What is it?

An auditory processing disorder interferes with an individual's ability to analyze or make sense of information taken in through the ears. This is different from problems involving hearing per se, such as deafness or being hard of hearing. Difficulties with auditory processing do not affect what is heard by the ear, but do affect how this information is interpreted, or processed by the brain.

An auditory processing deficit can interfere directly with speech and language, but can affect all areas of learning, especially reading and spelling. When instruction in school relies primarily on spoken language, the individual with an auditory processing disorder may have serious difficulty understanding the lesson or the directions.

Common areas of difficulty and some educational implications:

Phonological awareness

Phonological awareness is the understanding that language is made up of individual sounds (phonemes) which are put together to form the words we write and speak. This is a fundamental precursor to reading. Children who have difficulty with phonological awareness will often be unable to recognize or isolate the individual sounds in a word, recognize similarities between words (as in rhyming words), or be able to identify the number of sounds in a word. These deficits can affect all areas of language including reading, writing, and understanding of spoken language.

Though phonological awareness develops naturally in most children, the necessary knowledge and skills can be taught through direct instruction for those who have difficulty in this area.

Auditory discrimination

Auditory discrimination is the ability to recognize differences in phonemes (sounds). This includes the ability to identify words and sounds that are similar and those which are different.

Auditory memory

Auditory memory is the ability to store and recall information which was given verbally. An individual with difficulties in this area may not be able to follow instructions given verbally or may have trouble recalling information from a story read aloud.

Auditory sequencing

Auditory sequencing is the ability to remember or reconstruct the order of items in a list or the order of sounds in a word or syllable. One example is saying or writing "ephelant" for "elephant."

Auditory blending

Auditory blending is the process of putting together phonemes to form words. For example, the individual phonemes "c", "a", and "t" are blended to from the word, "cat".

Information was taken from http://www.ldonline.org/article/6390/

The following suggestions are presented in a sequence which should help ensure that your concerns do not go ignored. Of equal importance, this sequence should help avoid setting off any premature alarms, which may not be in the child's best interests.

Write down the reasons you suspect a problem might be present or developing, carefully documenting examples in which the concerning behavior is taking place.

This will help in two ways. First, it will help confirm or alleviate your concerns. If there is cause for concern, it will help you get a more focused idea of where the difficulty lies. This list will also be helpful if further action or meetings with other professionals are necessary.

Interventions:

First, a few words about interventions in general. Interventions need to be aimed at the specific needs of the child. No two children share the same set of strengths or areas of weaknesses. An effective intervention is one that utilizes a child's strengths in order to build on the specific areas in need of development. As such, interventions need to be viewed as a dynamic and ever changing process. Although this may sound overwhelming initially, it is important to remember that the process of finding successful interventions becomes easier with time and as the child's learning approach, style, and abilities become more clear.

The following examples provide some ideas regarding a specific disability. It is only a beginning, which is meant to encourage further thinking and development of specific interventions and intervention strategies.

The following represent a number of common interventions and accommodations used with children in their regular classroom:

Do not rely solely on an area of weakness.

If instructions are given orally, try to supplement this with written or other visual cues. While it is important to address the area of need directly and try to build up areas of weakness, it is also necessary that the student be able to function successfully in the classroom. A simple accommodation like backing up verbal directions with visual or written cues is one way to facilitate this.

Keep the area of difficulty in mind.

Simplifying verbal directions, slowing the rate of speech, and minimizing distractions can make a big difference to a person with auditory processing difficulties.

Plan specific activities for the areas of difficulty.

There are many activities that can help build auditory processing skills, whether it be in the area of phonological awareness, auditory discrimination, or any of the other areas in this realm. Rhyming games, for example, can help build phonological awareness as well as discriminating between similar and different sounds. Sorting games can help build auditory memory, as the number of variables and steps involved in the sorting can be easily controlled to adjust the level of difficulty.

Information was taken from http://www.ldonline.org/article/6390/

Common areas of difficulty and some educational implications:

Spatial relation

This refers to the position of objects in space. It also refers to the ability to accurately perceive objects in space with reference to other objects.

Reading and math are two subjects where accurate perception and understanding of spatial relationships are very important. Both of these subjects rely heavily on the use of symbols (letters, numbers, punctuation, math signs). Examples of how difficulty may interfere with learning are in being able to perceive words and numbers as separate units, directionality problems in reading and math, confusion of similarly shaped letters, such as b/d/p/q. The importance of being able to perceive objects in relation to other objects is often seen in math problems. To be successful, the person must be able to associate that certain digits go together to make a single number (ie, 14), that others are single digit numbers, that the operational signs (+,,x,=) are distinct from the numbers, but demonstrate a relationship between them. The only cues to such math problems are the spacing and order between the symbols. These activities presuppose an ability and understanding of spatial relationships.

Visual discrimination

This is the ability to differentiate objects based on their individual characteristics. Visual discrimination is vital in the recognition of common objects and symbols. Attributes which children use to identify different objects include: color, form, shape, pattern, size, and position. Visual discrimination also refers to the ability to recognize an object as distinct from its surrounding environment.

In terms of reading and mathematics, visual discrimination difficulties can interfere with the ability to accurately identify symbols, gain information from pictures, charts, or graphs, or be able to use visually presented material in a productive way. One example is being able to distinguish between an /nl and an Imp, where the only distinguishing feature is the number of humps in the letter. The ability to recognize distinct shapes from their background, such as objects in a picture, or letters on a chalkboard, is largely a function of visual discrimination.

Visual closure

Visual closure is often considered to be a function of visual discrimination. This is the ability to identify or recognize a symbol or object when the entire object is not visible.

Difficulties in visual closure can be seen in such school activities as when the young child is asked to identify, or complete a drawing of, a human face. This difficulty can be so extreme that even a single missing facial feature (a nose, eye, mouth) could render the face unrecognizable by the child.

Object recognition (Visual Agnosia)

Many children are unable to visually recognize objects which are familiar to them, or even objects which they can recognize through their other senses, such as touch or smell. One school of thought about this difficulty is that it is based upon an inability to integrate or synthesize visual stimuli into a recognizable whole. Another school of thought attributes this difficulty to a visual memory problem, whereby the person can not retrieve the mental representation of the object being viewed or make the connection between the mental representation and the object itself.

Educationally, this can interfere with the child's ability to consistently recognize letters, numbers, symbols, words, or pictures. This can obviously frustrate the learning process as what is learned on one day may not be there, or not be available to the child, the next. In cases of partial agnosia, what is learned on day one, "forgotten" on day two, may be remembered.

Whole/part relationships

Some children have a difficulty perceiving or integrating the relationship between an object or symbol in its entirety and the component parts which make it up. Some children may only perceive the pieces, while others are only able to see the whole. The common analogy is not being able to see the forest for the trees and conversely, being able to recognize a forest but not the individual trees which make it up.

In school, children are required to continuously transition from the whole to the parts and back again. A "whole perceiver", for example, might be very adept at recognizing complicated words, but would have difficulty naming the letters within it. On the other hand, "part perceivers" might be able to name the letters, or some of the letters within a word, but have great difficulty integrating them to make up a whole, intact word. In creating artwork or looking at pictures, the "part perceivers" often pay great attention to details, but lack the ability to see the relationship between the details. "Whole perceivers", on the other hand, might only be able to describe a piece of artwork in very general terms, or lack the ability to assimilate the pieces to make any sense of it at all. As with all abilities and disabilities, there is a wide range in the functioning of different children.

Information was taken from http://www.ldonline.org/article/6390/

The following suggestions are presented in a sequence which should help ensure that your concerns do not go ignored. Of equal importance, this sequence should help avoid setting off any premature alarms, which may not be in the child's best interests.

Write down the reasons you suspect a problem might be present or developing, carefully documenting examples in which the concerning behavior is taking place.

This will help in two ways. First, it will help confirm or alleviate your concerns. If there is cause for concern, it will help you get a more focused idea of where the difficulty lies. This list will also be helpful if further action or meetings with other professionals are necessary.

Interventions

First, a few words about interventions in general. Interventions need to be aimed at the specific needs of the child. No two children share the same set of strengths or areas of weaknesses. An effective intervention is one that utilizes a child's strengths in order to build on the specific areas in need of development. As such, interventions need to be viewed as a dynamic and ever changing process. Although this may sound overwhelming initially, it is important to remember that the process of finding successful interventions becomes easier with time and as the child's learning approach, style, and abilities become more easily seen.

The following examples provide some ideas regarding a specific disability. It is only a beginning which is meant to encourage further thinking and development of specific interventions and intervention strategies.

The following represent a number of common interventions and accommodations used with children in their regular classroom:

For Readings

Enlarged print for books, papers, worksheets or other materials which the child is expected to use can often make tasks much more manageable. Some books and other materials are commercially available; other materials will need to be enlarged using a photocopier or computer, when possible.

There are a number of ways to help a child keep focused and not become overwhelmed when using painted information. For many children, a "window" made from cutting a rectangle in an index card helps keep the relevant numbers, words, sentences, etc. in clear focus while blocking out much of the peripheral material which can become distracting. As the child's tracking improves, the prompt can be reduced. For example, after a period of time, one might replace the "window" with a ruler or other straightedge, thus increasing the task demands while still providing additional structure. This can then be reduced to, perhaps, having the child point to the word s/he is reading with only a finger.

For Writing

Adding more structure to the paper a child is using can often help him/her use the paper more effectively. This can be done in a number of ways. For example, lines can be made darker and more distinct. Paper with raised lines to provide kinesthetic feedback is available. Worksheets can be simplified in their structure and the amount of material which is contained per worksheet can be controlled. Using paper which is divided into large and distinct sections can often help with math problems.

Teaching Style

Being aware and monitoring progress of the child's skills and abilities will help dictate what accommodations in classroom structure and/or materials are appropriate and feasible. In addition, the teacher can help by ensuring the child is never relying solely on an area of weakness, unless that is the specific purpose of the activity. For example, if the teacher is referring to writing on a chalkboard or chart paper, s/he can read aloud what is being read or written, providing an additional means for obtaining the information.

Information was taken from http://www.ldonline.org/article/6390/

Adaptive skills incorporate the area of self-help skills such as eating, drinking and dressing.

By one:

feeds self cracker

holds cup with two hands; drinks with assistance

holds out arms and legs while being dressed

Between ages one and two:

uses spoon, spilling little

drinks form cup with one hand, unassisted\d

chews food

unzips large zipper

indicates toilet needs

removes shoes, socks, pants, sweater

Between ages two and three:

uses spoon, little spilling

gets drink form fountain or faucet independently

opens door by turning handle

takes off coat

puts on coat with assistance

washes and dries hands with assistance

Between ages three and four:

pours well form small pitcher

spreads soft butter with knife

buttons and unbuttons large buttons

washes hands independently

blows nose when reminded

uses toilet independently

Between ages four and five:

Cuts easy foods with a knife

laces shoes

Between ages five and six:

dresses self completely

ties bow

brushes teeth independently

crosses streets safely

By one:

follows moving object with eyes

recognizes differences among people; responds to strangers by crying or staring

responds to and imitates facial expressions of others

responds to very simple directions

imitates gestures and actions

puts small objects in and out of container with intention

Between one and two:

imitates actions and words of adults

understands and follows simple, familiar directions

responds to words or commands with appropriate action

is able to match two similar objects

looks at storybook pictures with an adult, naming or pointing to familiar objects on request

recognizes difference between you and me

has very limited attention span

accomplishes primary learning through own exploration

Between two and three:

responds to simple directions

selects and looks at picture books, names pictured objects, and identifies several objects within one picture

matches and uses associated objects meaningfully

stacks rings on peg in order of size

recognized self in mirror, saying baby, or own name

can talk briefly about what he/she is doing; imitates adult actions

has limited attention span; learning is through exploration and adult direction

is beginning to understand functional concepts of familiar objects and part/whole concepts

Between three and four:

recognizes and matches six colors

intentionally stacks blocks or rings in order of size

draws somewhat recognizable picture that is meaningful to child if not to adult; names and briefly explains picture

asks questions for information: why and how questions requiring simple answers

knows own age

knows own name

has short attention span; learns through observing and imitating adults and by adult instruction and explanation; is very easily distracted

has increased understanding of concepts of the functions and grouping of objects and part/whole

begins to be aware of past and present

Between four and five:

plays with words: creates own rhyming words, says or makes up words having similar sounds

points and names four to six colors

matches pictures of familiar objects

draws a person with two to six recognizable parts, such as head, arms, and legs; can name or match drawn parts to own body

draws, names, and describes recognizable pictures

rote counts to five, imitating adult

knows own street and town

has more extended attention span; learns through observing and listening to adults, as well as through exploration; is easily distracted

has increased understanding of concepts of function, time, part/whole relationships; function or use of objects may be stated in addition to names of objects

time concepts are expanding; can talk about yesterday or last week, about today, and about what will happen tomorrow

Between five and six:

retells story from picture book with reasonable accuracy

names some letters and numerals

rote counts to ten

sorts objects by single characteristics

is beginning to use accurately time concepts of tomorrow and yesterday

uses classroom tools meaningfully and purposefully

begins to relate clock time to daily schedule

attention span increases noticeably; learns through adult instruction; when interested, can ignore distractions

concepts of function increase as well as understanding of why things happen; time concepts are expanding into an understanding of the future in terms of major events

By age one

Milestones

Recognizes name

Says 2-3 words besides "mama" and "dada"

Imitates familiar words

Understands simple instructions

Recognizes words as symbols for objects: Car - points to garage, cat - meows

Activities to encourage your child's language

Respond to your child's coos, gurgles, and babbling

Talk to your child as you care for him or her throughout the day

Read colorful books to your child every day

Tell nursery rhymes and sing songs

Teach your child the names of everyday items and familiar people

Take your child with you to new places and situations

Play simple games with your child such as "peek-a-boo" and "pat-a-cake"

Between one and two

Milestones

Understands "no"

Uses 10 to 20 words, including names

Combines two words such as "daddy bye-bye"

Waves good-bye and plays pat-a-cake

Makes the "sounds" of familiar animals

Gives a toy when asked

Uses words such as "more" to make wants known

Points to his or her toes, eyes, and nose

Brings object from another room when asked

Activities to encourage your child's language

Reward and encourage early efforts at saying new words

Talk to your baby about everything you're doing while you're with him

Talk simply, clearly, and slowly to your child

Talk about new situations before you go, while you're there, and again when you are home

Look at your child when he or she talks to you

Describe what your child is doing, feeling, hearing

Let your child listen to children's records and tapes

Praise your child's efforts to communicate

Between two and three

Milestones

Identifies body parts

Carries on 'conversation' with self and dolls

Asks "what's that?" And "where's my?"

Uses 2-word negative phrases such as "no want".

Forms some plurals by adding "s"; book, books

Has a 450 word vocabulary

Gives first name, holds up fingers to tell age

Combines nouns and verbs "mommy go"

Understands simple time concepts: "last night", "tomorrow"

Refers to self as "me" rather than by name

Tries to get adult attention: "watch me"

Likes to hear same story repeated

May say "no" when means "yes"

Talks to other children as well as adults

Solves problems by talking instead of hitting or crying

Answers "where" questions

Names common pictures and things

Uses short sentences like "me want more" or "me want cookie"

Matches 3-4 colors, knows big and little

Activities to encourage your child's language

Repeat new words over and over

Help your child listen and follow instructions by playing games: "pick up the ball," "Touch Daddy's s nose"

Take your child on trips and talk about what you see before, during and after the trip

Let your child tell you answers to simple questions

Read books every day, perhaps as part of the bedtime routine

Listen attentively as your child talks to you

Describe what you are doing, planning, thinking

Have the child deliver simple messages for you (Mommy needs you, Daddy )

Carry on conversations with the child, preferably when the two of you have some quiet time together

Ask questions to get your child to think and talk

Show the child you understand what he or she says by answering, smiling, and nodding your head

Expand what the; child says. If he or she says, "more juice," you say, "Adam wants more juice."

Between three and four

Milestones

Can tell a story

Has a sentence length of 4-5 words

Has a vocabulary of nearly 1000 words

Names at least one color

Understands "yesterday," "summer", "lunchtime", "tonight", "little-big"

Begins to obey requests like "put the block under the chair"

Knows his or her last name, name of street on which he/she lives and several nursery rhymes

Activities to encourage your child's language

Talk about how objects are the same or different

Help your child to tell stories using books and pictures

Let your child play with other children

Read longer stories to your child

Pay attention to your child when he's talking

Talk about places you've been or will be going

Between four and five

Milestones

Has sentence length of 4-5 words

Uses past tense correctly

Has a vocabulary of nearly 1500 words

Points to colors red, blue, yellow and green

Identifies triangles, circles and squares

Understands "In the morning" , "next", "noontime"

Can speak of imaginary conditions such as "I hope"

Asks many questions, asks "who?" And "why?"

Activities to encourage your child's language

Help your child sort objects and things (ex. things you eat, animals. . )

Teach your child how to use the telephone

Let your child help you plan activities such as what you will make for Thanksgiving dinner

Continue talking with him about his interests

Read longer stories to him

Let her tell and make up stories for you

Show your pleasure when she comes to talk with you

Between five and six

Milestones

Has a sentence length of 5-6 words

Has a vocabulary of around 2000 words

Defines objects by their use (you eat with a fork) and can tell what objects are made of

Knows spatial relations like "on top", "behind", "far" and "near"

Knows her address

Identifies a penny, nickel and dime

Knows common opposites like "big/little"

Understands "same" and "different"

Counts ten objects

Asks questions for information

Distinguished left and right hand in herself

Uses all types of sentences, for example "let's go to the store after we eat"

Activities to encourage your child's language

Praise your child when she talks about her feelings, thoughts, hopes and fears

Comment on what you did or how you think your child feels

Sing songs, rhymes with your child

Continue to read longer stories

Talk with him as you would an adult

Look at family photos and talk to him about your family history

Listen to her when she talks to you

There are two categories within the area of motor skills: gross motor and fine motor. Gross motor skills deals with large muscle groups such as walking. Fine motor incorporate the small muscles such as writing.

By age one

Gross Motor

sits without support

crawls

pulls self to standing position and stands unaided

walks with aid

rolls a ball in imitation of adult

Fine Motor

reaches, grasps, puts object in mouth

picks things up with pincer grasp (thumb and one finger)

transfers object from one hand to the other

drops and picks up toy

Between ages one and two

Gross Motor

walks alone

walks backwards

picks up toys from floor without falling

pulls toys, pushes toys

seats self in child size chair

walks up and down stairs with hand held

moves to music

Fine Motor

builds tower of three small blocks

puts four rings on stick

places five pegs in pegboard

turns pages two or three at a time

scribbles

turns knobs

throws small ball

paints with whole arm movement, shifts hands, makes strokes

Between ages two and three

Gross Motor

runs forward well

jumps in place with two feet together

stands on one foot (with aid)

walks on tiptoe

kicks a ball forward

Fine Motor

strings four large beads

turns single pages

snips with scissors

holds crayon with thumb and fingers (not fist)

uses one hand consistently in most activities

imitates circular, vertical, horizontal strokes

paints with some wrist action; makes dots, lines, circular strokes

rolls, pounds, squeezes, and pulls clay

Between ages three and four

Gross Motor

runs around obstacles

walks on a line

balances on one foot for five to ten seconds

hops on one foot

pushes, pulls, steers wheeled toys

rides tricycle

uses slide independently

jumps over six inch high object and lands on both feet together

throws ball overhead

catches a bounce ball

Fine Motor

builds tower of nine small blocks

drives nails and pegs

copies circle

imitates cross

manipulates clay material (rolls balls, snakes, cookies)

Between ages four and five

Gross Motor

walks backward toe-heel

jumps forward 10 times without falling

walks up and down stair independently, alternating feet

turns somersault

Fine Motor

cuts on line continuously

copies cross

copies square

prints some capital letters

Between ages five and six

Gross Motor

runs lightly on toes

walks on balance beam

can cover 2 meters hopping

skips on alternate feet

jumps rope

skates

Fine Motor

cuts out simple shapes

copies triangle

traces diamond

copies first name

prints numerals 1 to 5

colors within lines

has adult grasp of pencil

had handedness well established

pastes and glues appropriately

By one:

smiles spontaneously

responds differently to strangers than to familiar people

pays attention to own name

responds to no

copies simple actions of others

Between ages one and two:

recognizes self in mirror or picture

refers to self by name

plays by self; initiates own play

imitates adult behaviors in play

helps put things away

Between ages two and three:

plays near other children

watches other children; joins briefly in their play

defends own possessions

begins to play house

symbolically uses objects, self in play

participates in simple group activity

knows gender identity

Between ages three and four:

joins in play with other children; begins to interact

shares toys; takes turns with assistance

begins dramatic play, acting out whole scenes

Between ages four and five:

plays and interacts with other children

dramatic play is closer to reality, with attention paid to detail, time, and space

plays dress-up

shows interest in exploring sex differences

Between ages five and six:

chooses own friends

plays simple table games

plays competitive games

engages in cooperative play with other children involving group decisions, role assignments, fair play