Auditory Processing

Is your child:

• Asking, ‘Wait, what did you say’?
• Having a hard time understanding words?
• Listening and paying attention but still not getting it?
• Struggling with reading because he does not ‘hear’ the letter sounds right?
• Having trouble spelling?
• Demonstrating poor vocabulary in spite of high intelligence?
• Getting lost in class?
• Asking people to repeat a lot?

Your child may say ‘what did you say’ a lot. It may seem like he or she didn’t hear you. Your child may have unexplained reading challenges.

When asked to repeat words that sound slightly different, he may pronounce them the same. For example, he may read ‘where’ instead of ‘were’ or ‘mack’ for ‘make’ or ‘bleed’ for ‘bled’ or ‘shock’ for ‘shop’ or ‘sack’ for ‘snack’.

Although many of these mistakes are common for early readers, children with problems hearing these sounds may continue to make errors while their peers ‘grow out of it’.

They may struggle to see the difference between two similar words. Their spelling is likely to be affected. It is very difficult to spell words correctly when the sounds were not correctly deciphered in the first place.

Children who listen but do not hear you, may have problems with auditory processing. ‘Auditory Processing’ refers to the brain’s ability to hear and understand information that comes in through the ears. Known expert in intelligence, Dawn Flanagan, describes it thusly,

“Auditory processing (Ga) refers to the ability to perceive, analyze, and synthesize a variety of auditory information (e.g., sounds) – auditory processing include listening to words with missing letters and saying the correct word (e.g., hearing “olipop” and saying “lollipop”) – listening to piano music and identifying the key in which the piece is being played (e.g., C sharp)” [2].

Auditory processing is not the same as basic hearing. Hearing is a combination of both what the ears do and what the brain does. Auditory processing is referring to the part that the brain does.

Auditory Processing has been identified as a key factor in intelligence, as established by the trusted CHC Theory of Intelligence [2].

Within this model, Auditory Processing includes the following skills: listening and verbal comprehension, temporal tracking, auditory cognitive relationships, discriminating sound patterns, auditory span memory, perception of distorted speech, and maintaining and judging rhythm [2].

In a child with poor auditory processing, the child’s brain is not correctly discriminating sounds. The progression of auditory processing complexity is as follows:

1. Rhymes and alliteration are the simplest form of auditory processing
2. Words within sentences
3. Syllables within words
4. Beginning sounds in words
5. Individual phonemes

Reading Problems: Generally, problems with auditory processing impact learning. This ability to discern the difference between similar phonemes is necessary for reading, and reading is necessary for most other subjects.

Following Directions: Auditory processing may impact a child’s ability to follow oral directions. For example, if the teacher says, ‘put a line through the yellow circle before you cross out the blue square’, your child may get confused.

Distractibility: Some children with auditory processing problems may be distractible. They may have a hard time filtering out background noise. In this case, their performance on tasks may suffer in a noisy environment, but they may demonstrate adequate skills when there are no distractions.

Although many children with auditory processing problems may appear distractible and inattentive, it is important to differentiate these challenges from attention and behavior problems.

Attention: Children with attention problems are more likely to be distracted in various environments, whether the environments are noisy or not. Of course, we all work better in a quieter setting.

However, children with true attention problems have persistent, pervasive problems with attention in multiple settings and environments.

Behavior: It is critical that parents are aware that problems with auditory processing do not explain or excuse poor behavior at school or at home. Although it may be frustrating to have some problems with auditory processing or sensory sensitivities, many children with these challenges are able to be compliant, social, and well adjusted.

If there are problems with defiance, aggression, and rule-breaking, auditory processing and other sensory needs do not provide the explanation. For more on behavior conditions, see the Behaving page.

If your child is struggling with auditory processing, a variety of professionals can be consulted.

First, have your child’s hearing checked.

• Talk to your pediatrician about having hearing checked
• If any concerns arise, request a referral to a pediatric audiologist
• If there are additional concerns, your child may require a hearing aid

Second, talk to the school about formal or diagnostic reading tests

• Most public schools have reading tests available that can test your child’s ‘phonemic awareness’ (meaning can he or she identify sounds within words)
• Diagnostic tests should provide an age and grade equivalent of your child’s abilities. If your child is two grade levels behind, this is a red flag

Third, talk to the school about formal speech / language tests.

• Speech / Language pathologists can test for your child’s ability to discern and articulate sounds
• If concerns arise, your school may have speech services to help address both the hearing and speaking of sounds

If there are additional concerns, talk to a school psychologist or licensed psychologist about testing.

• An IQ test can provide information about your child’s vocabulary and comprehension
• Many IQ tests provide a scale or an ‘index’ for auditory processing. Specifically, you can request that a measure of auditory processing be included in the testing
• The psychologist can provide you with a percentile rank and standard score. Standard Scores below 79 on Auditory Processing scales would be cause for concern

If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.

• Non-Compliance: if your child simply does not want to follow your directions, there could be a behavior problem. This problem is entirely different than auditory processing
• Intelligence: it may be that a cognitive problem is restricting your child’s processing of verbal information
• Verbal comprehension: it may be that your child is not understanding the information, rather than an issue of auditory processing. This difficulty would be evident in poor reading comprehension and oral comprehension.
• Articulation: it may be that your child is not able to hear or say sounds correctly
• Attention (Focusing): it may be that your child is struggling to pay attention to verbal information
• Learning problems: it is likely that problems with auditory processing impact learning, particularly with reading and spelling

Children who have significant problems in this area may have any of the following potential disabilities. *Note, this information does not serve as a diagnosis in any way. See the ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

• Autism Spectrum Disorder: many children with autism struggle with comprehension of verbal information
• Intellectual Disability (Educationally Identified Disabilities) – may be diagnosed clinically as well: children with low IQ and adaptive skills may struggle with auditory processing
• AD/HD: children with poor attention and regulation may have difficulty with auditory processing
• Developmental Delay (Educationally Identified Disabilities) – may be diagnosed clinically as well: many children with developmental problems have difficulties with auditory processing
• Dyslexia or Specific Learning Disability in Reading (Educationally Identified Disabilities): children with challenges in auditory processing may have a learning disability in reading

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.

• CLEAR Child Psychology: to obtain a customized profile of concerns for your child or to consult ‘live’ with a psychologist
• Psychologist: to test IQ and auditory processing specifically
• Pediatrician: to test hearing and to provide any necessary referrals
• Occupational Therapist (OT): to help with participation in music and P.E., where sounds may be overwhelming; to address sensory needs
• Speech Language Pathologist (SLP): to test for auditory discrimination and speech articulation problems and to provide treatment for such problems
• School psychologist: to potentially test IQ or to consider academic issues (generally only in the context of an IEP evaluation – parents cannot necessarily request an IQ test from the school psychologist)

Professionals may recommend the following types of tests for this symptom:

• Speech-Language tests: to evaluate speech sound discrimination and receptive language skills
• WISC-V or other IQ test: to evaluate auditory working memory or verbal comprehension
• GORT or other Achievement test: to evaluate phonemic awareness and reading skills

[1] Dawn P. Flanagan, Ph.D. (Nov 5, 2014). Cross-Battery Assessment: A Pattern of Strengths and Weaknesses Approach to SLD Identification St. John’s University, New York Yale Child Study Center, School of Medicine.

Link: http://www.nyasp.biz/conf_2014_files/Flanagan%20-%20Nov%205.pdf

[2] Sattler, Jerome (2014). Foundations of behavioral, social, and clinical assessment of children. p.140.

Amazon: https://www.amazon.com/Foundations-Behavioral-Clinical-Assessment-Children/dp/0970267126

[3] For information on the Auditory Working Memory index and the cognitive processes involved in reading and math: Gloria Maccow, Ph.D. (2016). Advanced Interpretation of the WISC-V, (2016).

Download: http://downloads.pearsonclinical.com/videos/WISC-V-020515/WISC-V-Advanced-Webinar-Handout-020515.pdf

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Previously Licensed: Sep 21, 2016
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