Understanding Auditory Processing Assessments

What is auditory processing?

Auditory processing (or central auditory processing) is the way the brain uses the information it receives from the ear. The brain analyzes the pitch, loudness, and duration of the incoming message to compare with previously stored information. If it finds a ‘match’ you understand or recognize what you hear.

What is an auditory processing disorder?

Sometimes something interferes with that process. Delays in the maturing of the nervous system, neurological problems, or disease may prevent the brain from interpreting sound correctly. When that occurs, there is an auditory processing disorder (APD). Although children are most often referred for AP problems, adults can also have the disorder.

Are there any symptoms that suggest an auditory processing disorder?

Someone with auditory processing problems may:

have difficulty hearing in noisy situations find it difficult to learn challenging vocabulary words or a foreign language misunderstand similar sounding words (i.e., time vs. dime or boost vs. boots) be unable to follow multi-step instructions be easily distracted when other sounds are present behave as if there is a hearing loss despite normal hearing have a history of ear infections, fluctuating hearing loss, or colds/allergiesHow can you know whether an individual has an auditory processing disorder, or some other problem?Because someone with auditory processing disorders may act like one with learning or behavior disorders, a diagnostic evaluation is necessary. The AP assessment examines other possible explanations so that an appropriate management plan can be developed.How do we begin the process?First, it is important to obtain a complete history including medical, developmental, family history of hearing or learning problems, and educational data, as well as a description of the types of difficulties the person is having. Routine hearing tests will be done to rule out problems with hearing sensitivity. We test hearing using tones and speech and evaluate the way the middle and inner ear works using specialized tests called otoacoustic emissions and tympanometry.If there is a loss of sensitivity or a medical problem, we will recommend medical management and may recommend hearing aids to compensate for any hearing loss. If hearing is normal and the hearing history or initial interview suggests that an auditory processing disorder is a possibility, we will ask that questionnaires be completed to help us understand how the person uses hearing in different situations. If other testing has already been completed, we will ask to review those results. We may request that additional testing be completed by other professionals, such as a speech specialist or educational psychologist, so we have a complete picture of the person’s abilities.If we continue to suspect an auditory processing disorder, an audiologist will perform other tests in a sound booth using calibrated equipment. Testing will investigate the specific problems identified during the screening process. What other kinds of tests are performed?Tests focus on four primary areas of auditory function. They assess how well the listener understands: when the information presented to each ear is different (dichotic listening) when parts of speech are missing or distorted (auditory closure) when the time patterns vary (temporal processing) when different parts of the speech signal are presented separately to each ear (binaural fusion). In addition, procedures that objectively assess the central auditory nervous system may be used. Only those tests necessary to fully understand how the person uses hearing will be performed. What happens after the tests have been completed?When an APD is confirmed, we will explain the test results and provide individualized recommendations. Suggestions might include: environmental adaptations appropriate seating tips for organization methods for getting and maintaining attention communication techniques therapy programs methods for compensating All suggestions will be based upon the strengths and weaknesses identified during testing. We will provide a written report explaining the problems investigated, the results of all tests performed, and the reasons for all recommendations.