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If your child appears to have trouble learning and seems to be “away with the fairies” they could have a hearing problem.

There’s often one in every class – the kid who seems to be off in a world of their own and has difficulty paying attention or following instructions. Some develop behavioural problems and act up, while others try to shrink into the background and not be noticed. Speech and language skills can be affected.

There are many reasons why some children are like this, but one explanation parents and teachers don’t always consider is that they may have a hearing problem called auditory processing disorder (APD).

Called the “hidden disorder” by experts, APD isn’t always picked up. But if it is, the child’s abilities can be greatly improved. It affects between three and 15% of children – more boys have it than girls – and many cases go undetected, but help is available.

What is auditory processing disorder?

It’s a condition in which the ears process sound normally, but the brain can’t always understand what has been said. It’s as if the ears and the brain don’t quite co-ordinate properly.

Audiologist Dr Bill Keith, of the Auckland-based APD specialist clinic Sound Skills, says the problem lies in the hearing pathways in the brain. “Children are unable to extract the message that they need from all the noise around them. Or they have trouble retaining auditory information, unless it’s brief.”

Parents or teachers may suspect a child has a hearing problem, but the child will pass standard hearing tests.

They may also have a normal level of intelligence, but need instructions repeated to them, and may struggle with complicated directions.

What causes APD?

The cause is unknown, but it’s thought there may be links to head trauma – during birth, for example – or an early history of glue ear. It’s also sometimes associated with other conditions, such as dyslexia, attention deficit disorder, autism or developmental delay.

How do you know your child has APD?

It can be hard to pick up – symptoms can range from mild to severe, and can also indicate other conditions. But some behavioural signals include:

  • Being easily distracted or unusually bothered by loud or sudden noises
  • Getting upset in noisy environments
  • Noticeable improvement in behaviour and performance in quiet settings
  • Difficulty following directions
  • Struggling to read, spell or write
  • Difficulty doing verbal maths problems
  • Finding it hard to follow conversations
  • They may also be quiet and shy, have behavioural problems and struggle academically and socially.

How is APD diagnosed?

Specialist clinics can carry out specific tests to see if your child has APD, although they usually don’t check children until they’re seven years old, as some of the skills that need to be evaluated for APD diagnosis don’t develop until they’re around this age.

What treatment is available?

Each child needs individual treatment, and may need to see several specialists, including an audiologist and speech therapist. Treatment options include training sessions to improve listening skills and language therapy to improve understanding, says Dr Keith.

Children may also have great results wearing a personal FM hearing device in the classroom. The teacher wears a microphone which clearly transmits their voice to a small headset worn by the child. This cuts out background noise, making it easier for the child to focus on what the teacher is saying.

Research done by the University of Auckland recently has found that not only do FM aids provide immediate help so children can hear their teachers better, but long-term use may also significantly improve their auditory skills to the point where they can do without the device.

How can you help children with APD?

  • Try to cut background noise
  • Use simple sentences
  • Ask your child to repeat directions

Case study

Name: Laura
Age: 7

Laura used to lack confidence, find school work challenging and spend her time in a dream world.

“We used to call it ‘Laura Land’,” says her dad Grant. “She was away with the fairies.”

Today, Laura is a bright and chatty youngster who’s brimming with confidence and finding it much easier to pay attention. Since being diagnosed with APD and using an FM listening device, she’s made huge improvements, such as doing better in class.

“She wasn’t below average before, but had to work so much harder than everyone else to understand things,” says Grant. “Maths was particularly challenging – she needed to see things visually and didn’t always do very well. But she recently came top of her year in a maths test, which was fantastic.

“It’s incredible what a difference the listening aids have made.”

Laura has had problems with her ears since she was little, suffering from numerous ear infections, and when she started school, teachers worried she might have a hearing problem as she didn’t seem to be paying attention. Tests showed her hearing was fine, but an audiologist said she could have APD, which Grant and his wife had never heard of.

They had to wait until she was seven to get her ears tested by a specialist, and it was a relief to learn she did have the condition. “It was good to know what was wrong and that something could be done about it,” says Grant, who was also relieved the government paid for Laura’s FM device.

“It means she can hear, she’s just unable to process the information the same way as other people do. It’s like a door has been opened to a whole new world for her.”

by Donna Fleming
New Zealand Woman’s Weekly (27 June 2011)