Auditory Processing Disorders

Problems following directions, understanding what people say, having trouble in background noise are common problems reported by people of all ages with auditory processing disorders. 

Some people with normal hearing or who use a hearing aid or cochlear implant, still may have trouble listening and understanding.  For children, it can make it difficult for them to learn in school and to learn to read. For adults, it can make it difficult to communicate with friends, family, and in work or community settings.  These problems can be really challenging when there is background noise.   

How do we begin assessing for Auditory Processing Disorders (APD)? 

At Memphis Speech and Hearing Center, we look at each patient as an individual. We begin by asking about current problems, medical history, education, and other therapies so we can fully understand what is happening.  Our testing begins with a hearing test so we can rule out hearing loss.  For patients wearing hearing aids or using cochlear implants, we will also test your devices to make sure they are working properly.   

How do we test auditory processing? 

Auditory processing tells how our brain makes a pattern of signals that represents each new word or sound that we hear.  These patterns are the building blocks of our vocabulary.  To test how well someone makes these patterns during everyday listening, we ask patients to tell us words when they are presented in special ways to demonstrate the brain’s processing abilities:  

Dichotic Listening Tests 

• Tests performance in each ear and the difference between ears when they are competing
• Tells us problems in the parts of the brain that are needed to join sounds coming from both sides of the head 

Speech Perception in Noise Tests 

• Tests how well words and sentences can be picked out when presented in background noise 
• Can compare performance in one ear to performance in both ears 

Frequency Pattern Tests

• Name and hum a pattern of tones that represent “high” or “low” pitches
• Tests ability to name a pattern of pitches and use words to describe it

Masking Level Difference Test

• Push a button when “beeps” are heard with a sound like a shower running in the background
• Tests how your brainstem uses timing differences to hear signals 

Listening in Spatialized Noise Test 

• Repeat sentences heard in “virtual” background with competing talkers

How do we diagnose Auditory Processing Disorder (APD)? 
 
APD is made up of several listening problems and at the Memphis Speech and Hearing Center, we try and find a patient’s specific auditory processing difficulty.

• One of the most common difficulties we see in patients is amblyaudia
  • Some call amblyaudia “lazy ear” because it means that one ear is working better than the other ear
• Dichotic Dysaudia is present when both ears have equal difficulty processing sounds   
• Patients with amblyaudia and dichotic dysaudia often report problems listening in noise 
• Some patients without amblyaudia or dichotic dysaudia only have trouble when listening in noise

Our goal is to focus on the specific problem so that we can help our patients.

What kind of therapy do we provide?

Auditory Rehabilitation for Interaural Asymmetry (ARIA) is a therapy that treats Amblyaudia by helping both  ears work together during listening tasks. ARIA has also been effective at helping some patients with Dichotic Dysaudia by helping them focus during challenging listening situations.  Speech understanding in background noise is also aided with ARIA and there are other programs that can assist with speech understanding that we recommend for our patients.   

Would a remote microphone hearing aid (FM system) be helpful? 

After ARIA and for many patients with Dichotic Dysaudia, we recommend use of a remote microphone hearing aid (RMHA) to boost auditory signals while listening during everyday tasks.  We can provide a recommendation for a RMHA and arrange the purchase of one if necessary.  See hearing assistance technologies.

What about patients with hearing loss who wear hearing aids? 

Auditory processing testing can be done while a patient is wearing amplification device/s.  Patients wearing two hearing aids can be assessed for auditory processing and if amblyaudia is identified, they can participate in ARIA to improve the balance between their two ears when processing information.  

Can testing identify other problems? 

Testing for auditory processing cannot diagnose but might suggest other problems such as attention deficit disorder, autism spectrum disorder, and working memory difficulty.  We address these issues and make recommendations for additional testing.