Central Auditory Processing Disorder & The Listening Program

[SpottedFoxx]

Has anyone used The Listening Program with their child? If so, would you mind sharing your opinion? It's expensive but I'll find the money if will help our son.

TIA

[gr33nie]

I have not heard of that particular program. However, based on my education (MS in SLP), I am not a fan of those kind of computer listening program. The term 'auditory processing' is actually incorrect. When people say that someone has an auditory processing disorder, what they are really talking about is a 'receptive language disorder.' It's not that the child is not hearing the sounds properly, it is farther up in the brain and has to do with complex language, not just simple sounds. A lot of those computer programs are based on the 'sound level' and not the more complex language level. So the premise that they are built on is incorrect. A true auditory processing disorder has to do with impaired ability to hear sounds when there is background noise and should be treated as a hearing problem by audiologists. Almost all kids who have an 'auditory processing disorder' label, actually have a receptive and/or expressive language disorder. 'auditory processing' is a label that just stuck because it is more understandable by lay people. Unfortunately, it has lead to a lot of products that are not targeting the correct area of difficulty and are usually expensive.

[SpottedFoxx]

Thanks for the feedback! Actually, since I didn't get a response right away here, I called my son's audiologist (she's also a language pathologist). She just laughed and said "Foxxy, there's a reason we don't offer that here. Save your money".

It really upsets me that people take advantage of parents of special needs children (and other groups for that matter). Like most parents, I'd sell my soul to help my child and they know it. Grrrrrrr. I'm going to have to have a chat with our speech therapist.

[Lollybrat]

Originally Posted by gr33nie

I have not heard of that particular program. However, based on my education (MS in SLP), I am not a fan of those kind of computer listening program. The term 'auditory processing' is actually incorrect. When people say that someone has an auditory processing disorder, what they are really talking about is a 'receptive language disorder.' It's not that the child is not hearing the sounds properly, it is farther up in the brain and has to do with complex language, not just simple sounds. A lot of those computer programs are based on the 'sound level' and not the more complex language level. So the premise that they are built on is incorrect. A true auditory processing disorder has to do with impaired ability to hear sounds when there is background noise and should be treated as a hearing problem by audiologists. Almost all kids who have an 'auditory processing disorder' label, actually have a receptive and/or expressive language disorder. 'auditory processing' is a label that just stuck because it is more understandable by lay people. Unfortunately, it has lead to a lot of products that are not targeting the correct area of difficulty and are usually expensive.

That's very interesting. Thank you for sharing that information!

I'm not familiar with the program OP mentioned, but I've been looking into Fast ForWord and we've been trying Earobics Step 1 at home with DS. Do you think these types of program have a positive effect at all?

(My DS is 6 and has ASD with Hyperlexia. He read well, but has difficulty understanding and using verbal language.)

[gr33nie]

Well, I certainly do not think that fast forward and earobics can hurt. A lot of people feel that it really helped their child. Having said that, is it that the program is really doing what it is supposed to be doing or is it that any program that requires that much time, sitting with an adult is going to show something? There is also the issue that when we as parents have spent so much time and $$ on something, we tend to feel that it has helped and our children. Studies have not shown that these programs are truly effective compared to other programs. At least studies that have not been done by people with a financial link to them. One of the big problems with those programs is that they are not able to key in on 'teachable' moments. You need a real therapist to be able to see and hear what your child is doing and respond in the moment to really 'teach.' Someone who can play around and find something that works to teach your individual child.

I think that fast forward and other programs like it are an easy way for someone to make $ w/out doing 'real' therapy.

My son in on the autism spectrum and struggles with all language, both receptive and expressive. If I truly thought it worked, I would do it in a heartbeat but my personal opinion is that it's not worth the $$.

However, like I said, I don't think that it would hurt but hours spent with a qualified speech therapist are going to be much better spent than on a computer.

just mho

[Lollybrat]

Thanks. DS gets speech therapy at school. We used to do private speech therapy during the summer, but my new insurance does not cover ST for autism and we cannot afford it out of pocket. Fast ForWord is beyond our budget at this point. But I was able to get Earobics from the lending library at the Special Education Regional Resource Center. I've gotten other materials from there as well, so we do more language exercises than just the computer games.

DS seems to enjoy most of the games in Earobics. I'm not sure if it is really doing what it claims to, in terms of auditory processing/receptive language. I mean, he is obviously getting better at the games, but I don't know if that really translates into real-life skills. However, I do think that the games are helping him learn how to listen and be attentive overall. So even if he isn't getting better at distinguishing "la" from "ra" in real life, he seems to at least be better at displaying good listening behavior (close mouth, look at the speaker, pay attention - that sort of thing).

I'm not sure if we will make it all the way through the Earobics program. DS completed a couple of the games already and in the others is getting to the point where they are no longer fun and just frastrate him. (And to be honest, I can't always tell the difference between the computer voice's "ra" and "la" either.).

Thank you for sharing your insight and experience.

[gr33nie]

Lolly

you put it perfectly! He probably is learning direction following and other useful things. I just do not believe that these listening programs 're-wire' the brain by using small units of sound like they claim to. I think computer programs, especially with an adult who is actively participating can work on various skills. For example, if the child were to pick the picture that matched the spoken sentence 'the squirrel is sitting in the tree' or ' The boy in running away from the bee' or maybe a program that asked 'Wh' questions and the child was able to chose a visual representation of the answer. There are so many possibilities like that (that you could also do with books and other materials too) that would be targeting actual language processing, not just sound discrimination or 'listening skills'. I think that 'listening' is very different from 'understanding'. One happens right as sound is perceived by the ear and one is much more complex and happens after the sounds travel up farther into the brain and have to be decoded into meaning (receptive language).

[efagan]

The Listening Program is not a computere program.
Central Auditory Processing Disorder (CAPD)is a distinct disorder that is diagnosed by an audiologist, often after screening by a speech-language pathologist. The SLP may have already diagnosed an auditory processing disorder (APD). Research indicatees the areas of the brain that are affected and evidence-based treatment options are available.

Dr. Elizabeth Fagan SLPD
Speech-Language Patholigist
www.fagancenter.com

[efagan]

Speak directly with a qualified Speech-Language patholigist who has studied The Listening Prgram after that person has done a complete review of your child's history. TLP may or may not be appropriate.

[beenmum]

Can you claifiy for me a bit?

Here CAPD is an auditory processing disorder that affects the ability to PROCESS sound (auditory). The term (which we use here)  does outline the actual deficit. The inability to process auditory imput (sound, language). It has nothign to do with hearing, as you said, but with processing area of the brain. My nephew has it.

 Is the label technically is used correctly if the deficiet is in the processing of auditory imput. Receptive language disorder may include this, but that label fails to include that the issue isnt with the hearing itself, but with the processing.

Also, here CAPD wont get you hearing help. It is not labelled as a hearing impairment and any of our Hearing Itinerary workers will not step in and work with CAPD kids as they have little supports aside from offering FM systems.

It like Corticial Visual Impairment. My DD sees, but her brain doesnt process visual information due to fragile and underdeveloped nerve pathways caused by lack of pigment (which brings blood supply to create nerve pathways).

Which is why glasses dont work. Same as why hearing aides dont work for CAPD.

I am a bit confused why CAPD is not appropriate for an auditory processing issue?

[efagan]

Central Auditory Processsing Disorder ( CAPD) is a disorder of the central auditory nervous system ( CANS) tha encompases areas of both right and left hemisphere and the corpus callosum but also engages the auditory brainstem and subcortical pathways. CAPD can affect the ability to locate and lateralize sound, auditory discrimination, auditory pattern recognition, temporal integration, temporal gap detection, integration and masking, dichotic listening and auditory performance with a degraded acoustic signal. If a child younger than 7 is having trouble knowing that key and tea are different, that is discrimination and work can be done. By age 7, the CANS Has matured enough for an audiologist to do a CAP evaluation. That person should have studied this field extensively and use health history (did the child have jaundice, history of ear infections, etc. ) as a portion of the diagnistic criteria.

[heatherdeg]

We did The Listening Program with my son.  He bombed his TAPS test (which was comprehending the spoken word).  TLP is just a program where they listen to music that is chosen for it's specific effect on the ears or brain--not sure which.  No games, no time with adults specifically, no working with an adult (although mine was in therapy at the time, they didn't use TLP during his therapy times).  Mine is also flagged for ADHD and is dx'd Asperger's (although apparently the two are often misdiagnosed as one another--so who knows... his developmental history is profoundly problematic in a way that is absolutely more spectrum than ADHD).

It helped him focus much better and by proxy, understand more of what was being said to him because he was better focused.  It also reduced his reactions to sensory stimuli.  We're actually going back to it (it's been a few years).

I'm not one for the labels.  There's too much "analysis by paralysis" and often missing the real problems that come with the template of a label.  Great jumping off point.  Notsomuch for programming.

HTH

[BethSLP]

Efagan,

Please explain to me how any of the current evaluations can actually pinpoint a problem with the CANS and rule out receptive and expressive language delays or attention problems.

The problem with the construct of CAPD is that the tests used currently DO NOT at all demonstrate a problem with the CANS.  The TAPS is a horrible test and most kids bomb it.  Look at the manual on the TAPS can check out its reliability.  Its laughable.  They state in their own manual that the reliability is somewhere between 28 and 100 percent reliable.  I'll translate:  it is not reliable.  That range is insane.

I am also an SLP and I 100% agree with Gr33nie.

Here is an example of a prompt on the TAPS test.  I don't even know what in the heck the directions are .

TAPS - Auditory Interpretation of Directions
 “I am going to say some sentences to you. You do not have to repeat the sentences exactly as I say them, but you must remember the meaning well enough to tell me what you would do, based on what I said.”

Umm, that was a mouthful.  What exactly are we doing again?

Then the prompt is:
  “If your teacher asked you to put your hat on the table, what would you do?”

And the child is expected to respond:

"I would put my hat on the table."

This is a LANGUAGE task.  Not a listening task.  A listening task would simply involve telling the child "Put your hat on the table" and see if they do it.  Further, it would be best accomplished in a real world normal setting (like the playground or the classroom) rather than a weird testing situation.

There are so many problems with the construct of CAPD.  It just baffling to me that its such a thriving business.

To me, what's dangerous about a CAPD diagnosis is that often speech therapists rely so much on standardized testing. They don't look at reliability, if the test is testing what it says it does, etc. Then they base their therapy on activities similar to the subtests the child does crummy on. For example, a goal I see written a lot for kids who have this diagnosis is digit recall. That means a speech pathologist says a list of numbers and the kid repeats them back. WHAT does that accomplish? It is in no way functional for daily life. IMO even if the child did have trouble with digit recall, there is no reason to target that. that subtest tells me nothing other than possible deficits in short term memory. I do not know of anyone who knows how to fix this. I might work with them on memory strategies (tied to language so its functional) and also teach them now to use a cognitive organizer. Not everyone has the best memory. Its A-OK to write down a phone number....most of us do. You give the kid strategies and functional routines to assist them with trouble areas. Drilling digit recall makes absolutely no sense. I always try to check myself "If I was this child's parents, would I feel like I was getting my money's worth?" KWIM? 

Rather than treat the language disorder, they go for low level perceptual drills based on test conclusions that  could not be reliably made, and assumptions that counter everything we know about speech and language and how we learn language.  Its baffling to me.

XOXO

Beth

[efagan]

CAPD is diagnosed by an audiologist. The screening performed by a SLP may include the TAP but generally Is the SCAN-3 because it includes dichotics, gap detection, time compressed speech and filtered speech. The screening may also include The Listening Inventory and complete neuropsychological and language evaluations.
The Listening Program is a wonderful therapy tool for many reasons but is seldom specified as a specific therapy for CAPD.

[seamoonmommy]

Originally Posted by gr33nie 

I have not heard of that particular program. However, based on my education (MS in SLP), I am not a fan of those kind of computer listening program. The term 'auditory processing' is actually incorrect. When people say that someone has an auditory processing disorder, what they are really talking about is a 'receptive language disorder.' It's not that the child is not hearing the sounds properly, it is farther up in the brain and has to do with complex language, not just simple sounds. A lot of those computer programs are based on the 'sound level' and not the more complex language level. So the premise that they are built on is incorrect. A true auditory processing disorder has to do with impaired ability to hear sounds when there is background noise and should be treated as a hearing problem by audiologists. Almost all kids who have an 'auditory processing disorder' label, actually have a receptive and/or expressive language disorder. 'auditory processing' is a label that just stuck because it is more understandable by lay people. Unfortunately, it has lead to a lot of products that are not targeting the correct area of difficulty and are usually expensive.

Hello, it's my first post here, so I apologize if this has been covered elsewhere...

I am also looking for a review of the Listening Program (compared to Earobics, also). I personally disagree with the comment that "When people say that someone has an auditory processing disorder, what they are really talking about is a 'receptive language disorder.'" While some parents may say that, my daughter happens to has true CAPD (as well as language processing disorder). She has trouble listening/ comprehending in noisy situations (even with background noise most people don't pay attention to, such as an air conditioner), cannot distinguish when more than one person is speaking, has had sensory integration issues (not with textures or stimming, but with "switching gears" from listening to oral directions into doing writing or motor skills).

She will have a sound system in school, but I'm looking to help her overcome some of these issues (I know they cannot be cured, but training helps). Based on various reports and evals done by her audiologist and SLP, programs were suggested. Her audiologist suggested Fast ForWord, Earobics, or another one (something like Linda Mood Bell?). She stated that she's heard good reviews of The Listening Program, but cannot recommend it because of the lack of clinical proof. Her SLP suggested The Listening Program. I am not how to choose which to do. If anyone can advise, please help.

[Emmeline II]

Quote:

Originally Posted by efagan 

CAPD is diagnosed by an audiologist. The screening performed by a SLP may include the TAP but generally Is the SCAN-3 because it includes dichotics, gap detection, time compressed speech and filtered speech. The screening may also include The Listening Inventory and complete neuropsychological and language evaluations.
The Listening Program is a wonderful therapy tool for many reasons but is seldom specified as a specific therapy for CAPD.

Yes. Ds had an evaluation for Asperger's/SPD/ADHD that included an SLP suggesting CAPD. We took ds to an audiologist at the university who concluded that he did not have CAPD, "just" the receptive language disorder.

We do have listening program CDs that we borrow from his ST, and they seemed to have some benefit while he was in school--not sure why, but it wasn't hurting so .

[raksmama]

A few years back my son did the Earobics home program:

http://www.amazon.com/Earobics-Step-Home-Version-Foundations-Windows/dp/0669524425

He was tested for CAPD by an audiologist but we were told he did NOT have it. However as listening was definitely not his strength either, the audiologist recommend he do the Earobics program at home. I must say it did help and even my son, 11 at the time, had to admit it helped improve his listening skills. Honestly I think a lot of people childen and adults could benefit from doing it.

[Lollybrat]

I wanted to post an update since this thread is active again.

As I mentioned upthread, last summer I did Earobics Step 1 with DS at home. He liked games in the program a lot and we did see some improvement in his listening behavior.

Last month, DS was tested for CAPD. I have wanted to have him tested for several years, but he had to wait until he turned 7. He was tested at the audiology department at the local Children's Hospital. DS was very cooperative with the testing and seemed to enjoy the tests. They started with a full hearing test, which he passed. Then the audiologist did the SCAN-3 and another test I forgot the name of.

DS was found to have significant auditory processing delays/deficits. The audiologist is not ready to diagnose him with the disorder, but she would like to test him again in another 18 months and see how he progresses. She also said that there are additional tests that can be done as he gets older. Part of the difficulty in DS's case is that the tests are not normed for children with autism and there just isn't a lot of research in how auditory processing develops in kids like DS.

The area DS scored lowest in was dichotic listening, which is where the two ears receive competing messages. This makes sense to us because it seems like when we are in busy environments, crowds, or places with multiple things going on, DS simply cannot hear us.

The two areas DS scored very well in (above average for his age), was phonemic awareness and listening with general background noise. The audiologist told me that these are the two areas targeted by the Earobics program we did. So I was glad that we did Earobics, since it does seem to have had a positive affect on his abilities.

I asked the audiologist about The Listening Progrsm. She told me it more for Sensory Integration Disorders involving sensitivity to noise/sounds rather than true CAPD.

[efagan]

Ask your audiologist about treating the dichotics with DIchotic Interaural Intensity Difference (DIID) training.

[Schae]

Is TLP the same as Therapeutic Listening (TL)? My son's OT recc'd TL for his sensory issues, and it has helped us tremendously. He concentrates better and his listening is actually much better too. His teacher has noticed it as well. We did not have to pay for the system, and he has used it for 3 months. I do think that we have reached 'the peak' of what it can do, and now he no longer needs it.

Dunno if that little anecdote helps you any.