Do you know the difference between APD and Development Disorder?
Are you one of those people who often ask other people to repeat themselves or mishear what people say? Or have a hard time hearing under a noisy environment, forget instructions that were given orally, or suffer understanding those instructions?
Have you also ever felt that your kid is having trouble following the teachers’ instructions at school and falling behind in class? And that your kid might be suffering from developmental disorder?
The culprit might be APD
Today, we will take a look at the symptoms of and treatments for APD, a disease not yet known in Japan, along with actual cases in other countries.
Why do people mistake APD as developmental disorder?
Auditory processing disorder, or APD, refers to the hearing difficulty faced in daily conversations even when audibility tests indicate no medical issues.
Symptoms include difficulty in catching words spoken quickly or in a small voice, hearing long monologues, and the relative difficulty in hearing and comprehending auditory information compared to visual information.
These symptoms are often seen as related to intellectual disability, APD is often mistaken as developmental disorder, but there are few cases of patients with organic disorder localized in their ears.
Not only adults but children are also affected by APD, it is said that it presents in about 2 % of the Japanese population, which is a big social issue. But its fundamental cause is yet to be revealed.
There are four types of APD
The symptoms of APD, a disease oft misunderstood because of its obscurity, are, for the first time, categorized and defined into four types by the National Center for Learning Disabilities located in the United States based on their study results.
Identifying your own type may facilitate taking effective countermeasures, for your reference.
① Auditory Discrimination：lack of ability to distinguish sound
“Discrimination” is the ability to understand sound as words and distinguish them from each other.
- Difficulty in distinguishing words pronounced similarly
- Difficulty in memorizing details of information acquired auditorily
② Auditory Figure-Ground Discrimination：lack of ability to distinguish figure from ground
Autidory figure-ground discrimination is the ability to identify information that needs to be listened to and to concentrate on key information from background information.
- Difficulty in distinguishing individual sound under noisy environment
- Difficulty in following oral instructions
- Difficulty in hearing lectures in classrooms
③ Auditory Memory：lack of ability to memorize sound under a certain duration
Auditory memory is the ability to memorize and understand sound as words.
- Difficulty in auditory discrimination including difficulty in memorizing instructions that involve several steps
④ Auditory Sequencing：lack of ability to memorize sound sequence
Auditory sequencing is the ability to hear, identify and organize the order in which messages were delivered.
- Difficulty in recalling the order in which instructions were given
- Mixing up digits in numbers
Solutions to APD that are gaining prominence abroad
What solutions are there to mitigate APD symptoms?
Here are a few cases from abroad.
＜Solutions with therapy＞
Speech therapy can improve one’s reading as well as language comprehension.
APD patients have difficulty distinguishing sounds from each other. They might mishear “cat” as “that” or “bed” as “dead”.
In the US, there are patients of APD that worked with trained therapists and improved their ability to understanding these sound differences.
Therapy includes various exercises targeted at alleviating specific auditory disorder including Fast ForWord, a computer-run program which I will later further explain, and a one-on-one training with a speech therapist.
In the case of training to overcome issues of sound discrimination, experts are said to begin with a quiet environment and then proceed to an environment with more background noise.
When training to improve auditory memory, it is apparently effective to conduct sequence routine training. By repeating a certain set of numbers and instructions, trainees can strengthen their listening ability.
＜Curing APD through change of environment and devices＞
The degree of APD symptoms differs depending on the patient’s level of maturity and the surrounding environment or circumstance. Consequently patients with different ages and living environments require different treatment.
For example, school teachers in classroom settings can help APD students by clearing up sounds inside the classroom as much as possible, such as closing classroom doors to shut out outside noise and sitting APD students away from pencil sharpeners, fans and other devices that emit noise.
＜Curing APD through technologies＞
Do you know “sound field systems”, in lieu of classroom speaker systems with sound problems like sound reflections and muffled sounds?
By installing the sound field system, the teacher’s voice flows from speakers around the classroom. The teacher’s voice is dispersed evenly throughout the classroom, allowing students to hear better regardless where they sit.
Another option is to allow the use of personal listening devices (PLD) that help students hear their teachers more easily. The teacher wears a wireless mic that can transmit voices to each student’s personal speaker through Wi-fi or Bluetooth.
One option that is easy to introduce even at home is a text-to-speech (TTS) software that can be installed on computers as well as smartphones.
By using TTS devices, patients are exposed to a multisensory reading experience through reading while listening. Research shows such experience improves word recognition.
40 to 60 hours’ usage and 1-2 years’ worth of outcome!?
As a program that supports children over five years of age who cannot follow instructions at school and keep pace with the class, Fast ForWord is well known in the US.
Fast ForWord is an evidence-based applied reading and language program and is considered to be extremely effective in curing APD. 40 to 60 hours of using this program apparently gives the student a one to two years worth of learning effect.
The Fast ForWord program for example uses sound-adjusted voices that are played slowly to distinguish sound differences such as “ba” and “da”.
The cost of this program is $999, or 120,000 yen, according to a report published by the US Department of Education in 2013.
Although the software is not familiar in Japan yet, it is systematic and easy to understand. We'll watch its developments.
When we wrote about APD some time ago, the reaction from the readers was stronger than we expected.
While there are patients who suffer from symptoms of APD, articles regarding its treatment and the disorder itself are not common in Japan.
As the cause of APD has yet to be fully elucidated, I was not sure if I should cover this topic. Still, I decided to write this article, because I've met those who've suffered from APD and felt their struggle.
It is my hope that this post will help parents and children with APD to alleviate the symptoms.
14th Japan Society for Pediatric ORL, “The current state of and measures for Auditory processing disorder” 2019
SOUND READING SOLUTIONS, “SOUND READING SOLUTIONS FOR AUDITORY PROCESSING DISORDERS IN CHILDREN” 2020
Understood, “Assistive Technology for Auditory Processing Disorder", 2020
Author of this article
She spent four years covering the U.S. economy for the U.S. bureau of a Japanese news agency, writing and translating articles.
Based on the latest articles and papers on the U.S. economy, she provides a global perspective on Japan's hearing loss and the current state of hearing aids and sound collectors.
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