The Difference You've Made In The Life Of My Child

I was grateful to receive this kind note of appreciation this week from a parent a few years after working with her son in therapy for an auditory processing disorder.

"Hi, Lynn,

I wanted to give you an update on _____ and how far he has come after working with you. 

As he entered junior high, I felt there was a piece of the puzzle still missing. After his Auditory Processing Disorder was diagnosed, and he had 2 years of intensive therapy with you, he seemed better with directions, school work, and life.  His grades in high school have far outpaced his grades in junior high.

Last fall he took the PSAT and scored very high; he is in the running for a National Merit Scholar seat.  He also took the ACT in Dec and scored a 35.  He plans on applying to very competitive schools and wants to study chemical engineering.  I feel that the APD therapy helped him realize his potential and he was able to prove to himself, peers, and teachers that he is smart.  LD’s do not define him.  Most importantly, _____  recognizes the difference the therapy made in his life.  Many times he was reluctant to go, but now, agrees that he needed help.  

He is also a rock star when playing Taboo.  My mother attributes it to the games you use to play with him.

Thank you for all you did to help _____  and exhibiting extreme patience when working with him (he remains VERY stubborn)!

Many thanks,

_____"

This quote by Dr. Suess was included in the note. 

MANAGING "LISTENING LARRY'S" AUDITORY PROCESSING NEEDS IN THE CLASSROOM

Students with auditory processing disorders can have difficulty in any situation in which the

signal they are listening to is degraded. This means that they will have difficulty when there is background noise when the person speaking is more than 6 feet away, when the person is not facing them, and when the person has a foreign accent or does not speak clearly. The following suggestions may be helpful.

IMPROVING LISTENING LARRY’S AUDITORY SKILLS

1. Consider a trial use of an FM listening system in the classroom and in other difficult listening situations to reduce the negative effects of distance and competing noise. An FM system is a listening system in which the teacher wears a close microphone and the Larry wears a radio receiver. Larry will hear the teacher as if he were standing next to his ear in a room with no background noise.

2. Larry is in private therapy with Lynn A. Wood M/A.CCC/A, LSLS, Cert AVT, where his needs are identified and are treated in order to maximize his auditory learning and performance. A systematic program of auditory training is used to improve his auditory processing, auditory memory and auditory attention. Collin is practicing listening in noise and in targeting auditory skills as well.

MODIFYING THE ENVIRONMENT

1. Select quiet classrooms if possible. It should face a quiet street and not face traffic or be

near toilets, stairway, gymnasium, or the lunchroom.

2. Use acoustic treatment such as carpeting on the floor and acoustic tiles on the ceiling. If

carpeting cannot be installed in the entire room at least put it in especially noisy places areas.

3. All chairs and movable tables should have rubber stoppers (or tennis balls) to reduce noise.

4. Seat the Larry close to the teacher and allow him to change his seat if the Teacher moves around the room. Be certain Larry can see the teacher’s face so he can  Use visual cues.

5. Whenever possible, seating should be away from the window or doorway, or any noisy

equipment  (i.e. audiovisual equipment.)

MODIFYING TEACHING STYLE

1. Write information and homework in handouts or on the smartboard so the Larry does not  have to rely on listening to get the correct assignment.

2. Check with the Larry to be certain that he understands. Repeat or rephrase if necessary.

3. Consider pre-teaching some of the academic materials to reduce listening in the classroom.

4. Whenever possible, small groups learning should take place outside of the classroom in a quiet room to maximize their benefit by reducing the interference from competing noise etc. 

5. Allow Larry to take a  “time out” during his day if he requests when listening is not required. This will reduce the stress of listening. 

6. Larry may need extended test-taking time, and individualized test directions.

7. Larry may benefit from use of or a note taker to record classroom activities.

STRATEGIES FOR AUDITORY PROCESSING DISORDER

Several strategies exist which may positively impact a Larry in their educational environment.  These strategies are divided into parent, teacher, and Listening Larry approaches.

Teacher Modification Strategies

Classroom environment:

Reduction of noise/minimize distractions

􏰀Preferential seating away from noise

􏰀Use of classroom amplification system

 
 Teaching techniques:

Clear enunciation at a slow-moderate rate of speech
􏰀Insert purposeful pauses between concepts
􏰀Shortened verbal instructions; only pertinent content
Provide visual cues during lecture and/or oral directions
􏰀Provide repetition of oral information and steps of assignment
􏰀Give breaks between intense concepts taught for comprehension
􏰀Check for comprehension early and often
􏰀Have Larry repeat directions to the teachers
􏰀Preview and review concepts for lecture
 
 Peer assistance:

􏰀Use of a positive peer partner for comprehension of directions
􏰀Use of cooperative learning groups
􏰀Use of a note-taker
 
 Possible Assignment modifications:

􏰀Allow extended time to complete assignments and/or tests
􏰀Provide visual instructions
􏰀Preview language of concept prior to assignment
􏰀Frequent checks for comprehension at pre-determined points
􏰀Vary grading techniques
 
Modification Strategies, which are being, incorporated in his private therapy:

􏰀Use of primarily audition in therapy to improve and maximize his listening.
􏰀Use of short and long term memory techniques (i.e. rehearsal, chunking, mnemonics, visual imagery)
􏰀Listen  for meaning rather than every word
􏰀Teach active listening behaviors
􏰀Teach Larry to advocate for themselves by asking frequent questions about the  material, asking for multiple repetitions or requesting speaker to “write it down”
􏰀Teach organizational strategies for learning information
 
Parent Modification Strategies:

􏰀Keep directions or commands short and simple
􏰀Use praise often and be positive
􏰀Use visuals or gestures at home to compensate for listening difficulties
􏰀Assist the Larry in asking clarification questions and being their own advocate
􏰀Preview and review classroom material
􏰀Review homework directions and assignment due dates with the Larry
 
Other specific skill strategies that focus on auditory remediation exist in the literature in auditory processing disorders.  However, the school-based speech-language pathologist may not necessarily speak to these acoustic skill strategies without a direct IEP goal, which addresses an area of the Larry’s educational deficits.  In addition, Larry will benefit greatly from his time in the classroom that pull out services may not meet his academic needs. Also, since IEP goals are derived from a comprehensive assessment and eligibility in other special education certifications as well as direct effect on educational performance, the team may not work with specific auditory skill remediation in isolation.  For further information about acoustic skill remediation please refer to the References portion of this section.

REFERENCES

Karen L. Anderson, Ph.D., CCC/A.; http://successforkidswithhearingloss.com

Carol Flexer, Ph.D., CCC/A, LSLS Cert. AVT;  www.carolflexer.com

Jane R. Madell, PhD CCCA/SLP, LSLS, Cert AVT; www.JaneMadell.com

Management of Auditory Processing Disorders (APD)

http://kidshear.com.au/

Typically, an auditory processing disorder results in a significant deficit in how the brain perceives and interprets sound information. Poor auditory processing abilities negatively impact the use of spoken language, receptive and expressive communication, academic learning and social skills.

Research indicates that with appropriate intervention, children with APD can become active participants in their own listening, learning, and communication success. Thus, when auditory rehabilitation is navigated carefully, accurately, and appropriately, an individual’s prognosis is good in spite of being afflicted with APD.

Treatment of APD generally focuses on three primary areas:

1. Changing the learning or communication environment
The primary purpose of environmental accommodations and/or modifications is to improve access to auditorily presented information are often listed in a student’s 504 Plan.

2. Learning and using compensatory strategies
Compensatory strategies teach individuals with APD to take responsibility for their own listening success or failures. The individual uses a variety of active listening and problem-­‐solving techniques to be an active participant in daily listening activities.

3. Auditory Rehabilitation for APD
Auditory Rehabilitation targets maximizing auditory processing skills rather than only putting accommodations in place that are usually visual in nature and do not impact the auditory disorder. Research shows that vision is not a good substitute for hearing. If it were, APD would not present with such challenges.

http://www.gemmlearning.com/

Auditory Rehabilitation Therapy involving a systematic program of auditory training

includes two main areas:

Improving the individual’s auditory processing, auditory memory and auditory attention
1. auditory association abilities.
2. auditory comprehension and direction following abilities.
3. auditory closure abilities.
4. auditory memory ability to retain auditory information both immediately and after a delay.
5. auditory memory sequencing.
6. linguistic auditory processing for higher-­‐level language, learning and
communication.
7. auditory processes for auditory integration.
8. ability to attend to important auditory information including attending in the midst of competing background noise and verbal distractions.
9. auditory comprehension/receptive and expressive language including vocabulary, syntax, morphological markers, complex sentence structures, conceptual language, social and pragmatic language.
10. communication repair strategies and clarification techniques

Recruiting higher-­order skills to help compensate for the auditory deficit
Examples based on an individual’s needs are targeted and may include such as learning and using:
a) auditory retrieval strategies to improve word retrieval of known but evasive vocabulary
b) synonyms to circumvent word-­‐finding blocks
c) categorization or grouping to facilitate auditory memory
d) chunking to aide in recall of sequences of numbers and other types of information 
e) mnemonic devices to assist in auditory memory
f) creating and use of a verbal description when referring to concrete items and situations

The degree to which an individual’s auditory deficits will improve with therapy cannot be determined in advance. However, with appropriate auditory rehabilitation, individuals with APD can become active participants in their own listening, learning, and communication success. 

Therapy for Auditory Processing Disorder: A Parent's Viewpoint

A kind email out of the blue:

I greatly appreciated Collin's Mom email that shared how well her son is doing in his school. I am thankful that I was a part of his middle school years and a stepping-stone to his success. 

So often, therapy for auditory processing gets a bad rap.

I think it is because Audiologists/SLPs write goals and spend most of the therapy time working on compensatory skills rather than building up and developing auditory skills where the problem originates. Vision is not a good substitute for hearing in any context.

What is it like to have APD?

This video is made for anyone who wants an understanding of how people with APD
 deal with the world, and how frustrating it is to just even have a conversation. 

"Each conversation takes my full attention, along with complications such as: background noises, and other distractions. "

Experience first hand the activity demonstrated in the video.

http://www.pbs.org/wgbh/misunderstoodminds/experiences/attexp2a.html

Auditory Activity: Listening to Directions
	A child's ability to pay attention and focus on a teacher's instructions can mean the difference between scholastic success or failure. The following activity attempts to illustrate what it might be like for a first-grader with an attention disorder to try to concentrate on a set of oral instructions amidst a cacophony of classroom distractions. This activity requires Flash player. > Get Flash Plugin You should be sure that your computer's audio is turned on. When you're ready to begin, select the "Begin" link.

For more info please visit: 

kidshealth.org/parent/medical/ears/centr­al_auditory.html

http://www.pbs.org/wgbh/misunderstood...

Games that Target Auditory Processing or Related Skills

Terrific Talkers share a resource for: