The term auditory processing and perception disorders summarize certain hearing impairments that are exclusively localized in the area of the further processing of the auditory nerve impulses. Sound conduction and sound perception are not affected. The procedural underperformance concerns, for example, sound localization, auditory selection ability or auditory short-term memory.
What are auditory processing and perception disorders?
Abbreviated as APD by ABBREVIATIONFINDER, the term auditory processing disorders was introduced and defined in 2000 by the German Society for Phoniatry and Pedaudiology (DGPP). The processing or processing of sound in certain areas of the brain is extremely complex. Sound processing affects both unconscious and conscious processes.
For example, differences in travel time of the sound between the right and left ear and certain sound refraction processes on the auricle are used to localize a sound source. Another important perception performance is the ability to differentiate between different tones that hit the left and right ears at the same time in the auditory pathway and to be able to assign them to the right or left ear.
Important for speech recognition is the ability to recognize words within a “sonic circle” and to save them for a short time for unconscious further processing. With an APD, at least one of the complex further processing processes is restricted. The sound conductivity in the outer and middle ear as well as the conversion of the mechanical auditory impulses into nerve impulses in the cochlea are not affected by an APD.
The exact causes to which an APD could be traced back have not (yet) been adequately clarified. There are different explanations that are discussed among experts. The AVWS is often first noticeable in everyday language use. Difficulties in differentiating between different consonants such as “b” and “p” or “d” and “t” then become noticeable.
Differentiating between the syllables “da” and “ta” or “da” and “ba” also causes difficulties. Since the diagnosis of APD is usually associated with a conduction disorder or a sound sensation disorder, frequent and long-lasting otitis media in childhood and environmental influences are discussed as one of the causal complexes. Furthermore, brain development disorders due to insufficient oxygen supply during childbirth and similar factors come into consideration.
In some cases, the child is under or overstrained during language development, which reduces the child’s ability to differentiate between different sounds. Due to ascertained familial accumulations, genetic reasons are occasionally mentioned, which up to now could not be corroborated with concrete gene mutations apart from the statistical figures.
Symptoms, ailments & signs
Complaints and signs of auditory processing and perception disorders show up either in early childhood during the phase of language development or in advanced age. In the early phase of the APD it is difficult to follow a conversation when loud background noises can be heard at the same time.
It causes problems to filter out the speech information from the entire noise complex and to process it further. Frequent inquiries and misunderstandings or confusion of words are typical for this phase. Affected children find it difficult to follow the lesson with concentration.
The children tend to cover their ears when there is a lot of background noise, as is often the case in kindergartens, for example, or they even refuse to go to kindergarten. A limited auditory memory can also be conspicuous, making it difficult to remember spoken language.
Diagnosis & course
In children, a peripheral hearing disorder, which is based on problems in the outer, middle or inner ear and causes symptoms similar to APD, is much more common than the auditory processing and perception disorder. This assumes that sound conduction and sound sensation disturbances must be carefully ruled out prior to the diagnosis in order to avoid a misdiagnosis.
Unambiguous diagnostic procedures in the form of speech audiometry should only be carried out in phoniatric-pedaudiological centers or by appropriately trained ENT doctors. The possible interferences that can be the basis of an APD are checked in different audiometric procedures. The course of the disease depends on the underlying disease that is causing it, although in most cases it is not known.
If the APD is recognized in children during the language development phase, further problems in psycho-social development arise – if left untreated – because the disorders of perception and processing can lead to learning difficulties and social isolation. Reading and writing disorders, language development disorders, attention deficit disorders and hyperactivity disorders are often associated with APD.
In the case of an auditory processing and perception disorder, there are acoustic processing problems in the auditory nerve. These problems can prove to be very annoying and annoying in the long run, especially since therapy is difficult in some cases. The disease has various consequences, especially for schoolchildren.
These include that oral tasks and dictations are poorly understood, a tendency to dyslexia and lack of concentration, impaired foreign language learning or permanent discomfort in a noisy environment. If behavioral abnormalities indicate this form of disorder, an accurate diagnosis should be made, as it can lead to delayed or incomplete language development.
The disorder can be assessed in good time by kindergarten educators and teachers and verified with tests by speech therapists or occupational therapists. School, child and adolescent psychologists and psychiatrists make the exact diagnosis. But ENT doctors can also diagnose the disorders in a targeted manner and assess the severity, as can pediatric audiologists and clinics for phoniatrics.
People with auditory processing and perception disorders have particular difficulties in selecting, localizing and discriminating sounds as well as hearing with both ears. The causes include both medical factors (middle ear, brain damage) and environmental influences.
There are a number of audiometric tests (hearing tests) that can help identify the presence of this condition. Several audiometric procedures must always be used in order to rule out other disorders of the auditory-cognitive apparatus with certainty.
When should you go to the doctor?
Ideally, processing and perception disorders should be treated as soon as they are first discovered in a patient. In this way, various other complaints can be avoided in adulthood. Immediate treatment is needed, especially in children, to avoid bullying or teasing. The processing and perception disorders can manifest themselves in a greatly delayed development of the language.
Those affected can no longer follow simple conversations and thus cannot actively participate in everyday life. Furthermore, the patients can feel very disturbed by background noise. A doctor should also be consulted in the event of irritation or inexplicable aggressiveness on the part of the person concerned. It is not uncommon for patients to be unable to memorize simple content and as a result suffer from significant developmental disorders. The quality of life of those affected is significantly restricted by the processing and perception disorders.
As a rule, a pediatrician or general practitioner is consulted first in the case of processing and perception disorders. Furthermore, the disorders themselves and the underlying disease are treated by a specialist. However, a positive course of the disease cannot be predicted in every case.
Treatment & Therapy
The therapeutic options for treating APD in children are essentially limited to exercises that enable the child to compensate for some of the deficits. The focus is on psychological care for the child and those in the immediate vicinity such as parents, siblings, and educators.
For a large number of other therapies that are primarily aimed at training a wide variety of auditory functions such as high-tone training or training threshold training is not recommended according to the current state of science. Computer-aided speech therapy programs that can be used to accompany personal care, on the other hand, can be rated as helpful and expedient.
Basically, any therapy should be checked for effectiveness from time to time in order to be able to readjust it if necessary. Passive measures in the form of noise-absorbing wall cladding in the home environment or in the classroom can also be helpful, if this can be set up.
Outlook & forecast
The prognosis of an auditory processing and perception disorder depends on the individual causes, the cooperation of the patient and the therapeutic steps offered. A possible cure is definitely given under optimal conditions.
Mostly children get sick from the disorder. Relatives or educators notice the impairments and should consult a doctor as early as possible. The sooner medical care is initiated, the better the chances of recovery.
The processing of the sound in the brain does not take place comprehensively and can be trained with the child. In many cases there are psychological or emotional causes that must be taken into account in order to improve the chances of recovery. Separations, deaths or a change of friendship can trigger trauma in a child that has not been dealt with. The upbringing methods of the relatives or the way the parents interact with one another and with the child are very decisive and have a strong influence on positive development and healing.
In the event of abuse or shock, the child needs psychotherapeutic help. This can take several months or years. In many cases, the auditory processing and perception disorders disappear within an ongoing therapy. Techniques for reducing stress and understanding the situation help the child immensely. In addition, targeted training and exercise units are important in order not to suffer permanent impairments.
There are some possible complex causes under discussion which can possibly be held responsible for the triggering of an APD. However, the possible processes that cause the disease to occur are not yet adequately understood. There are therefore no direct preventive measures that could effectively protect against the APD.
This is especially true if the disease is caused by gene mutations. Indirect prevention is a healthy lifestyle, in which not only stress but also rest phases are planned. This also applies to nutrition, if it is fortified with natural foods and helps to strengthen the immune system.
In most cases, there are no special measures and options for follow-up care available to the person concerned with processing and perception disorders. These disorders should be recognized and treated at a very early stage so that no further complaints or complications arise in adulthood. In general, early detection has a very positive effect on the further course of the disease and is therefore also in the foreground.
As a rule, self-healing cannot occur in the case of processing and perception disorders, so that the person concerned is definitely dependent on treatment. The affected children are dependent on comprehensive and intensive therapy for processing and perception disorders so that these complaints can be alleviated. Above all, the parents must support the children in this therapy and initiate it.
Psychological support is also very important so that the children do not experience depression or other psychological disorders. Furthermore, contact with other people affected by processing and perception disorders can also be useful, as this often leads to an exchange of information. The processing and perception disorders do not reduce the life expectancy of the children.
You can do that yourself
In children with auditory perception disorders (APD), the problems are particularly evident in school. The following information should be observed here in order to make learning easier for the child. A place close to the teacher is important. Have the child sit so that they can see the teacher’s mouth clearly.
A calm, balanced neighbor ensures little distraction. Visual aids such as a volume traffic light and pedagogical skills can be used to ensure a calm learning environment in the class. It is important that the child can signal to the teacher when they have not understood him.
Conversations at home should take place without additional acoustic distractions such as television, radio or telephone. Eye contact between parent and child is an important signal that the child has noticed information. This can be seen in the child’s reaction. Shouting after the child is not helpful. These statements often fail the recipient.
Children with APD are often very exhausted after school. They need a break before starting their homework. It is important to agree on fixed learning times and to stick to them consistently. There is a great risk that the child will otherwise not start their homework voluntarily. If the homework takes too long each day, this should be discussed with the teacher.