Talk:Auditory processing disorder

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Auditory processing disorder article · Talk page · Research papers

Merging Listening problems" into Auditory Processing Disorder

Auditory processing disorder (APD) is about having problems processing what you hear, or having listening problems. APD is the listening disability dolfrog (talk) 17:38, 24 April 2010 (UTC)

• And the listening problems described for cognitive reasosns are the result of having APD dolfrog (talk) 16:15, 5 May 2010 (UTC)

Not worth merging. Firstly, the Listening problems article is largely about a different entity: people whose processing is fine, but who aren't focused on the task because of personal agendas or acquired bad listening habits. Secondly, I'm not even sure the content is worth keeping; it's not a multiply-sourced neutral take on listening problems, but gives a presentation of the main theories of a single book - J. Dan Rothwell's In the Company of Others - as if they were generally accepted fact. Gordonofcartoon (talk) 23:44, 6 May 2010 (UTC)

• • Gordon I would go along with that dolfrog (talk) 18:55, 7 May 2010 (UTC)

Behavioral problems

I 'removed tend to have behavioral problems' as I question the accuracy of that statement. my understanding is that behavioral problems tend to only come in to play when its co-existing with something like ADHD and Autism can we verify that this characteristic exists with people that only have CAPD Tydoni (talk) 20:40, 4 July 2010 (UTC)

I'm not going to revert, but if someone tells you "turn left into the station" or "lift higher above the washer" and you listen "turn right into the station" or "lift lower above the washer", you're going to be accused of behavior problems. Your confusion may well lead to other problems; lacking proper reinforcement, I can see how APD could lead to a poorly developed Executive Function skillset, resulting in a (somewhat correct but misleading) diagnosis of ADHD. htom (talk) 02:13, 7 January 2011 (UTC)

Confusing cause and effect?

Those who have APD tend to be quiet or shy, even withdrawn from mainstream society due to their communication problems, and the lack of understanding of these problems by their peers. -it's uncited and it can be the opposite - shyness and withdrawal causing hearing problems, not the other way around. This problem looks very similar to problems faced by language learners who cannot recognize sounds of the foreign language, simply because their ears are not trained to recognize them.--Ancient Anomaly (talk) 01:49, 7 January 2011 (UTC)

It's not a hearing problem, it's a listening problem. The ears are working fine, the mixups occur later in the language processing center -- and it can have the consequences you describe. Hearing (loud, quiet sounds; high, low pitchs) will test fine. htom (talk) 02:17, 7 January 2011 (UTC)

So? Are you trying to refute my argument or are you just nitpicking?--Ancient Anomaly (talk) 01:47, 9 January 2011 (UTC)

Or if I wasn't clear enough - I meant that being a loner can cause problems with language processing, because recognising the sounds and words of the language needs practice like everything else.--Ancient Anomaly (talk) 02:37, 9 January 2011 (UTC)

I agree that a lack of exposure can cause the auditory system not to recognise phonemes (and thus words) correctly. That's not the problem with APD. Words that are known and used by the victim, both in listening and speaking, are mis-recognised when presented to the ear as other words (sometimes words with tangential association) in the victim's vocabulary that were not presented to their ear (their ear (and ours) hears the word "left" and their mind listens to the word "port" instead, to make an example, or hears "port" and listens "wine"), or words are not "listened" at all, they are just deleted from the data stream. If the external ear is at the lowest point of the processing tree, the problem (seems) to be occurring at a level (or levels) higher than that of phoneme recognition, at or above the level of word recognition. There's a similar problem that people can have of word confusions and omissions in reading and writing, and whether this is the same problem and/or cause as APD is unclear, at least to me. Clearer? htom (talk) 04:52, 9 January 2011 (UTC)

You are obviously talking about some different disorder. --Ancient Anomaly (talk) 04:11, 11 January 2011 (UTC)

APD is an umbrella term, covering a number of particular problems with a number of causes. I'm pointing out a flavor of it that doesn't fit your description of cause, but does fall into the APD diagnosis umbrella (at least the hearing form of it.) I think you're trying to over-simplify the complexities involved, which will not help any of the patients trying to learn about what their doctor told them, especially if they know they do not have the particular cause you describe. Yes, that can be a cause; it is not the only possible cause, and not the only possible effect, either. htom (talk) 22:07, 11 January 2011 (UTC)

I'm sorry, but all sources and everything I was able to find supports my version i.e. the problem with recognizing sounds and words, not hearing synonymes instead or anything similar.--Ancient Anomaly (talk) 22:16, 11 January 2011 (UTC)

[[1]] htom (talk) 01:05, 12 January 2011 (UTC)

So?--Ancient Anomaly (talk) 19:38, 22 January 2011 (UTC)

I'm sorry that your research shows that it's all phoneme recognition. You'd think that if that was the case that they would call it something like that, rather than saying it was a general descriptor including that. You could look at Aphasia or Paraphasia or (especially, perhaps) Transcortical sensory aphasia. htom (talk) 23:53, 22 January 2011 (UTC)

Why? This article is not about aphasia. As I said before, you are talking about something else.--Ancient Anomaly (talk) 17:42, 23 January 2011 (UTC)

APD is an umbrella term for a variety of disorders that affect the way the brain processes auditory information. It does not include language disorders. People suffering APD have trouble with understanding spoken language, because they can't hear the phonemes. It's not aphasia, paraphasia or anything of the sort.--Ancient Anomaly (talk) 17:52, 23 January 2011 (UTC)

And I could not find anything about the "variety of disorders", so I'm tagging it with {cn}--Ancient Anomaly (talk) 17:57, 23 January 2011 (UTC)

<out You should really read the entire paper, already cited: http://www.asha.org/docs/html/TR1996-00241.html htom (talk) 03:01, 24 January 2011 (UTC)

You should read it. It indeed mentions aphasia, but not as a part of APD.--Ancient Anomaly (talk) 19:03, 24 January 2011 (UTC)

From the cited paper:

A Central Auditory Processing Disorder (CAPD) is an observed deficiency in one or more of the above-listed behaviors. For some persons, CAPD is presumed to result from the dysfunction of processes and mechanisms dedicated to audition; for others, CAPD may stem from some more general dysfunction, such as an attention deficit or neural timing deficit, that affects performance across modalities. It is also possible for CAPD to reflect co-existing dysfunctions of both sorts.

and:

Language Use

The impact of CAPD on language use is particularly evident in spoken language comprehension. Adults with CNS pathologies and children with developmental language disorders or learning disabilities frequently have difficulty comprehending spoken language, even when they have the necessary language knowledge. If an individual with one of these conditions were to have a central auditory processing disorder, such a disorder would certainly contribute to the comprehension difficulties. For example, patients with right hemisphere lesions of temporal-parietal areas have difficulty analyzing spectral information and thus may lack the intonational information that assists in language understanding.

It is important to note, however, that in contemporary models of language use, the eventual comprehension of a spoken utterance depends upon much more than the processing of acoustic signals. The listener must not only identify, or estimate, the acoustic aspects of the signal, but also must interpret its linguistic value. This requires the activation of lexical representations, grammatical analysis, and judgments of meaning-in-context, to name just a few of the operations invoked in typical language processing models. Working with such models, aphasia researchers point to deficits in resource allocation (McNeil, Odel, & Tseng, 1991), attention (Robin & Rizzo, 1989), or computational inefficiency (Shapiro & Thompson, 1994), as well as temporal processing, in their explanations of language comprehension difficulties. A similar range of explanations can be found in the developmental language literature as well.

The relative importance of “bottom up” (i.e., signal-related) processes and “top down” (i.e., centrally emanating) processes undoubtedly varies among individuals and utterances, depending upon such factors as brain organization, content familiarity, and signal competition (Cole & Jakimik, 1979; Klatt, 1979; Lass, 1984; Marslen-Wilson, 1987; Marslen-Wilson & Welsh, 1978).

Because language comprehension is determined by a number of different factors, clinicians should be cautious in attributing language comprehension difficulties to CAPD in any simple fashion. Likewise, diagnoses of CAPD require comprehensive audiologic assessment and cannot be made solely on the basis of poor comprehension of spoken language.

and

Approach #1: Enhancing Language Resources. Understanding spoken language depends not only on the acoustic signal and its properties, but also on what the listener brings to the listening situation. Listeners routinely use their knowledge of phonology, grammar, and vocabulary, as well as their world knowledge, to “fill in the blanks” of a speech signal. This capacity becomes even more crucial when signal properties are degraded because of auditory system deficiencies. For example, knowledge of comparatives, conjunctions, and other cohesion devices may be particularly useful in the processing of spoken discourse, and intervention could be directed to the learning (or recovery) of these forms (Wren, 1983). It may also prove useful to prepare clients for upcoming lessons, conferences, and the like by teaching any new vocabulary they will need. The information obtained from a speech-language assessment will help the clinician to determine what areas of language to target in intervention.

Once language forms are learned (or recovered), clinicians must also help clients use this knowledge, reliably and automatically, to interpret acoustic signals. Because much of what constitutes central auditory processing is preconscious, occurring without effort or awareness, this intervention goal cannot be met simply by encouraging clients to use what they have learned. Clients will also need opportunities for extended practice with newly learned (or recovered) grammatical patterns or words in order to improve their efficient use of this knowledge in speech processing (Casby, 1992; VanLehn, 1989).

There are some processing difficulties that cannot be addressed by increasing the availability of, or access to, language knowledge. Virtually all individuals with CAPD, in some or another situation, experience such signal degradation that their language resources are not automatically triggered. To assist with these occasions, clinicians can help clients with CAPD learn explicit comprehension strategies. By consciously focusing on crucial aspects of the spoken signal such clients can improve language processing. For example, they can learn to monitor their level of comprehension, pay greater attention to specific speech sounds, use prosody and sentence structure to predict degraded message elements, or deduce word meaning from context (Miller & Gildea, 1987).

Approach #2: Improving signal quality. The second approach to intervention for individuals with CAPD is directed towards improving the quality of the acoustic signal. One way this goal can be achieved is by reducing competing acoustic signals in the listening environment — that is, by reducing background noise and reverberation time. Another way signal quality can be improved is by boosting the intensity of the signal through preferential seating and the use of assistive devices such as FM systems or soundfield amplification. Devices such as these should be evaluated by an audiologist to ensure optimal fitting and to minimize possible detrimental effects (American Speech-Language-Hearing Association, 1994a).

Finally, the quality of linguistic signals can be improved by having communication partners, such as teachers or spouses, speak more slowly, pause more often, and emphasize key words (Ellis Weismer, & Hesketh, 1993; Keith, 1981). Visual aids such as gestures or graphic displays may also prove useful to speech understanding as long as the cues are readily interpretable. Although there has been some enthusiasm for sound control approaches (e.g., occlusion of the weaker ear), there is no theoretical or empirical support for their use.

and:

Parallel difficulties in clinical decision making arise in the treatment of the adult with cognitive/linguistic disorders, (e.g., aphasia). Language comprehension problems in this population could result from memory and attention deficits, from impaired access to language knowledge, or from difficulties in registering the temporal properties of the speech signal. In fact, all of these factors may be combining to produce the behavioral outcome.

One might argue that if the client performs normally with nonverbal stimuli in tasks with competing signals, basic signal processing capabilities are not likely to be the problem. This argument assumes, however, that verbal and nonverbal assessment tasks are perceptually equivalent and are processed by the same auditory processing mechanisms—an assumption that is still a matter of debate. The situation is no better if the client has difficulty with the nonverbal stimuli. One cannot conclude that signal processing is therefore the primary explanation for failure to comprehend spoken language. Inadequate mastery of language could still be a major contributor.

Relative measures of auditory function, such as ear differences, monaural versus binaural differences, and message-to-competition ratio differences, may assist the clinician in determining the relative contributions of auditory-specific versus more generalized processes. For example, auditory dysfunction that is limited to one ear may manifest as an ipsilateral or contralateral ear deficit, whereas deficits in general processes would be likely to affect performance from both ears. In many cases, however, the evidence is not clear, and decisions about the relative contributions of auditory versus language or other general processes must remain uncertain.

I'm trying to maintain good faith, but it really seems to me that your understanding of the problem is very different way than the experts. You seem think it's solely that people have not been trained to hear language elements; they seem to think that that is one of many potential problems involved. htom (talk) 21:38, 24 January 2011 (UTC)

It isn't. You seem to think that this is a language problem. It isn't. People with APD have problems with comperhension because they can't hear well. Everything, including this "paper" agrees with me on that. Yes, they don't know what causes it, but everyone except you seems to agree that APD is a hearing problem.--Ancient Anomaly (talk) 03:02, 26 January 2011 (UTC)

Compare and contrast, please, the bold and italic parts below of the first quote above. You seem to be saying the italic part is not there:

A Central Auditory Processing Disorder (CAPD) is an observed deficiency in one or more of the above-listed behaviors. For some persons, CAPD is presumed to result from the dysfunction of processes and mechanisms dedicated to audition; for others, CAPD may stem from some more general dysfunction, such as an attention deficit or neural timing deficit, that affects performance across modalities. It is also possible for CAPD to reflect co-existing dysfunctions of both sorts.

Auditory Processing Disorder (APD) is a listening disability or having problems processing what you hear all sound which includes the human sound communication system speech, sounds of nature, sirens, alarms etc. APD is not a hearing impairment. dolfrog (talk) 00:11, 21 June 2011 (UTC)

No VPD?

Where's the visual equivalent of this condition, visual processing disorder? Strangely enough there's not an article for it on here. 70.29.244.213 (talk) 06:34, 10 February 2012 (UTC)

There are many visual processing, and other sensory processing issues, may be you could find the relevant research and create the article. dolfrog (talk) 17:53, 23 June 2012 (UTC)

Proposed Merger with King-Kopetzky syndrome

I feel that King-Kopetzky syndrome should be merged into this article. From what I understand, King-Kopetzky syndrome is an outdated name for Auditory Processing Disorder, so basically, there are two articles abou the same condition.CircleGirl (talk) 04:39, 9 December 2018 (UTC)

I have now merged the two pages.CircleGirl (talk) 00:50, 15 December 2018 (UTC)

Removal of prevalence data

I contributed epi data earlier that was removed, even though the cited sources are excellent source of information.

The removed information stated: " Although the actual prevalence is currently unknown the prevalence of APD in children has been estimated at 2-7% in US and UK populations . APD prevalence is much higher in the elderly, and increases with age."

This paragraph was replaced by a sentence saying there were no good epi studies. Perhaps they could have said insufficient and asked for other sources. The Framingham Heart Study cohort is a highly respected study. We could link to it. — Preceding unsigned comment added by UIowagrad (talk • contribs) 16:43, 11 January 2019 (UTC) UIowagrad (talk) 16:45, 11 January 2019 (UTC)

User:UIowagrad Okay I see you added those details here [2]

And than you removed them yourself here [3]

Doc James (talk · contribs · email) 05:59, 22 January 2019 (UTC)

User:UIowagrad did you mean to do this?[4]

Looks like you are editing an old version of the page. I adjusted. Doc James (talk · contribs · email) 21:08, 22 January 2019 (UTC)