There is more to listening than just hearing.
A miraculous process that begins in the womb, learning to communicate is a vital part of expressing oneself and of understanding and interacting with the world. A child’s ability to listen well affects every aspect of his or her life. But for some 1.5 million children in the United States who have normal hearing and intelligence, communication and language are blocked. Words are jumbled and distorted. These children have a hard time following directions and become frustrated in trying to make themselves understood, which often leads to unruly behavior, poor school performance, social isolation, and low self-esteem.
Auditory Processing Disorder (APD) affects the brain’s ability to accurately process the sounds of speech, which in turn impedes the ability to communicate. Experts are just beginning to unlock the mystery of this confounding condition. As a result, APD is often undiagnosed or misdiagnosed. But hope is here. Now veteran speech-language pathologist Lois Kam Heymann offers the first practical guide to help parents dramatically improve the listening and language skills of their children, whether they have a diagnosed auditory processing disorder, slow language development—or simply need practice listening. Inside this reassuring, action-oriented book you’ll find
• easy-to-identify milestones to help parents pinpoint challenges that may arise during each stage of their child’s development from birth to age eight
• the tools and checklists needed to assist parents in recognizing APD early
• tips to distinguish APD from other listening/learning disorders, including ADD, ADHD, LPD, and PDD
• methods to encourage a child’s natural listening abilities through books, stories, nursery rhymes, songs, lullabies, toys, and games
• home techniques to hone a child’s auditory processing—whether he or she has severe APD limitations or just needs to build listening “muscles”
• specific suggestions on how to improve a child’s listening skills outside the home—at school, during after-school activities, even when at a restaurant
• an analysis of traditional classroom settings and effective ways parents can advocate for better sound quality
• guidelines for finding the right professionals to work with your child
With hands-on ways for improving a child’s ability to listen to instructions, process information, and follow directions, parents can turn simple activities into powerful listening lessons in only minutes a day. The bottom line: Learning how to listen in our noisy, complicated world is the key to a happy and engaged child.
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Lois Kam Heymann, MA, CCC-SLP, is a recognized leader in the treatment of children with listening, learning, and auditory challenges. As a private speech and language pathologist, she has more than thirty years of experience working with families and also serves as a consultant to hospitals and schools, including the Children’s Hearing Institute and more than a dozen school districts in and around New York City. A noted educator, Heymann teaches auditory therapy at the State University of New York at New Paltz and has presented hundreds of seminars and workshops nationally for doctors, speech and language pathologists, teachers, and parents. She lives in Rosendale, New York.
Chapter One
When Hearing Isn’t Listening:
The ABCs of APD
Margaret’s beautiful baby boy Billy Ray was six months old when she began to sense that something wasn’t right. Why didn’t Billy Ray look at her, even when Margaret took him in her arms and murmured his name? Margaret had a powerful sense that the sounds her little boy made, so different in pitch and tone from her first child’s coos and giggles were just, well, wrong. And Margaret rarely had any sense that her son was making his baby sounds in response to the things his mom said or did.
Her doctor assured her there was nothing to worry about. “Boys start to talk later than girls,” he explained. “Besides, Billy Ray is the second child in the family. His need to communicate with you is not as great.” Well, he’s the doctor, Margaret thought. Yet in her heart, she just couldn’t accept these reasonable-sounding explanations. Margaret felt deep down that Billy Ray should be responding more to her and her husband’s voices and the sounds and noises in their home. Based on her experience with her first child, she sensed that the pre-speech vocalizations Billy Ray made should be different from what they were. Reaching for a box of rice one afternoon at home, Margaret impulsively rattled it behind Billy Ray’s head. When he again failed to react, Margaret knew what she had to do. The following day, she had Billy Ray’s hearing checked, fully expecting that her child had a hearing impairment.
The results came back normal.
Undeterred, Margaret arranged for consultations with two separate pediatric neurologists. After a battery of tests and examinations with Billy Ray and a lengthy interview with Margaret, both doctors concluded that Billy Ray had pervasive developmental disorder (PDD). Margaret had never heard of PDD, a condition involving developmental delays of socialization and communication skills. She tried to be as upbeat as possible as each neurologist explained what PDD was and described a therapeutic preschool and the necessary therapy that would accommodate Billy Ray’s special needs. Margaret was grateful for the diagnosis—having one gave her something new to focus her efforts on—but worried that the doctors were sentencing her beautiful little boy to a life of isolation. Nevertheless, Margaret did the research, fought with her insurance company, and adjusted her family’s budget so that Billy Ray could attend the school and receive the therapy that both doctors recommended.
But by age two Billy Ray was still uncommunicative. Worse, as he grew from infant to toddler, Billy Ray’s inability to listen began to be an educational and social ball and chain for him. Frustrated by an invisible wall that complicated and confused nearly everything he was asked to do, Billy Ray cried and acted out a lot. Unable to state his own needs or understand what other boys and girls asked for, he pushed and grabbed for toys, upsetting his peers and testing his teachers’ patience. As his mother looked on helplessly, Billy Ray increasingly retreated into a world of his own. Instead of each new day offering a chance to grow, develop, and interact more meaningfully and happily with the world around him, Margaret, Billy Ray, and their family faced a daily struggle simply to cope.
Margaret could see how much it hurt and confused Billy Ray when he misunderstood and was in turn misunderstood, but she was at a loss as to how best to help her son. It felt as if Billy Ray was on the other side of a door, knocking for her to unlock it, and Margaret simply didn’t have the key. Increasingly Margaret worried that if she couldn’t find a way to open the door and lead Billy Ray out into the full, rich world of experience, her little boy would never be able to play and connect with his sister, make friends in school, fall in love, go to college, or live on his own. Margaret redoubled the hunt for the key. There must be something she’d missed, someone she hadn’t consulted. She made calls, quizzed other parents, scanned parenting websites and chat boards, and read and reread everything she could find about Billy Ray’s diagnosed disorder, PDD.
Along the way she happened upon a website that described yet another three-letter syndrome. When she read the symptoms of APD or auditory processing disorder, she could scarcely believe it. Here was the exact list of what Billy Ray was going through. Children with APD:
•Have trouble listening and hearing, especially in noisy environments
•Struggle to distinguish between similar-sounding words and sounds
•Don’t follow directions well
•Frequently ask for clarification and to have words repeated
•Do poorly in reading and reading comprehension, spelling, and other classes where verbal directions are key
•Fare better in independent activities and classes where listening isn’t a central requirement
One other item made her sit bolt upright:
•Are often misdiagnosed with other disorders such as ADD (attention deficit disorder), ADHD (attention deficit hyperactivity disorder), and pervasive developmental delay (PDD)
Intrigued—and hopeful that perhaps there would be more that she could do for Billy Ray if this was his true problem—Margaret started to look further and asked more questions of the growing list of specialists she’d already consulted. She felt she was on the path to discovering how to unlock the proverbial door for her son.
Margaret is certainly not alone in her search to help unlock the door to healthy development for her son. If you’re reading this book, you likely suspect that your own child has one of these three-letter syndromes, or you already have a suggested diagnosis in hand and are trying to digest as much information as possible going forward.
Generally speaking, auditory processing disorder is a term for a group of conditions in which the parts of a child’s brain tasked with turning sound into language and hearing into listening don’t do their jobs right. How this issue develops and at what age it most often does so is little understood—we’ll discuss this more below—but it is estimated that between 1.5 million and 2.5 million children a year are diagnosed with this disorder. Because auditory pathways leading from the ear into the brain and the auditory processing centers within the brain itself are continuously developing throughout infancy and early childhood, it’s not possible to screen for and definitively establish the presence of an APD in a child until she or he is six or seven years old. A specific diagnosis detailing the magnitude of the APD as well as any related or concurrent problems such as ADD or ADHD and the right course of therapy and treatment cannot in turn be made until the child is seven or eight. But there are clearly many, many more younger children dealing with these listening difficulties. We think some children are even born with this issue. Unfortunately, because the development of auditory processing skills is linked with a growing child’s use of language and increasingly complex communications and social interactions and cannot be accurately measured until those skills develop, parents have to go without formal diagnosis and intervention for too long. The ideas in this book will help you understand what’s at stake in your child’s listening development and in turn help your child from the moment you begin to suspect that there may be a problem. You don’t need to wait for a formal diagnosis to begin to help.
THE ABCS OF APD
In broad strokes, it’s easiest to understand hearing—the process of experiencing sound—as a...
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