OT and Slowed Auditory Processing Speed / Disorder

What Can You Do?

Judy Benz Duncan, Occupational Therapist

For many children, auditory processing speed, often combined with an auditory processing disorder, impact how and what they hear. Processing speed refers to the pace that you are able to take in information, understand it, and then respond.

Impact of Slowed Auditory Processing Speed

The information coming in can be visual (letters, numbers, actions) or auditory (language and sounds). Some children have faster processing speed than others, which has nothing to do with how smart the child is, it just refers to how fast they are able to take in, interpret, and act on the information.

Struggling with slowed processing speed however, can affect a child’s ability to interact, or perform tasks related to learning, school activities, and in their daily life. Slowed processing speed impacts the ability to learn at all stages of a child’s development. It can make it harder to achieve mastery of the basics of reading, writing and counting, or affect the inability to perform basic tasks quickly and accurately.

Slowed Auditory Processing and Background Noise

Having slowed auditory processing speed is usually aggravated when there is background noise present. Most situations come with their own degree of noise, especially a playground, lunch-room, a party, the gym, the grocery store, at home or in the car with music or the tv playing. Even the hum of the refrigerator or clunks from the dryer is enough noise to interfere. The “noise” can also come from your child’s brain trying to remember step one of a direction, when you are already on step three or four.

Blank Stares and “What?” or “Huh?”

If you find that your child often responds to you with a blank stare, a “Huh?”, or “What?”, or does not seem to be able to follow a simple direction (although to them two to four steps in the direction is not so simple). For example, you are getting ready to leave the house, and you ask your child to “finish their breakfast and put your bowl in the sink, get their coat, and meet me at the door.” Trying to work their way through multiple steps in a direction usually results in increased frustration, stress, and maybe even sensory overload.

Slow auditory processing speed makes it extremely hard to take in all the information quickly enough to be able to finish following through to complete the directions and task.

Slowed Auditory Processing Speed

Signs and Symptoms

Signs and symptoms can vary from mild to severe. If you feel your child is having auditory processing difficulties, look over and see how many of the following your child displays and which may indicate further assessment:

o   Becomes overwhelmed by too much information at once

o   Needs extra time to act or make a decision

o   Is easily distracted by sounds or noise

o   Avoids noisy environments

o   Their behavior, attention, and performance improve in quieter settings

o   Has difficulty following simple directions (especially if multi-step)

o   Do they say, “Huh?” or “What?” often?

o   Do they “mishear” or “misunderstand” words or sounds?

o   Do they seem to have more difficulty hearing where there is background noise?

o   Do they seem to miss out on understanding directions given?

o   Do they often seem inattentive to what’s going on around them?

o   Do they have difficulty interacting in social or group situations?

If you choose, have your child tested for auditory processing disorder (APD) or central auditory processing disorders (CAP) by a professional audiologist. Usually children are six-seven years old before this type of testing. Usually when a child is of school-age, the auditory processing challenges may compromise their success on academic work.

The only way to accurately diagnose the condition is with a battery of tests, including the CAP (central auditory processing test), performed by an audiologist who monitors the child’s hearing as he or she listens to words and sentences as background noise is slowly increased and to instructions spoken at faster speeds.

OT Suggestions for Activities & Strategies for Slowed Auditory Processing

• Reduce any background noise when you can

• Have your child look at you when you are talking to them

• Speak at a slightly slower rate and increased volume

• Speak clearly and try to pronounce each word so that you are not using blended or slang words

• Present directions one step at a time, allowing time for your child to understand what is expected before giving the next direction

• Reduce the number of words given in your directions – make it simple

• Try not to hurry your child, especially when they are trying to get their thoughts in order

• Call their name before you start speaking to them

• Provide a quiet space for play or work activities

• Provide written or visual directions or memory-type cards to help your child understand the schedule or sequence for the activity

• Ask your child to repeat the directions back to you (can do with each step, or as they are able, for 2-3 steps at a time)

• Try to keep with a set routine for some tasks (like what needs to be done before leaving for school, or what to do to get ready for bed)

• Encourage organization – if they are trying to remember the directions while also trying to find what they need, they can easily become overwhelmed and “forget” what they need to do next or what they are looking for

• If in Pre-school through grade school, try speaking with the teacher/staff about altered seating where they will be less distracted (sitting in the front, sitting with back to window, sitting where they cannot see what’s going on in the hall)

• Teach your child that it is ok to move to a quieter place, or to ask for the music to be turned down, etc, when they feel they cannot hear or that they are too distracted to focus on what they are working on

• Provide activities that promote:  Auditory discrimination (telling one sound apart from another, and trying to determine what each of the sounds are that they may be hearing at once) and Auditory memory games

Some Game Suggestions:

• Mother-May-I Game or Simon-Says Game (Start with giving one direction, like “put your hand on your head,” then move on until you are asking for 2-3-5 or more steps in your directions, such as “raise your right arm, take one step forward, turn around”

• Letter Tile / Block Hunt (Ask for your child to find specific letters – start with one, then ask for 2 or 3 or 4 at a time for them to hear and remember)

• Treasure Hunt (Gather several items and put in a box or bucket – ask your child to find 1 item, then ask for 2, 3, 4 at a time for them to remember and look for – for example, “can you find me a toy car, a block, a stuffed animal, a red ring,” and so on); if your child is able, ask for them to find the items from around the house, so that they need to travel from room to room and remember what they have been asked for

• Story Time (If you are reading a story, ask your child to tell you what you just read before moving on to the next page; ask a few questions about what is happening in the story to see how much they are taking in and understanding)

• Recall and Repeat (Ask your child to remember colors or animals and repeat them back to you, such as “here is a red, blue, yellow car – what colors did I just say?” – or “you have a cat, dog, bunny, horse, stuffed animal – can you tell me what animals I just said?”

• Take a Message Game (Ask your child to go tell their mom or dad, or brother, etc, a message from you – make it simple to remember! Practice this skill on a regular basis

• Listen Close (if you have a few toy music instruments, try to have your child identify which one you are playing without them looking; or let them sit quietly and try to name all the house sounds that they are hearing

• These are just a few ideas that you can start with – Take the time to check out on-line all of the auditory processing activities and games that are available – there are many free to download pages, as well as special kits and packets full of great learning sheets and activities!

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