classroom management of a child with apd
TRANSCRIPT
By: Dr. Rebecca Lowe, Kate Tucker, Sara
Gammill, Tyler Russell, Randa Walls
Classroom Management of a Child with
Auditory Processing Disorder
WHAT IS MEANT BY AUDITORY
PROCESSING?
Katz, Stecker & Henderson (1992)
described central auditory processing as
"what we do with what we hear.“
ASHA 2005 TECH REPORT=
AUDITORY PROCESSING
(C) Auditory Processing = refers to the efficiency and effectiveness by which
the central nervous system utilizes auditory information.
How well the brain can process incoming auditory information.
ASHA’S
DEFINITION:
ASHA defines the Central auditory processes as: the auditory system mechanisms and processes responsible for the following
behavioral phenomena.
Sound localization and lateralization – where the sound is located
Auditory discrimination – ability in telling speech sounds apart
Bat vs bat bat vs pat same or different
Auditory pattern recognition – long vs short, high pitch vs low pitch
Temporal aspects of audition – snowdrift vs snow drift – timing aspects
Auditory performance with competing acoustic signals – ambient noise
Auditory performance with degraded signals – auditory closure
CAPD = refers to difficulties in the processing of auditory information in the CNS demonstrated by poor performance in one or more of
the above listed skills.
AUDITORY PROCESSING
DISORDER
(C) APD = a deficit in the neural
processing of auditory stimuli that is
not due to higher-order language,
cognitive, or related factors.
Although APD may co-exist with other
disorders - it is not a result of these
disorders.
• The failure to understand spoken language in a meaningful way without what is commonly considered a hearing loss is called an auditory processing problem .
• Other terms that have been used interchangeably include: Auditory Comprehension Deficit, Central Deafness, Central Auditory Processing Disorder, Word Deafness, and Auditory Perceptual Processing Dysfunction.
(Massaro, 1975; Kamhi, 2011; Understanding auditory, 2014)
Another way to explain….
• Myth #1: Auditory processing disorder is the same thing as being hard of
hearing. Fact: Most people with APD have no hearing loss. Speaking
loudly to them won’t help them understand what you’ve said.
• Myth #2: Auditory processing disorder is uncommon. Fact: Although
there is little research about APD, more is needed to determine how
common APD is.
• Myth #3: People with auditory processing disorder are not as intelligent
than their typically developing peers. Fact: Children with APD may score
lower on verbal IQ tests than their peers do, but does not mean that they
are not intelligent.
(Kamhia, 2011; Keith, 1981)
5 MYTHS ABOUT APD:
• Myth #4: Auditory processing disorder is another name for ADHD. Fact:
People with APD and ADHD may show similar symptoms, including being
easily distracted and inattentive. Many children diagnosed with APD may
also be diagnosed with ADHD.
• Myth #5: Children with auditory processing disorder are lazy and appear to
be rude. Fact: Kids with APD may appear to be ignoring others. Their
difficulty processing auditory information causes this behavior.
(Kamhia, 2011; Keith, 1981)
5 MYTHS ABOUT APD
CONTINUED:
“Ok, class, before you line up to go outside for recess, take your
homework out, and put it on your desk, then hang your backpack
up and line up in alphabetical order.
Bob hung his backpack up and was first in line.
EXAMPLE OF AUDITORY
PROCESSING DISORDER:
• Recurrent ear infections
• Middle ear fluid
• Pregnancy complications
• Labor and delivery complications
• Genetics
• Birth defects
• Lead, mercury and other environmental poisons and toxins
(Medwetsky, 2011; Witton, 2010)
POSSIBLE CAUSES OF APD:
WHAT ARE SOME OF THE
BEHAVIORAL
MANIFESTATIONS OF APD?
(BARAN, 2000)
Difficulty hearing in noisy situations or with competing messages
Difficulty following long conversations or lectures
Misunderstanding messages
Difficulty hearing conversations on the telephone
Difficulty learning a foreign language or challenging vocabulary words (or understanding foreigners’ accents)
Difficulty remembering spoken information (i.e., auditory memory deficits)
Difficulty taking notes
Difficulty following multi-step directions
Difficulty in directing, sustaining, or dividing auditory attention
Difficulty processing nonverbal information (e.g., poor musical and singing skills)
Difficulty learning songs, nursery rhymes
Sometimes have difficulty with reading, spelling and learning problems
SOME ACADEMIC CHARACTERISTICS OF
CHILDREN WHO HAVE APD?
APD may indirectly lead to academic difficulty that manifests with some of the following characteristics.
Baran (1999) identifies the following:
Poor expressive and receptive language abilities
Poor reading, writing, and spelling
Poor phonics and speech sound discrimination
Difficulty taking notes
Difficulty learning foreign languages
Weak short-term memory
Behavioral, psychological, and/or social problems resulting from poor language understanding and poor academic skills.
• https://www.youtube.com/watch?v=iabuAiYZVxI
IDENTIFYING SYMPTOMS OF APD:
• Phonemes
• Rhyming
• Decoding words
• Poor auditory memory
(Medwetsky, 2001; Fey et al., 2012)
PROCESSING PROBLEMS THAT
MAY OCCUR:
• 1st Grade: When children are not learning letter-sound correspondence
• 4th Grade: When reading, writing, and lecture become more advanced and
less contextual (no pictures)
• 7th Grade: When reading and writing become less narrative (1sr person).
(Bellis, 1996)
TYPICAL GRADE LEVELS WHEN
AUDITORY PROCESSING DISORDER IS
IDENTIFIED:
• Children spend 45-60% of their day focused on listening, much of that
time in school.
• Classrooms are often noisy places, and children often have a harder time
than adults hearing speech in these noisy environments
• Proper intervention is necessary.
(Sirimanna, 2011; Bellis, 1996; Keith, 1981)
INTERVENTION NEEDED:
• Students with a language or auditory processing disorder (APD) react to
changes in their environment differently.
• No two students have exactly the same deficits.
(Paul, 2008; Cacace & McFarland, 1998)
FACTS ABOUT APD:
• Allow for a longer response time
• Maintain a routine
• Write information on the board
• Use a cue word
• Maintain eye contact
• Repeat important information
• Use visual aids
• Encourage questions
(Kamhia, 2011; Walker et al., 2011; ASHA, 2004a)
ACCOMMODATE THE
ENVIRONMENT
• Preferential Seating: Seating the child in the front of the class is where he/she will have better visual reception of the area, which is where most teaching takes place.
• Reduce Background Noise: Make every effort to reduce and/or eliminate extraneous noise.
• Consider Your Distance: When an APD child is spoken to from a great distance (more than 5 feet), he/she will have difficulty comprehending what is said.
(Kamhia, 2011; Walker et al., 2011; Bellis, 2003)
ACCOMMODATIONS FOR SEATING
FOR STUDENTS WITH APD:
• Children with APD should be seated where they can see the teacher
without any difficulties and they are away from any distractions or noise.
• Everyone hears and understands better if you can see the speaker’s face.
• Being able to see the speaker is critical for the child with virtually any type
of APD.
• Do not assume the best seat in the class is always the front row.
(Kamhia, 2011; Walker et al., 2011; Bellis, 2003)
MODIFICATIONS FOR SEATING
CONTINUED:
• Reduce external visual and auditory distractions.
• A large display of posters or cluttered bulletin boards can be distracting.
• A study corral in the room may help.
• Ear plugs may be useful for distracting noise from a heater or air
conditioner, the pencil sharpener, or talking in the hallways.
(Kamhia, 2011; Fey et al., 2012; Walker et al., 2011)
MODIFICATIONS FOR SETTING:
• Consider The Acoustics: If the room has tiled floor and unfinished walls, there is a high probability a lot of echo will occur within the room.
• Obtain visual attention: Get eye contact from a APD child before talking to him/her. This can be done by simply touching him/her on the shoulder or using an auditory prompt (ie. Saying his/her name).
• Slow down speech: Too much information too quickly is difficult for a APD child to comprehend. State one idea at a time, and then pause so he/she can process the information, and then move onto the next idea.
• Make the child responsible for understanding: Encourage him to repeat back what he has heard to make certain he understands. Don’t embarrass him by having him prove it in front of the class, do it in a sidebar one-on-one .
(Kamhia, 2011; Walker et al., 2011)
ACCOMMODATIONS FOR
SETTING:
• Think before criticizing: If the child does not respond, or his/her response
is inappropriate, consider that he/she did not understand what you said.
• Simplify directions: Break multi-step directions into one or two parts
before proceeding to the next part of the directions.
• Provide additional written or visual material: Simple words and visual cues
that give him/her an idea of directions will help him/her keep up.
• Consider sensory issues
(Kamhia, 2011; Walker et al., 2011)
ACCOMMODATIONS FOR
SETTING CONTINUED:
• An FM system is a broadcast-type device that assists in filtering out background noise and delivering clearer spoken speech to the student.
• Personal FM systems, with a student wearing an earpiece and the teacher wearing a headpiece microphone, can be more effective in improving the sound-to-noise ratio and making it easier for a student to not miss any information.
(Johnston et al., 2009; ASHA 2002b; Rosenberg, 2002)
CONSIDER A FM SYSTEM:
• Gain the child’s attention before giving directions
• Speak slowly and clearly, but do not over exaggerate speech.
• Use simple, brief directions. Give directions in a logical, time-ordered
sequence.
• Use words that make the sequence clear, such as first, next, finally.
• Use visual aids and write instructions to supplement spoken information
(Bellis, 1996; Walker et al., 2011; Crandell & Smaldino, 2001)
ACCOMMODATIONS FOR
SPEAKING:
• Use mnemonics
• Repeat or rephrase information to your child
• Use graphic organizers
• Play games
• Listen to nature sounds and identify their location
• Learn to play the piano
• Teach active listening and whole body listening skills
(Sirimanna, 2011; Fredrick et al., 2012; Katz, 1983)
TIPS AND TECHNIQUES:
• Allow a “buddy system” that the child can use to check on homework
assignments or other instructions.
• Consider the use of tape recorders for some children who need a
repetition of directions, spelling words, or lectures.
• Provide pre-printed lecture notes or outlines to help the child listen
• Headphones help block out background noise that may interfere with the
brain processing information.
• Give children a tool to work out problems easily without the hassle of
pencils, paper and erasers.
(Sirimanna, 2011; Fredrick et al., 2012)
TIPS AND TECHNIQUES:
• Children with Auditory Processing Disorders have difficulties
distinguishing the sounds or phonemes in spoken words, especially those
in complex words and sentences.
• Children will not only have difficulty hearing the differences between
words that sound alike (think, thing, sink, thin), but they can also have
difficulty understanding the connections between those words and the
letters used to represent them.
• This is why children with Auditory Processing Difficulties often have
trouble with reading and spelling. Since they cannot hear the sound
distinctions between words, the rules linking sounds to letters and letter
groups can be hard for them to master.
(Chermak, Hall & Musiek, 1999; Walker et al., 2011; Jutras et al., 2007)
HOW DOES AUDITORY PROCESSING
AFFECT MY CHILD’S LEARNING?
• difficulties remembering information given
• language development
• comprehension
(Chermak, Hall & Musiek, 1999; Fredrick et al., 2012; Walker et al., 2011; Jutras et al., 2007)
HOW DOES AUDITORY PROCESSING
AFFECT A CHILD’S LEARNING?
CONTINUED
• Though a child with APD struggles with auditory processing, they often thrive when information is presented visually.
• Computer based education works well for APD students
Strong interactive graphics do two things:
1. Adds the 'glue' so that information sticks and
2. Allows children with APD to work independently
so they begin to build self confidence.
(Chermak, Hall & Musiek, 1999; Fredrick et al., 2012; Jutras et al., 2007)
HOW DO YOU TEACH A CHILD
WITH APD MOST EFFECTIVELY?
• Problems in the future with employment and education (Ebbels, 2014)
• Reduced communication function in social situations (Johnston et. al, 2009).
• Because of academic difficulties in adolescent population being overlooked, Speech-
Language Pathologist should help teachers and staff identify the difference between
poor academic performance and APD (Heine & Slone, 2008).
IMPACT ON CHILD WITH APD IF
NOT IMPLEMENTED:
• Sounds At Home- $6.99
• Auditory Memory Ride- $19.99
• School of Multiple Step Directions- $18.99
• Keyword Understanding-$8.99
• Storybuilder for IPad-$7.99
IPAD APPS FOR APD:
• 100% Listening
• 50 Quick Play Listening Games
• The Auditory Processing Game
• Barnaby’s Burrow-Auditory Processing Game
GAMES FOR CHILDREN WITH
APD:
Only an Audiologist can make a diagnosis of APD.
There is no one specific treatment approach for all children with APD.
Just because a child has APD does not mean they will exhibit learning, language, or communication deficits.
(Understanding auditory, 2014)
KEY POINTS TO CONSIDER
American Speech-Language-Hearing Association (2002b). Guidelines for fitting and monitoring FM systems. Rockville, MD: Author.
American Speech-Language-Hearing Association (2004a). Guidelines for addressing acoustics in educational settings. Rockville, MD: Author.
Bellis, T. J. (1996). Assessment and management of central auditory processing disorders in the educational setting: From science to practice. Singular Publishing.
Bellis, T. J. (2003). Assessment and management of central auditory processing disorders in the educational setting: From science to practice (2nd ed.). Clifton Park, NY: Delmar Learning.
Cacace, A. T., & McFarland, D. J. (1998). Central auditory processing disorder in school-aged Children: A critical review. Journal of Speech, Language, and Hearing Research, 41(2), 355-373.
Chermak, G. D., Hall 3rd, J. W., & Musiek, F. E. (1999). Differential diagnosis and management of central auditory processing disorder and attention deficit hyperactivity disorder. Journal of the American Academy of Audiology, 10(6), 289-303.
Crandell, C. & Smaldino, J. (2001). Improving classroom acoustics: Utilizing hearing-assistive technology and communication strategies in the educational setting. Classroom Acoustics: Understanding Barriers to Learning. Volta Review, 101, 47-62
Ebbels, S. (2014). Effectiveness of intervention for grammar in school-aged children with primary language impairments: A review of the evidence. Child Language Teaching and Therapy, 30, 7-40.
Fey, M. E., Kamhi, A. G., Richard, G. J., Nippold, M., & Schwarz, I. (2012). Auditory training
REFERENCES
Frederick J., G., Diedesch, A. C., Kubli, L. R., Walden, T. C., Folmer, R. L., Lewis, S., & Leek, M. R. (2012). Performance on tests of central auditory processing by individuals exposed to high-intensity blasts. Journal of Rehabilitation Research & Development, 49(7),1005-1024.
Heine, C., & Slone, M. (2008). The impact of mild central auditory processing disorder on school performance during adolescence. Journal of School Health, 78, 405-407.
Johnston, K. N., John, A. B., Kreisman, N. V., Hall III, J. W., Crandell, C. C., (2009). Multiple benefits of personal FM system use by children with auditory processing disorder (APD). International Journal of Audiology, 48(6), 371-383.
Jutras, B., Loubert, M., Dupuis, J. L., Marcoux, C., Dumont, V., & Baril, M. (2007). Applicability of central auditory processing disorder models. American Journal of Audiology, 16(2), 100-106.
Katz, J. (1983). Phonemic synthesis. In E. Laskey & J. Katz (Eds.), Central auditory processing disorders: Problems of speech, langauge, and learning (pp. 269-272). Baltimore: University Park Press.
Kamhia, A. G. (2011). What speech-language pathologists need to know about auditory processing disorder. Language, Speech & Hearing Services In Schools, 42(3), 265-272.
Keith, R. W. (Ed.). (1981). Central auditory and language disorders in children . San Diego, CA: College-Hill Press.
Massaro, D. (1975). Understanding Language: An information-processing analysis of speech perception, reading, and psycholinguistics. New York, NY: Academic Press.
Medwetsky, L. (2011). Spoken language processing model: Bridging auditory and language processing to guide assessment and intervention. Language, Speech & Hearing Services In Schools , 42(3), 286-296.
REFERENCES
Paul, R. (2008). Auditory processing disorder. Journal of Autism and Developmental Disorders, 38(1), 208-209.
Rosenberg, G. (2002). Classroom acoustics and personal FM technology in management of auditory processing disorder. Seminars in Hearing, 23(4), 309-318.
Sirimanna, T. (2011). Auditory processing disorder. Special Educational Needs: A Guide for Inclusive Practice, 82.
Understanding auditory processing disorders in children (2014). Retrieved July 20, 2014, from http://www.asha.org/public/hearing/Understanding-Auditory-Processing-Disorders-in-Children/
Walker, K. M., Brown, D. K., Scarff, C., Watson, C., Muir, P., & Phillips, D. P. (2011). Temporal processing performance, reading performance, and auditory processing disorder in learning-impaired children and controls. Canadian Journal of Speech-Language Pathology & Audiology, 35(1), 6-17.
Witton, C. (2010). Childhood auditory processing disorder as a developmental disorder: The case for a multi-professional approach to diagnosis and management. International Journal of Audiology, 49(2), 83-87.
REFERENCES