Auditory Processing Disorder

Little-Known Disorder Can Take a Toll on Learning
By TARA PARKER-POPE

Ms. O’Donnell’s quest to help her son led her to Lois Kam Heymann, left, an auditory therapist, whom Blake now works with.
Parents and teachers often tell children to pay attention — to be a “good listener.” But what if your child’s brain doesn’t know how to listen?

That’s the challenge for children with auditory processing disorder, a poorly understood syndrome that interferes with the brain’s ability to recognize and interpret sounds. It’s been estimated that 2 to 5 percent of children have the disorder, said Gail D. Chermak, an expert on speech and hearing sciences at Washington State University, and it’s likely that many cases have gone undiagnosed or misdiagnosed.


The symptoms of A.P.D. — trouble paying attention and following directions, low academic performance, behavior problems and poor reading and vocabulary — are often mistaken for attention problems or even autism.

But now the disorder is getting some overdue attention, thanks in part to the talk-show host Rosie O’Donnell and her 10-year-old son, Blake, who has A.P.D.

In the foreword to a new book, “The Sound of Hope” (Ballantine) — by Lois Kam Heymann, the speech pathologist and auditory therapist who helped Blake — Ms. O’Donnell recounts how she learned something was amiss.

It began with a haircut before her son started first grade. Blake had already been working with a speech therapist on his vague responses and other difficulties, so when he asked for a “little haircut” and she pressed him on his meaning, she told the barber he wanted short hair like his brother’s. But in the car later, Blake erupted in tears, and Ms. O’Donnell realized her mistake. By “little haircut,” Blake meant little hair should be cut. He wanted a trim.

“I pulled off on the freeway and hugged him,” Ms. O’Donnell said. “I said: ‘Blakey, I’m really sorry. I didn’t understand you. I’ll do better.’ ”

That was a turning point. Ms. O’Donnell’s quest to do better led her to Ms. Heymann, who determined that while Blake could hear perfectly well, he had trouble distinguishing between sounds. To him, words like “tangerine” and “tambourine,” “bed” and “dead,” may sound the same.

“The child hears ‘And the girl went to dead,’ and they know it doesn’t make sense,” Ms. Heymann told me. “But while they try to figure it out, the teacher continues talking and now they’re behind. Those sounds are being distorted or misinterpreted, and it affects how the child is going to learn speech and language.”

Blake’s brain struggled to retain the words he heard, resulting in a limited vocabulary and trouble with reading and spelling. Abstract language, metaphors like “cover third base,” even “knock-knock” jokes, were confusing and frustrating.

Children with auditory processing problems often can’t filter out other sounds. The teacher’s voice, a chair scraping the floor and crinkling paper are all heard at the same level. “The normal reaction by the parent is ‘Why don’t you listen?’ ” Ms. Heymann said. “They were listening, but they weren’t hearing the right thing.”

The solution is often a comprehensive approach, at school and at home. To dampen unwanted noise, strips of felt or tennis balls may be placed on the legs of chairs and desks. Parents work to simplify language and avoid metaphors and abstract references.

The O’Donnell household cut back on large, noisy gatherings that were upsetting to Blake. Twice-weekly sessions focusing on sounds and words, using rhyme and body gestures, helped him catch up on the learning he had missed.

Help inside the classroom is essential. One family in Westchester County, who asked not to be named to protect their son’s privacy, met with his teachers and agreed on an array of adaptations — including having his teacher wear a small microphone that directed her voice more clearly to a speaker on the student’s desk so he could better distinguish her voice from competing sounds.

Nobody knows exactly why auditory processing skills don’t fully develop in every child, according to the National Institute on Deafness and Other Communication Disorders. Scientists are conducting brain-imaging studies to better understand the neural basis of the condition and find out if there are different forms.

Reassuringly, the disorder seems to have little or nothing to do with intelligence. Blake has an encyclopedic knowledge of animals — he once corrected his mother for referring to a puma as a mountain lion. The Westchester child is now a 17-year-old high school student being recruited by top colleges.

“He’s in accelerated Latin, honors science classes,” said his mother. “I remember I used to dream of the day he would be able to wake up in the morning and just say, ‘Mommy.’ ”

Not every child does so well, and some children with A.P.D. have other developmental and social problems. But Ms. O’Donnell says that treatment is not just about better grades.

“It definitely affected his whole world,” she said of her son. “Not just learning. It cuts them off from society, from interactions. To see the difference in who he is today versus who he was two years ago, and then to contemplate what would have happened had we not been able to catch it — I think he would have been lost.”

A version of this article appeared in print on April 27, 2010, on page D5 of the New York edition.
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1. April 26, 2010
5:26 pm
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APD sounds very much like the audio distortions that occur to those of us who have some hearing loss in the mid-range of audible frequencies. That surely causes havoc trying to follow conversations at a noisy restaurant or raucous dinner table.
Host: Would you like a little more soup?
Hard of hearing guest: No, I don’t think I’d like to go sit on the widow Moore’s stoop. But thanks for asking.
I’m pretty sure some of my auditory twisting came from conditioned listening to my dear Tarheel mother who was known to bemoan the fact that that America had dropped “the Atomic Bum” on Japan. For years I had visions of a massive Clem Kadiddlehopper being hoisted out of the Enola Gay over Hiroshima. The horror, the horror.
Of course auditory distortion in daily life can be no laughing matter if you are trying to comprehend what’s going on in a classroom. At least now there are some strategies and tools to help out. If nothing else works, you can try, “What did you say?”

— ca
2. April 26, 2010
5:28 pm
Link
Listening skills are fundamental to reading–according to brain science researcher & “brain trainer”, Dr. Michael Merzenich.

Here’s an excerpt from his interview with Dr. Ginger Campbell:

Click here for the whole transcript from Brain Science Podcasts:

http://docartemis.com/Transcripts/54-brainscience-Merzenich.pdf

Ginger Campbell: So you have to learn to listen right before you can learn how to read.

Michael Merzenich: “It’s only when you’re sorting information appropriately does this translation of- I mean after all, reading is simply based upon the translation of what you hear in a written form.

And if what you hear is not represented in the brain in the normal way, it’s a very bad representational system. It really doesn’t represent what you hear.

So unless you correct that- unless you correct the listening, you cannot really generate a reader.

I mean you can do it only by using alternative strategies for reading, but you can’t use a phonological approach to reading.

You have to use a whole-word or other approach- then you can be successful. But you can’t use the classical efficient approaches to learn to read. So you have to correct the listening to correct the reading.”

— The Healthy Librarian
3. April 26, 2010
5:32 pm
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My oldest (currently 19) and adopted at age 3 from El Salvador, had auditory processing disorder.

When she was 5 we were told she would never learn to read, was mentally retarded, ADHD etc. etc.

What helped even more than the teacher wearing a microphone was going through Fast Forword. This is a computerized auditory processing program that is basically auditory exercises (2 hours/day x 6 weeks). It has been published (under “HAILO”) in both Science and Nature and has been validated in numerous double blind studies.
http://www.scilearn.com
http://www.fastforword.com

It made a huge difference. She was saying “I can understand my teacher within a couple of weeks of starting it. Her IQ increased by 50 points over five years. Currently she’s a B student in college.

— Shari DeSilva
4. April 26, 2010
5:56 pm
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When my daughter was in grade school, there was a big discrepancy between some of her skill levels. Though her teacher was not necessarily alarmed, I was. I had her tested and discovered she had an auditory perceptual defecit. She literally could not distinguish between sounds that we all take for granted, as different. She worked with a therapist, addressing those issues specifically. She is a college graduate, who had earned merit scholarships.

If your gut tells you something is not quite right, listen to it. Better to be told you’re wrong or overreacting, that to miss the boat with an unattended problem that could have been improved.

— lessi
5. April 26, 2010
6:38 pm
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My neice has been diagnosed 16 years ago. She has her drivers license and just got into college. She is aware of her needs and can ask for study guides and support from her teachers. She learned to advocate and to self soothe her anxiety. She is an A student and will be studying speech pathology.

— brooklyn