think- is there an adult equivalent of the team at GOSH who diagnose do you think?

used2bthin

Currently adults who require an APD assessment are referred to National Hospital for Neurology and Neurosurgery
Queen Square London
which just happens to be next door to GOSH.
The Medical Research Council have also published an Adult APD pamphlet.
There is an adult APD forum the OldAPDs which is now over 10 years old, and has over 500 members.

The OldAPDs and APDUK combined in an online research program "How APD affects adults" in conjunction Australian Psychologist Damien Howard, and two of the resulting articles "Controlling the Chaos" and "The Trouble with Strangers"
were published in APDUK newsletters No.1 and No.2, both of which can be downloaded from the APDUK Newsletter web page

There is also a a list of books which were available from Amazon when we last published the web site. Some of the titles may be available from your local library

I have been reading with interest and just want to say thanks to the OP for starting the thread and thanks to Dolfrog for all the info. DD#1 is being referred to GOSH to check for APD and I have found this really interesting and helpful so far.

Dolfrog, (or anyone in the know) could you give me some kind of idea what sort of support we could/should expect in school for APD, assuming this is (part of) her problem (also suspected aspergers). Currently DD#1 (6yrs in yr1) is moved to suitable seats so she is at the front of classes to help with concentration, but she just seems to be lost with instructions/information that are given to her, despite being a well behaved compliant child. Do you know of children getting any 1:1 support in class for APD? School seem to think as DD is making progress that there is no problem. I think she should be doing better. She is at the bottom of her class academically and whilst I agree there is some progress I don't think she is stupid and that they have unreasonably low expectations for her. Do GOSH help plan a support program for children with APD? I presume if so these are specific to each individual given your previous thread about all the subcategories. Sorry for so many questions but seems like in ideal time and thread to ask. Thanks