Auditory processing disorders - what were your DC's first signs?

[MissBetsyTrotwood]

Just that, really.

DS2 is 3.5 and at school nursery. He has a severe hearing loss in his left ear and vestibular hypofunction which has given him problems with his mobility. He's moving well now though and even managing a balance bike.

He's very friendly and chatty and I think this masks the fact that he doesn't really know what's going on around him. He has 'conversations' with everyone and anyone, but it's all out of context iykwim. Simple, predictable instructions like 'put your shoes/coat on, sit down' etc he can grasp but he cannot follow instructions in games or small group activities at nursery. He watches what other children around him are doing and copies their lead. He can't do colours, either.

Nursery are concerned and so am I. I don't know if it's just being young for his age or if there's something else going on.

Thanks in advance.

Do nursery think it's APD? Or something else? Or they're not really sure what it is?

When did he last see the audiologist about his hearing loss? What did she say?

Who diagnosed 'vestibular hypofunction'?

I think it could be a symptom of an awful lot of things - and I wouldn't want to narrow it down to APD yet.

Nursery aren't sure - they think the first stop is back to Speech Therapy. He was discharged from them at 6mo as he was v communicative during his home assessment with them... they've been around in the background though and made contact when he started pre school. They said they'd pop in and see him but have not so I'll have to get back on to them. Having been on their caseload as a baby he will go to the top of the list if I take him in to a drop in clinic so I might do that as well after Xmas. Nursery mentioned APD but it sounds like an umbrella term for a massive range of difficulties and must be hard to diagnose.

The hearing tests he had as a baby showed his hearing loss was conductive but, as vestibular hypofunction is virtually always seen alongside sensory neural hearing loss this is now up for debate. They be able to confirm sensory neural loss now until he's a bit older and can do some different tests. As, up until now, his progress has been largely OK (except for his balance) he's on twice yearly reviews by the audiologist.

Another audiologist with a balance specialism at the Nuffield Centre at the Royal Free diagnosed vestibular hypofunction. This was after all the crazy balance tests that tracked eye movement... It took 3 attempts to get him to participate in these and I don't blame him. They were weird!

It's all just so odd and, to be honest, daunting. Thanks for getting back though, IndigoBell. DH doesn't want to discuss it until there is a clearer picture but it's all I want to talk about... Very early days though. You are right, to narrow it down now is silly.

What are his conversations like? Is it any echolia type stuff?

Not knowing colours could be as simple as colour blindness (in my DSs case) - or word finding difficulties (in my DDs case)

Is crazy balance a symptom of APD? It's certainly a symptom of dyspraxia / spd type stuff.

I agree with you that APD is an umbrella term for a massive range of difficulties, and therefore would want to investigate everything a bit more before settling on that.....

I think Speech Therapy is a good place to start. What you need to know first (I think :) ) is whether he has a problem with his receptive language or not.

At home (when you can control things a bit more) does he understand your instructions equally if it's noisy or if it's quiet?

He seems OK when it's noisy. He's the younger child, there are often other children in the house over playing and we have a large dog so it's a busy environment with lots of movement.

His talk is all over the place! Very entertaining but off on lots of different tangents and very little discussion of anything, iykwim and definitely not a conversation exactly. Again, I've only one older one to go on and his friends but I definitely remember having longer communications with them. I could talk about a subject with them, whereas with him we can say one thing about it and then it's onto the next thing. Another typical exchange was just now, colouring in, I said to him "Ooh, DS2, is that a cat in the picture?" His response was "No, I have a dog!"

A speech therapist should give us a little more advice... Thanks again for listening to me whitter on!

I'm really, really no expert.

But could it be more something like disorderd speech? (There have been some threads about that recently) Or some other weird thing I don't know about?

I don't think APD would explain why he can understand instructions in a noisy environment, but not in a small group situation IYSWIM. (But maybe it does explain it - it's not something I know about)

When he said 'No, I have a dog' is that because he thought you said 'Do you have a cat?' - which maybe would indicate APD - or is it because he just has general problems with language......

Speech therapist our next stop I think. Just have to get past the comments from the relatives at Xmas now... . "Isn't he a funny little thing!" "What an odd child!" Arrghhh!

MissBetsyTrotwood

Auditory Processing Disorder (APD) is a listening disability, or about not being able to process what you hear.
UK Audiologists currently will not assess for or diagnose APD until the age of 6 years of age as there could be many cognitive development issues that may not be reached until the age of maturation (when children stop growing out of developmental issues) That said some severe auditory conditions can cause APD at a younger age and consultants at say Great Ormond Street Hospital would be in the best position to provide advice.
Not being able to follow or process sound based information such a the meaning of conversations or following multiple or changing verbal instructions can be symptoms of APD as can having problems with listening with low levels of background noise.
You may have to look at multiple or co-morbid disabilities which can occur, and is a feature of many spectra of developmental disabilities.
Regarding APD you may find the APDUK web site a useful source of information, or it's predecessor which is now my own website both of which are designed to be APD (and / or me) friendly

Thank you dolfrog. The audiologist we've seen since he was born has been fairly good at organising referrals. He is very young still and we will have to wait and see I think.