Many of us have heard these statements from the field regarding students’ various issues in the auditory processing area:
- “Melody has a problem with auditory discrimination.”
- “Sean has difficulty with auditory sequence tasks.”
- “Ken failed the auditory figure-ground subtest. He can’t distinguish background from foreground messages.”
- “Jana has trouble with auditory blending, and/or auditory synthesis.”
The age-old question many clinicians might ask themselves is: Should I work directly on these skills listed above, which suggest problems with “auditory processing,” to strengthen language, reading, and/or other aspects of academic learning?1, 2
Or should I dig a bit deeper to understand what these descriptions may mean—especially in terms of planning relevant and curriculum-based intervention?
Narrowing in on a Vague Diagnosis
Diagnosis and treatment of auditory processing disorders (APD) has been a controversial area of clinical and educational practice for decades. The viability of APD (sometimes called central auditory processing disorder, or CAPD) as a unique clinical entity and the treatment of auditory gaps, separate from language and other factors, has been discussed in depth in journals and texts on speech/language and audiology, and is not within the scope of this article.
But what steps can you take when receiving a description as per above or a teacher saying, for example: “I think Sarah has an auditory processing problem”?
Digging Deeper for Assessment
How can you move forward, beyond the confusing terminology? These suggestions will help you better understand the situation:
1. Ask the teacher (or referral source) to describe in greater detail the behaviors that make them suspect APD.
It is helpful to get more information about the materials used, instructions given, and so forth to see if there’s “more than meets the ear.” Some auditory tasks are harder than they look on the surface, for example, auditory discrimination tasks.
2. Try to find out the situations in which the student is having an auditory issue.
Also find out when they are not having an issue!
3. Ask about the student’s reading level.
There is a strong reciprocity between spoken and written systems. Stronger readers tend to perform better on certain auditory tasks.
4. Address the comprehension ability of the student.
Spoken and written comprehension are among the keys to understanding auditory issues.
Keep your eyes focused on how students function with auditory information in the real world in different situations. The more familiar a student is with the words or topic they are asked to process, the easier it may be to process incoming auditory information. It may be helpful to consider your own experiences trying to process a foreign language you are less familiar with to get a sense of the interaction between language knowledge and auditory correctness.
- Kamhi, A. G. (2014). Improving clinical practices for children with language and learning disorders. Language, Speech, and Hearing Services in Schools, 45(2), 92–103.
- Wallach, G. P. & Ocampo, A. (2017). Comprehending comprehension: selected possibilities for clinical practice within a multidimensional model. Language, Speech, and Hearing Services in Schools, 48(2), 98–103.