Auditory Processing Difficulties: When Your Child Listens But Can’t Understand

July 20, 2020 The Ed Psych Practice No Comments Referrals Auditory Perception, Auditory Processing Difficulties, Auditory Training, Auditory Working Memory, Decoding Language, Decoding Speech Sounds, Learning Delays, Speech and Language Therapy

Takeaway: Auditory processing difficulties pop up when a child has trouble processing sounds. So, she can hear fine but her brain struggles to interpret what she hears. Thankfully, there’s a lot we can do to help: (1) Start speech and language therapy, (2) Teach her coping skills, and (3) Modify her environment.

Children can sometimes try their best to listen, but still not get what’s being said.

Being a parent often means playing the role of detective. Say you notice that your child seems to lose focus easily. You start to worry that she might have attention issues. Then you notice that she struggles to follow instructions, and you remember how she took ages to learn nursery rhymes when she was younger. So, does she have a learning difficulty? But what about the fact that you have to repeat yourself often when talking to her? And the fact that background noises make it harder for her to follow what you’re saying. Maybe it’s that she can’t hear? You feel that you’re almost right, but not quite. And then you strike gold: the issue isn’t that she can’t hear — it’s that she can’t understand what’s being said. Now, what’s that about?

Auditory processing disorder is a condition where a child can hear just fine but struggles to process what she hears.

So it’s really about decoding language and speech sounds. Her ears work just fine but her brain processes what she hears a bit differently. For example, she might find it hard to distinguish the word ‘hat’ from ‘bat’, or ‘near’ from ‘fear’. Or she might not hear the ‘gaps’ between words — so she ends up listening to a string of words bumping against each other to form nonsense sounds. And since it’s her brain that’s working differently, you could repeat yourself multiple times and she might still not register what you’re saying.

So, why does her brain have such a hard time processing speech?

Our brains cycle through four tasks when trying to understand what someone is saying. And a child with auditory processing difficulties finds one or more of these tasks challenging.

Telling sounds apart. She may be able to hear sounds but she can’t spot the difference between them — like in our ‘near/fear’ example above. This could make it harder for her to speak, too. She might mispronounce words or drop syllables — like saying ‘bay’ instead of ‘baby’. That’s why nursery rhymes can be a nightmare — because the rhyming and alliteration add to the confusion.
Separating speech from background noise. Telling sounds apart is just the first step. Next, she has to isolate speech from whatever other noises she hears. So, a loud classroom can be quite jarring because her brain is trying to figure out which sound it’s supposed to focus on.
Remembering what she hears. Even if she was to separate speech sounds from each other and filter out background noise, she’s still got to store what she’s heard. So her short-term and long-term memory for sound needs to be good. If not, her brain will forget bits of the conversation, which means it doesn’t have vital data to make sense of what’s being said.
Keeping speech sounds in order. If she can’t sequence what she hears, she’ll make mistakes like saying ‘ephelant’ instead of ‘elephant’. And maths could become hard if she starts switching the order of digits — like saying ‘43’ instead of ‘34’.

Children can have a range of auditory processing difficulties.

On one end of the spectrum, we have children who are severely affected. They might struggle to learn and use words, to put the words together to form sentences, and to understand the meaning of those sentences. They might also have a language disorder. But on the other end of the spectrum, the difficulties are milder. Here, a child might only have problems processing sound. So she’ll struggle only when there’s a lot of background noise, for example. And she might well outgrow her difficulty as her brain’s auditory pathways develop (they’ll keep evolving till she’s a teenager).

Spotting these difficulties is hard because the signs are often quite subtle.

As we saw with the ‘detective’ parent earlier on, we can interpret a child’s behaviour in many ways. So, if she’s easily distracted in class, is it because she’s got a short attention span? Or is it that she can’t separate a teacher’s voice and the background noise? And after trying for a bit, she gets frustrated and loses interest. These sorts of distinctions are hard to make, so you’ll need the help of a specialist.

Tests for auditory processing difficulties are different from regular hearing tests.

Remember, her ears are fine — it’s her brain that’s working differently. So, a regular hearing test done in a quiet room isn’t testing for the right things. Instead, we’ll need to alter the challenges. That means people speaking at different speeds, with multiple accents, and varying levels of clarity. We’ll also need to find out what kinds (and volumes) of background noise affect her. And we’d need to do sound-pattern recognition tests. Plus, it’ll help to test her speech and language skills, and her cognitive abilities (i.e., how does she think, read, remember, reason, pay attention, etc.?).

How can we help a child with auditory difficulties?

We can tackle the challenge on three fronts:

1. Speech and language therapy

Listening is a skill that can be developed with practice, and auditory training is the perfect practice tool. The idea is to have the child listen to different sounds (not just people speaking), which she’ll then have to identify. And then we give her feedback about whether she was right or wrong. This feedback loop will help her spot the nuanced differences in sound that she wouldn’t otherwise have learned. And as her auditory processing improves, we make the listening exercises incrementally harder. This sort of therapy:

Strengthens auditory working memory, so she gets better at remembering what she hears.
Speeds up auditory processing, allowing her to quickly recognise what’s being said and keep up with a conversation.
Sharpens auditory attention, making her better at separating what someone’s saying from the background noise.

2. Teach her coping skills

While we develop her auditory skills, we can also teach her how to deal with her emotions. For example, if she gets frustrated at not being able to follow along in class, it’ll help if she knows how to manage that frustration. And she can learn to break down seemingly unsolvable challenges into bite-size ones that she can actually tackle.

3. Adapting her environment

Small changes at home and school can help.

At home. If background noise is an issue, then you could try and change the acoustics of her room. Carpets and soft furnishings dampen distracting echoes, for example. And you can switch off TVs and other loud appliances that might get in the way of conversation.
At school. Teachers could wear tiny microphones and your child could have a speaker on her desk to help her hear better. And she could use multisensory learning where possible — images and graphics would work better than spoken instructions, for example. Also, her classmates can pitch in to help. They could make sure to get her attention before speaking, speak clearly (not too fast, not too slow), and repeat themselves (or use different words) if needed.

Does your child have auditory processing difficulties? Consider contacting a specialist.

The Ed Psych Practice offers consultation, advice, and problem solving for parents, nurseries, schools, and colleges, in London. We have educational psychologists and therapists, who can help.

Phone: +44 (0) 78 3344 7356
E-mail: Office@TheEdPsych.com