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Tell me about Auditory Processing Disorder?

post #1 of 9
Thread Starter 
I am posting this about my niece/godchild.

I will use the term "we" here because I have been helping my sister in law figure this all out, she asks me for advice a lot.

I had suspected APD and brought it up to SIL, this was a few years ago. She is now 6. She's adopted so we don't know her history up until 15 mos other than she was probably a victim of neglect prenatally and maybe beyond.

Her symptoms at that age were a severe debilitating fear of loud noises, popping sounds (balloons, fire, gas stoves, gum, toys w/sound and even lava lamps) when she gets scared she completely loses control screaming, goes stiff and starts shaking. She has gotten a little better about some things but now anything that will potentially make a noise freaks her out. (like fire/balloons) She often has to wear headphones with music to distract her at parties etc.

She doesn't have much of a speech delay, still talks younger sometimes, like replaces she with her etc.

Now she is in first grade her teacher and mom are having a very difficult time with her doing work and reading. She will refuse to do work in class and put her feet up on the desk. (not sure if that's even related or if she just wants to get attention, that seems to be an issue as well)

The part she is having a lot of trouble with now is reading. She is at a very low level in reading (was almost held back in kg) and can barely read 3 letter words like "mat" and if she does read it she forgets it by the next page.

She accuses people of yelling and totally tunes people out when she can. When doing homework she claims she can't because the dishwasher, or other random noises are bugging her.

If you sit face to face with her, tell her what to do, and have her sort of repeat it back she will get it but often things get lost in translation it seems. She does have trouble following directions and when she gets in an argument with her brother or cousin she will hit or scream at the top of her lungs. Same if she ends up in a time out she screams so loud you would think that the neighbors would call the cops. She doesn't seem to understand consequences rationally...and that seems to be one of the only consequences that work at all, although she just screams and screams. If you tell her she can come play if she stops screaming she stops for two seconds and starts screaming again. (this is my experience with her) She gets tons of pos. reinforcement. She just seems a lot younger, which is hard because my dd is the same age and they fight a lot.

She's also having trouble with accidents in her pants at school, first it was because she was scared of the sounds of toilets but now we don't know what it is.

Does this sound like just APD? She has been tested and was found to have an auditory processing problem but not bad enough to get help in the way of OT or help at school. (I've been telling SIL to insist on more help and keep pushing it especially now that she is 6) The doctor did some initial tests for Autism and said she was not autistic and her hearing is perfect. The doctor didn't know what APD was when she asked him about it. She was tested through another avenue.

It's just becoming more and more of an issue as she falls more behind and behavioral issues grow. Does this seem like something more? She asked me if I thought it was ADHD but it seems so much of the symptoms are just from APD related issues. She isn't hyperactive and the only ADD thing would be that she forgets things, but that is also a APD symptom too right?

My nephew (other side of family) was diagnosed APD and seemed to grow out of it but I don't think it was very severe at all.

I'm curious about this but mostly just want to help my niece out. THanks in advance.
post #2 of 9
That absolutely does not sound like auditory processing disorder. There is a book on APD called "When the Brain Can't Hear." It is way more like having a hearing impairment when you do not.

What she has sounds like an emotional reaction to loud sounds. Or sensory processing disorder.
post #3 of 9
Also, APD would never be treated by an OT, it would be treated by a speech therapist. SPD would be treated by an OT. APD can only be diagnosed by an audiologist. My daughter has APD. I have 2 sons who have SPD with their PDD-NOS.
post #4 of 9
Thread Starter 
Thanks for such quick responses!!!!

Hmmm..that's strange. Maybe she is getting information that is mixed on both types. I found this list for APD:
  • Have trouble paying attention to and remembering information presented orally
  • Have problems carrying out multistep directions
  • Have poor listening skills
  • Need more time to process information
  • Have low academic performance
  • Have behavior problems
  • Have language difficulty (e.g., they confuse syllable sequences and have problems developing vocabulary and understanding language)
  • Have difficulty with reading, comprehension, spelling, and vocabulary
Which says it's for APD, and she has all of these. It's really hard for her to understand directions and you have to talk to her like she is much younger, slowly and in very short sentences. She also repeats things she hears, like phrases, that don't make sense in the context she uses them.

But then there is this list for
Signs Of Auditory Dysfunction: (no diagnosed hearing problem)
1. Hypersensitivity To Sounds (Auditory Defensiveness):
__ distracted by sounds not normally noticed by others; i.e., humming of lights or refrigerators, fans, heaters, or clocks ticking
__ fearful of the sound of a flushing toilet (especially in public bathrooms), vacuum, hairdryer, squeaky shoes, or a dog barking
__ started with or distracted by loud or unexpected sounds
__ bothered/distracted by background environmental sounds; i.e., lawn mowing or outside construction
__ frequently asks people to be quiet; i.e., stop making noise, talking, or singing
__ runs away, cries, and/or covers ears with loud or unexpected sounds
__ may refuse to go to movie theaters, parades, skating rinks, musical concerts etc.
__ may decide whether they like certain people by the sound of their voice

I think all of these apply too...so you guys are saying it's probably this? You know, I don't know if my sil knew these were two different things, I didn't know that either. I thought they were basically the same thing, just that APD was a branch of SPD. Sheesh, I'm glad I asked. My SIL does have the book, I was actually told about it on MDC a while ago and she sorta read it. (I think I am more of a researcher than she) so maybe she needs to revisit it. I am not with her at the doctor, etc, but I want to help her out and I knew I could get some good info here.

It's really hard when you go to a doctor and they don't seem to know what either is! They did want to do OT with her, so it makes sense that you guys are right.
post #5 of 9
Yep, it could be APD. It's always difficult to assess any learning disabilities because of overlap and varying degrees of the disability. I have two daughters that were both diagnosed with APD. They are six years apart and they both present very differently - almost like they have different disabilities. The oldest one is in high school now and she was diagnosed by Maria Abramson and everybody agrees she is a classic case of APD.

When she was in preschool she would go stiff and shake like you described. Everybody thought she was having a seizure but UCLA said no when she was tested. I don't think that is a symptom of APD but it's important to note the similarity. She has had many specialists. When we first presented the diagnosis to the school in the mid 90s they had never heard of Auditory Processing before. We're fortunate to be near so many great programs and we have tried some of the best. She has always had trouble with reading, filtering sounds, etc. She also wears headphones to block out external sounds to concentrate. She never had any anger issues and is mild mannered. The absolute best and most effective program we ever used is called AIT - Auditory Integration Training. It is considered Taboo by ASHA and many other associations but it works. The audiologist that performed the audiology sessions during the AIT training was astounded by the results. We referred about a dozen other kids for testing to her that were going through the same AIT program and she said she has NEVER seen anything work so well. AIT is only 10 days. It isn't research based which is why so many people think it's bad. The other program that worked well for us is PACE - Processing and Cognitive Enhancement. We always did Fast ForWord, Linda Moodbell, Earobics, SOI (very good), and quite a few others.

It does get better if you use some of these programs. See if you can get an assessment from somebody outside the school. This will help you get an IEP but you have to put it writing with the school.
post #6 of 9
Honestly, it sounds like she could have Fetal Alcohol Spectrum Disorder. If you are not sure whether or not she was exposed to alcohol in utero, it may be worth looking into. She sounds A LOT like my son and it took us several years to get his diagnosis....we just didn't know the extent of the alcohol exposure. He has pretty severe learning disabilities, behavioral issues, sensory issues, anxiety, etc.
Here is a great resource to read more about FASD

post #7 of 9
Thread Starter 
Thank you so much, I will be forwarding this information to her.

It's so hard when so many issues have so many similar symptoms and those symptoms vary. I am just trying to help her because my niece is struggling so much right now in first grade.

Thanks again!
post #8 of 9
I just glanced at the responses so if I'm repeating someone, please forgive me.

A good starting point would be a developmental pediatrician. Unlike a regular pediatrician, they specialize in developmental delays such as APD, SPD, FAS, etc.

You are a good sister to help your sister navigate these waters. They can be rough. Wishing you all much luck.
post #9 of 9
the problem with these ABC soups of diagnosis is that it can all blend together. My 3 year old has a lot of those signs...screaming, talking too loud, etc but he has been evaluated as being NT. My oldest is on the ASD and he has the Soup Diagnosis I call it. PDD-NOS, OCD, SPD, APD....

If her only problem is sounds then it could be both or either. A kid with autism can have a auditory issue and sensory issues, a kid can have sensory issues alone with auditory issues etc.

I would push for both an OT and a speech evaluation. She could be sensitive to the sounds in her environment due to sensory issues.

A great book about all these inter connections between these things is The Mislabeled Child
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