Auditory processing disorder (APD) is an “umbrella” term covering a variety of central auditory processing deficits. APD is listed as a disorder in the WHO International Classification of Diseases, editions ICD10 and ICD11. However some academics promote an alternative terminology, “listening difficulties”. While less emphasis on a “disorder” label might be a good thing, “listening difficulties” unfairly suggests a lack of attention on the part of the person with APD.

In a recent international conference presentation SoundSkills audiologist Dr Bill Keith addressed controversies surrounding APD including the terminology debate. At SoundSkills we like the educational psychology and inclusive education approach of discussing strengths and weaknesses rather than “disorders” and favour a range of terminology options. We are accordingly reducing emphasis on the “disorder” term and making more use of auditory processing “weaknesses” or “difficulties”. Obviously at times the officially recognised term “APD” is necessary. As part of the conference presentation participants were polled on preferences. The majority favoured having a range of terms, but definitely not “listening difficulties”.

Many people with autism experience auditory processing difficulties and research confirms that they benefit from the same treatments which help other people with auditory processing disorders. This personal testimony provides an illuminating insight into the experiences and benefits of hearing aid use to alleviate auditory processing difficulties.

Note: SoundSkills adheres to international protocols which require hearing aids to be fitted by an audiologist using “real ear” acoustic measurement methods to determine the actual sound levels in the user’s ears (that is, not remote hearing aid fitting by estimation and postal delivery). SoundSkills also follows research evidence in recommending accessory remote microphones with low-gain hearing aid fittings to provide enhanced audibility in situations where the background noise level or distance from the speaker are such that it is difficult for hearing aids alone to provide sufficient assistance.

Read article here

The team at SoundSkills congratulates our friend, colleague and APD research collaborator, Dr Suzanne Purdy from the University of Auckland, who has been awarded the American Academy of Audiology International Award for Hearing for 2021 to acknowledge her significant contribution to audiology internationally.

https://audiology.org.nz/news/american-academy-of-audiology-honors-and-awards-2021-international-award-for-hearing-professor-suzanne-purdy/

2020 was a promising year for participation at conferences with sessions on auditory processing disorder (APD), until a world pandemic resulted in the cancellation of most conferences internationally. Dr Bill Keith, Director of SoundSkills, was planning to report APD research findings at the Hearing Across the Lifespan (HeAL) conference in northern Italy, and the American Academy of Audiology annual conference in New Orleans, both at venues that were early Covid 19 hotspots. Both conferences were cancelled. The HeAL conference has been rescheduled for mid 2021 and the AAA 2021 Convention will be held as an online conference. An Australia-New Zealand online audiology conference was hastily arranged and Prof Suzanne Purdy and Dr Keith made a joint presentation on New Zealand APD research. Dr Keith also presented on APD at New Zealand conferences of paediatricians (live), educational psychologists (online), and Ear Nose and Throat Surgeons (live). APD teaching for audiology and speech-language students at the University of Auckland was all conducted online. SoundSkills staff conducted seminars for various groups including resource teachers for learning and behaviour (RTLBs), the Raukatauri Music Therapy Centre, and parent seminars.

Children with autism spectrum disorder (ASD) frequently also have auditory processing difficulties which affect their ability to hear and communicate especially in difficult listening situations such as when there is other conversation or noise going on. The auditory processing difficulties may also affect ability to hear prosody in speech, that is the changes in tone and emphasis that add meaning to spoken language and help us distinguish the emotion associated with a statement and whether or not it is a question or is spoken with humour. Complex auditory environments are stressful for children with ASD as they are also for many children with APD. SoundSkills is participating in a project with APD and ASD experts at the University of North Texas and the University of Melbourne to diagnose and treat auditory processing deficits in children with ASD. The project is supported by hearing instrument company Sonova.

Research at the University of Melbourne has shown that wearing remote microphone hearing aid systems in class reduces listening stress for children with ASD. Research at the University of North Texas has shown that children with ASD benefit from auditory training and the use of remote microphone hearing aid systems. Research by Dr Joan Leung at the University of Auckland has shown that children with ASD can improve their understanding of prosody with training, and that this training progresses faster if they wear remote microphone hearing aid systems. All this research shows that many children with ASD can be helped to hear and communicate better.

Dr Leung is also the ASD Adviser on the staff of SoundSkills and has been working with SoundSkills clinicians to develop their skills and protocols for working with children with ASD, and diagnosing and treating their auditory processing difficulties.

Data analysis for five research projects funded by the William Demant (previously Oticon) Foundation and carried out by SoundSkills and the University of Auckland has been completed and writing up the results for publication in scientific journals has begun. The projects investigated:

• actual and optimal duration of use of remote microphone hearing aid systems by children with APD
• actual and preferred listening levels of remote microphone hearing aid systems by children with APD
• the effects of different levels of loudness on auditory memory, the auditory brainstem response and speech perception in quiet by children with APD
• quantification of degree of disability for APD
• phonological perception training for children with APD both with and without remote microphone hearing aid systems

A project currently in progress is examining whether it is possible to correct amblyaudia, suppression of input from one ear by the brain in difficult listening situations (the auditory equivalent of ‘lazy’ eye), by gradually varying the loudness difference between the weak ear and strong ear over a matter of weeks in children with APD wearing remote microphone hearing aid systems. Professor Suzanne Purdy at the University of Auckland has a number of APD research projects underway including measuring brain function in children with APD using functional magnetic resonance imaging (fMRI), and benefits of auditory training for older adults with mild cognitive impairment. Auditory neuroscience colleagues in the Eisdell Moore Hearing and Balance Research Centre are measuring electrical brain responses to sounds in mice with autism traits to better understand the effects of autism on the central auditory nervous system of the brain.