Auditory processing relates to how the brain handles the words and sentences it receives through hearing. Auditory processing weaknesses affect listening and comprehension.
Referral for auditory processing testing is often initiated by teachers or parents who observe behaviours in a child which suggest a hearing disorder. The child may regularly have difficulty understanding spoken instruction and following directions; frequently request repetition of oral information; and appear inattentive. The child may also be behaviourally disruptive and may be underperforming at school. Adults seek assessment when they notice difficulty listening, paying attention or remembering information at work.
Assessment for auditory processing skills begins with a routine hearing assessment by an audiologist. Children, teens and adults with auditory processing weakness usually have normal hearing sensitivity. They are able to hear faint sounds and can discriminate simple speech sounds presented in favourable listening conditions. Normal hearing test results therefore do not explain the observations made and concerns raised at school, home or work. It is when listening conditions are less than ideal or when auditory signals become complex that these ‘hearing’ difficulties manifest. Central auditory testing reflects the analysis of sound which occurs beyond the inner ear in the brain.
A person’s auditory processing profile will identify strengths and weaknesses based on various listening tasks. These weaknesses may be bottom-up or top-down. Bottom-up auditory weaknesses may include difficulty interpreting speech that is degraded; poor temporal processing; or weakness in processing auditory signals that are delivered simultaneously. Top-down auditory weaknesses may involve higher level processes such as language, phonological awareness, auditory or working memory. Both types are often involved. This information is essential for planning appropriate intervention and for determining when referral to other health professionals such as psychologists and paediatricians is appropriate. Sometimes children and adults have already seen other professionals who refer them for auditory processing assessment.
Who does it affect?
While it is difficult to reliably identify auditory processing weaknesses before the age of 7, it is possible to screen for potential speech or language-based challenges and to support the development of auditory function. Auditory processing issues often come to the forefront in school as children and adolescents experience learning or listening challenges. Adults may question their listening skills in work and social settings.
What is the impact?
Auditory processing weakness affects a person’s ability to listen for, process, and understand auditory (usually verbal) information, especially in less than ideal conditions, such as noisy environments, poor signal reception, rapid or muffled speech, accents, or when there are multiple speakers. Poor auditory processing affects the ability to learn, retain and integrate important information that is delivered through the hearing system.
Can anything be done?
Just like any part of the human body, the auditory system develops and matures throughout childhood and adolescence. Auditory processing weaknesses can improve and even resolve naturally over time. This may not be the case for everyone, however. For some, intervention tailored to the auditory profile is the preferred course. Combinations of environmental modification, speech and language training, and computer-based intensive listening training programs are commonly recommended for persons with auditory processing difficulties. While there is no quick fix, positive changes are possible when appropriate intervention is followed.
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