Why Auditory Delays Are So Easy to Miss

December 24, 2020 The Ed Psych Practice No Comments Referrals Auditory Delays, Central Auditory Processing Disorder COPD, Communication, Language Processing Difficulties, Learning Difficulties, Occupational Therapy, Processing Sounds, Spectrum Disorder, Speech Therapy, Spoken Language

Takeaway: Auditory delays (i.e., hearing problems) are tough to spot because their symptoms are often quite subtle. And they can be confused with other developmental differences like dyslexia, ADHD, developmental language disorder, etc. But with the right kind of specialist, your child can learn to reverse and/or adapt to these hearing challenges.

Most deep-rooted challenges first pop up as unusual behaviours. Take Emily, for example.

Any healthcare specialist knows to pay attention to unusual behaviours. In the case of 3-year-old Emily, her parents took her to a child psychologist because she seemed disconnected from the world and rarely showed any affection.

Unusual behaviours can often be traced back to more than one cause, though.

Emily was no exception, and her psychologist soon noticed some clues. Emily was a premature child, had breathing issues at birth, and showed some developmental delays early on. She started crawling, walking, and talking very late. She didn’t smile or hug her parents until after turning 3. After a bit more investigating, it looked like Emily might have Asperger’s syndrome, but she also had significant problems with her hearing.

When there are multiple causes, some of the less obvious ones might get overlooked. And this often happens with hearing issues.

For example, Emily wouldn’t get startled by loud noises. And when her parents spoke to her from far away, she seemed not to hear them, or lost interest halfway through a sentence. But these differences weren’t as obvious as her not showing affection to her parents. (Note: auditory delays also get overlooked in children with other differences like dyslexia, developmental language disorder, etc.)

So, what are ‘auditory delays’? They’re when a child’s brain takes longer than usual to learn how to process sounds.

All children’s brains pass through a largely similar process of development. But for some, this development is slower or slightly different. With auditory delays, there’s no problem with the mechanics of hearing (i.e., the ear, the inner ear, and so on). Rather, the brain struggles to process what the ears send it. So, a child with auditory delays might have problems telling sounds apart (‘near’ sounds like ‘fear’), separating speech from background noise, remembering what she hears (i.e., her memory for sounds), or keeping speech sounds in order (saying ‘ephelant’ instead of ‘elephant’). We notice these same difficulties with an auditory processing ‘disorder’, but with auditory delays, the problem often resolves itself over time. That’s because children’s brains continue to evolve well into adolescence, and so often ‘catch up’ by the time they’re adults.

But even if auditory delays can resolve themselves over time, they still cause damage. And that’s why it requires to be diagnosed quicker.

Even if they’re temporary, these delays can make school and socialising so much harder for your child. Imagine her trying to keep up with her classmates when less information is getting to her brain. Or her trying to navigate complex primary-school social life without the cues other people have to guide them. Chances are she’ll feel isolated and unhappy, finding it hard to make and keep friends. And even a few months of this can have long-term effects on her, because of how pivotal childhood can be.

The solution? Learn to spot the common signs of auditory delays.

Your child might pass basic audiometry tests (i.e., measuring the physics of sound — things like frequency thresholds, intensity, pitch), but she still might have auditory delays. So, look for these signs, instead.

Problems hearing people when in a crowded environment like a noisy classroom. She might find it hard to separate her teacher’s voice from the voice of her friend chattering next to her.
Struggling to stay focussed. If she’s confused by multiple voices, then she might find it hard to stay engaged in class. And so she could come off as distracted or uninterested a lot of the time. This seeming distractedness is a big sign of a deeper issue at play. It’s often assumed to be ADHD, but problems with hearing can cause the same kind of behaviour.
Difficulty remembering instructions. Since she struggles to process and remember speech sounds, following instructions becomes extremely hard. She might do the wrong thing or miss out critical details. And she might also keep asking for people to repeat themselves. Teachers can get irritated if they assume she just ‘never listens.’ And her friends might get frustrated that she takes ages to learn the rules of a new game.
Unclear speech sounds. If she’s having problems processing what she hears, it could translate into problems with her speech, too. Young children might start speaking late, and older children might seem like they’re mumbling or talking too loud/soft. Remember, if she can’t hear herself speaking, how will she change her speech patterns?
Poor vocabulary and language. Hearing problems make it harder to learn a language. With vocabulary, it’s easy to learn words like ‘dog’, ‘twelve’, and ‘run’ — which are visible and concrete. But it’s harder to learn words like ‘envy’ or ‘satisfied’. And it’s near impossible to combine these abstract words into long sentences.

Thankfully, there’s good news. Once we’ve spotted auditory delays, we can set goals and evolve a plan. That’s what happened with Emily (from earlier).

You can significantly improve your child’s life by giving her the right help at the right time. For example, Emily’s therapist came up with a list of goals for her. Occupational therapy focussed on improving Emily’s core strength and motor skills. Speech and language therapy focussed on improving her pronunciation, her ability to separate speech from background noise, and her ability to take in and remember instructions, Speech therapists worked on Emily’s social skills — specifically, how to take turns talking and listening during conversations.

In addition to these major therapies, there are simple tactics we can teach.

For example, give your child only one instruction at a time. And use short, simple phrases when giving these instructions. After a while of doing this, gradually increase the number of instructions and then the length of the phrases. For example, you’d begin with ‘put your toys away.’ Later, you’ll make it ‘put your toys away and make your bed.’ And so on. You could also experiment with showing pictures or gesturing when talking to her — to help supplement what she’s hearing. And to minimise background distractions, sit close to her when talking, or take her to a quieter place for longer conversations.

The idea here is that while her therapist(s) are working to improve her skills and abilities, she can learn to maximise the skills she currently has.

The trick is to adapt your communication style and try to change her home and school environments too. At school, for example, you can ask her teacher to seat her near the front of the class, but to the side. That way she can see both her teacher and her classmates as they speak. And once her classmates know about her specific challenges, they too can modify their speech patterns to help. They might start turning to face her when they’re speaking, speak more clearly, and slow down their pace. A good speech and language therapist can give you a list of other steps you can take to help your child.

Are you concerned that your child might have auditory delays? Consider consulting a specialist for support. The Ed Psych Practice offers consultation, advice, and problem solving for parents, nurseries, schools, and colleges, in London. We have psychologists and therapists who can help assess your child and offer guidance and support.

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

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