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What is a Central Auditory Processing Disorder?

Sometimes the brain is unable to understand and interpret auditory information in a normal way. If normal hearing doesn’t feel normal for you, find out if you could be dealing with an auditory processing disorder.



What is a central auditory processing disorder? That's our topic today on Ask the Hearing Doctors. Hi, I'm Jim Cuddy and this is Ask the Hearing Doctors. And I'm joined today by Dr. Jenna Valania, a doctor of audiology with Hearing Doctors. The Washington DC Metro area's highest-rated audiology practice with over 1500, five-star reviews. Jenna, great to see you as always.


Thank you so much for having me.


Absolutely. So we're talking today about auditory processing disorders. What is a central auditory processing disorder?


Sure. There is the definition that you can Google and then there's a definition in just plain speech. So in simple terms, an auditory processing disorder is competing with your brain. So let's say you let's say you and I are talking, for example, and there's some background noise going on in the hallway or in the room next door to us.


My brain is perceiving that background noise and your voice to be at the same level. It's trying to integrate it and it's having a hard time separating out what is speech and what is background noise.


So do you just not hear anything then, or do you just hear noise? What happens there?


That is a great question. So a lot of our patients had experience audio experience, auditory processing concerns. I actually have normal hearing. So when they sit in our sound booth, they get their button. Okay, we go through all those beeps those really soft sounds, they're hearing is normal. A lot of our patients get very discouraged after that because while we all love a test result, that's normal, having a normal test result doesn't suddenly make all of your symptoms going away go away.


So for some patients, they feel that they mishear words. So you and I could be looking right at each other. I see your lips say one thing, I hear another thing. Or it really is, oh, wait, I can we go to another room? I really need to get away from this background noise. I'm having a hard time concentrating on what you're saying. It's very fatiguing because your brain is working much harder than it has to.


I would imagine so. Obviously, there's got to be some sort of testing for this. Who can be tested? What should they do if they're having some of these types of symptoms?


Sure. So in our clinic specifically, we are able to see children in five and up all the way up to our oldest patients. And there are clinical norms, though, for kiddos, three and up. So most of the basic standard comprehensive testing is norm for three and a half and older. At our clinic we see five year olds. But if you have any questions or are looking for someone for younger than five we're happy to direct you to the appropriate facility.


Our patients, how our auditory processing evaluations work here. Is broken into two appointments? The first one is actually your standard hearing test. So unless you've come with one, we're going to do a comprehensive audiologic evaluation to establish your hearing thresholds, your speech discrimination, how your brain processes in both quiet and in background noise. But it's also really extensive case history.


So we provide you with all of the forms because for a lot of these patients, they're like, I don't know how to express what I'm hearing. You're telling me my hearing, you being the general you are telling me my hearing is normal. I don't perceive it to be normal. I have no idea how else to describe it to you.


This very thorough case history gives them words to describe what's going on and also may be able to give them some insight to what they're experiencing. Most importantly, this case history form reminds them that they are not the only ones that are experiencing this issue. People with auditory processing concerns do tend to isolate because they're just so frustrated in conversations that they don't want to participate anymore.


We're able to obtain scores that measure both the emotional impact, the social impact, and the logistic impact of your potential auditory processing disorder that you may have following our our testing. So we'll be able to put together a comprehensive exam as well as the data to kind of put you in a direction and finally get people some answers.


We also do an iPad game, so it's fun for people of all ages to be able to assess their auditory processing in different ways.


Now, how would I get this scheduled? Is this something I need a referral for?


Nope. You actually do not need a referral. And we are open to seeing all patients whether you've been seen here before or if this is your first time, so you do not need a referral. However, we are happy to send a copy of our comprehensive report and recommendations to your primary care physician. If you have one.


Somebody watching today, if they think they might need this test, what are some of the other signs that that might point to them needing this test and for them to probably give you a call?


Sure. So I want to also be specific in the fact that you don't necessarily have to have normal hearing. So while, a lot of patients that experience auditory processing are at their wit's end because they are just trying to get some answers. You also can have concerns for your auditory processing skills even if you have a hearing loss.


The tests are modified to account for a hearing loss, and you're hearing loss is part of your your treatment plan. We want to treat that hearing loss to be able to subsequently treat and improve your auditory processing skills. Now, Some things to look for as far as if it's a child or a student. Sometimes we have the parents send our case history form to the student's teacher because that's where a lot of auditory skills come into play when you're sitting in a classroom.


So for some parents and caregivers, they're able to see their child not in an academic environment, which is very insightful for us. But then also those teachers are able to say Okay, what is going on in a classroom? What am I seeing during this lesson? What am I seeing during this time of day? And something else to consider as well is there are some families that are maybe hesitant to get any type of auditory processing evaluation if there are other sensory concerns or if there's a diagnosis of autism or ADHD, ADD. We can do those types of tests on people with what we call those comorbid disorders. Meaning just because you have one thing does not mean we can't test for another.


What is the testing like? What should I expect if I call you? I'm having some one of these issues. I need. I feel like I need to have have this test will I expect to have done?


Sure. So a lot of our testing I call it listening games because it really it's not like any other test that you've had done before. We have the option to do the appointment in office. So the hearing test will be completed in office. But our comprehensive exam, our diagnostic testing can actually be done over telehealth. It's a unlike a test you've ever really had before, because what we're looking at is we're looking at how your brain does with competing words or competing stimuli.


So meaning sometimes you may have a word in one ear and a word in the other ear. Can you recite both? Do you join them together? Can you only pull one? Or if there's background noise, how do you perform in compared to quiet? Because we know that one of the main symptoms of an audit, some concerns for auditory processing is that listening in background noise. It's also a very similar symptom to someone with an untreated hearing loss or even a treated hearing loss.


So that's why we always start with our comprehensive exam. But that's what a lot of our patients come in here for. As I hear you, I know you're talking to me. My brain's picking up over here and not our conversation. And so a lot of those diagnostic tests are going to look into that based on the scores on the tests. It's based on norms. By age, we're able to come up with some treatment options or direct you to some therapy sessions.


You know, you mentioned telehealth as a part of this, but I think a lot of people would say is telehealth going to be the same and up to the same standard as an in-office visit?


That is a great question. And I think a lot of us over the recent years have started to think about the telehealth visits. What it gives you is patient access. Think about especially in the DMV area, how hard it is to drive, how hard it is with traffic to get places, to get from point A to point B, it could turn into a day long event.


And so offering those telehealth visits allow us to give the same quality of testing to those patients, whether they're in office or at home. Now, what you need for a telehealth visit is you do need to have reliable Internet. And thankfully, a lot of people now do have access to different hotspots. If they don't have reliable Internet in their home, they're able to go to a library or even go to their school to do some of these evaluations.


You also need a reliable set of wired headphones so that the testing can be delivered and calibrated as it would be sitting in a sound booth. And of course, the environment needs to be relatively quiet before we do any testing, we evaluate the environment. So whether it's a child and we have the parent do our checklist to make sure that everything is working appropriately, or it's an adult and they're able to verify that their device is set up correctly, then you are getting the exact same quality of care. 


A lot of the what we call the big names in auditory processing evaluations actually don't see a single patient in office. They see them all via telehealth. So the patient goes and gets a hearing test. They bring the hearing test in and it is all completed via telehealth allows us to reach more people.


And convenient for everybody as well. And that's that's a big thing. As you mentioned, traffic alone is can be a bear for people. So anything you can do to make things easier for folks. So now my auditory processing evaluation is done. What's next?


So at this time, our clinics are offering diagnostic testing and then we have relationships with people in the community that offer therapy sessions or treatment options. Same thing in person or via telehealth. We'll also put together some resources. And if we find that you need a little help in area A little bit, area B that maybe don't need full therapy sessions, or it's not part it's not an option for you. We're able to provide those recommendations in-house. If it is a school age child or teenager. We would put together a comprehensive report for the school if the Guardian allows.


It's great information. And I think it's really important to start with that phone call to the office just just to get the ball rolling and get your life back to normal.


Absolutely. And we've seen I think the most incredible part is we've seen it work. And there's so much more. And research has been pointing to this for years. You're hearing is not just right here. You're hearing is in your brain. We need to look beyond those beeps that travel up to our brain. What are we actually listening to?


Auditory processing evaluations dig deeper into that and allows people to have an insight and also give them their confidence back that we can help them.


That's great stuff. Jenna, thank you so much for your time.


Absolutely. Thank you for having me.


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