Introduction
Introduction
Auditory processing disorder (APD) can occur in isolation but it frequently occurs with other difficulties or disorders. Sometimes APD turns out to be the underlying cause of undiagnosed learning disabilities.
APD commonly occurs with specific language impairment and reading disorders including dyslexia.
Auditory processing, language and reading are neurologically entwined. Difficulties with auditory processing can affect phonological processing, the ability to recognise and interpret phonemes, the elements of spoken language. Impairment of phonological processing in turn affects language and reading development.
Auditory processing difficulties are commonly seen in children with autism spectrum disorder (ASD).
The auditory processing difficulties are a consequence of changes in the brain due to the ASD.
Children with global developmental delay may show difficulties with auditory processing
as a consequence of the developmental delay.
APD can co-occur with attention problems, i.e., Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD).
According to one research study, speech pronunciation difficulties may be more common in children with APD than in typically developing children.
Our clinical experience is that many children with APD also show signs of difficulties with visual processing.
Irrespective of cause, treatment is warranted, though results may be affected by any co-occurring disorder.
When testing children at SoundSkills we take into account other areas of difficulty and factors such as attention, memory, language, and cognitive ability. Observations from parents, school teachers and other professionals involved with the child are important and are taken into consideration in our evaluation. We recognise that other difficulties and disorders do not preclude a child from also having auditory processing difficulties. At SoundSkills APD Clinic we endeavour to help all children, irrespective of their other difficulties. Our specialist team of audiologists, speech language therapist, and Education Advisers evaluate individual needs and tailor treatment programmes to suit.
Traumatic brain injury (TBI)
Traumatic brain injury (TBI)
Auditory processing disorder is a common consequence of brain injury.
Hearing -elated issues are not always forefront of concern following a head injury but may become especially noticeable once the person tries to resume their regular activities such returning to work or school and socialising. There may also be the complication of hyperacusis, heightened sensitivity to sounds, with the result that sounds above moderate loudness are especially intolerable. Together with other effects of TBI, auditory processing difficulties can have severe effects on communication ability.
At SoundSkills we see children and adults with significant auditory difficulties as a results of head injury with TBI. Standard hearing test results may be normal, however the person will often have significant difficulties listening, processing information they have heard, and understanding when in groups or in noise. By identifying and understanding the auditory processing deficits, we can provide appropriate management, including treatment and intervention to help improve quality of life.
Children
Children
The Ministry of Health provides free hearing aids for children with other causes of hearing loss, but specifically excludes hearing loss due to APD. In a limited proportion of cases the Ministry of Education provides remote microphone hearing aid (RMHA) systems for high needs school age children diagnosed with APD. In order to be accepted for a trial the child must meet certain restricted criteria. SoundSkills assists clients to determine whether they might qualify for a Ministry of Education assistive hearing technology trial.
The Ministry of Education fitting service is variable across New Zealand; some children are provided equipment directly from their school, whereas some other children have their hearing systems fitted by an audiologist. In accordance with the New Zealand Guidelines on Auditory Processing Disorder we recommend that RMHA systems are fitted by an audiologist to ensure that the physical fit and the sound are set correctly for the individual child. SoundSkills can provide a fitting service for Ministry of Education funded RMHA systems on request. Fitting by a professional avoids such problems as incorrect volume/gain settings, different settings between left and right receivers, problems with physical fit, and fitting when there are contraindications that can only be identified through looking in the ear using an otoscope or microscope.
In the absence of public funding parents can purchase RMHA systems privately from SoundSkills. As a lower cost option manufacturer refurbished systems are sometimes available. SoundSkills offers a comprehensive service involving selection of a suitable solution, audiological fitting, a trial period of several weeks, and assistance throughout the trial period from one of our Education Advisers who will work with the family and school to carry out an effective trial with classroom observation and measurable goals and assist in reaching a decision on whether to proceed with the selected hearing equipment.
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ACC
When APD is associated with injury, ACC may cover the cost of assessment, recommended treatment, including RMHA systems, auditory training and language therapy.
Adults
Adults
Adults diagnosed with APD who also have some hearing loss evident in a standard hearing test, may be eligible for the Hearing Aid Subsidy Scheme (HASS) or the Hearing Aid Funding Scheme (HAFS) https://www.health.govt.nz/publication/guide-getting-hearing-aids-hearing-aid-subsidy-scheme . These schemes are provided by the Ministry of Health. The HASS provides a subsidy of $511.11 per ear. The HAFS covers the cost of hearing aids. These schemes do not include the cost of fitting appointments.