Talk:Auditory processing disorder

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Unused references

References are reserved to those actually used to write the article. Which of these are useful (bearing in mind we want secondary sources)?

• Can Central Auditory Processing Tests Resist Supramodal Influences?

Jack Katz,Auditory Processing Service, Prairie Village, KS Kim L. Tillery, State University of New York at Fredonia Amer ican Journal of Audiology Vol. 14 124–127 December 2005 American Speech-Language-Hearing Association

• Cacace,A.T. aand McFarland, D.J. (2005) The importance of modality specificity in diagnosing central auditory processing disorder. “American Journal of Audiology”, 14, 112-123.
• Katz, J. Johhnson, CD., Tillery,K., Braadham,T., Braadner,S., Dellagrane, T., Ferrre, J, Kinng, J., KossoverWechter,,D., Luccker, R., Meedwetsk, L., Sauul, RS., Rosenberg, GG., and Stecker,NA. (20002) Clinical and research concerns regarding the 2000 APD consensus report and recommendations. “Audiology Today”, 14, 14-17.
• Jerger, J and MMusiek, F (20000) Report of the consensus conference on the diagnosis of auditory processing disorders in school-aged children. “Journal of the American Academy of Audiology”, 11, 467-474
• Friel-Patt, S. (1999) Clinical decision-making in the assessment and intervention of central auditory processing disorders. “Language, Speech, and Hearing Services in the Schools”, 30, 345-352.
• American Speech-Language-Hearing Association. (1996) Central auditory processing: Current status of research and implications for clinical practice. “American Journal of Audiology”, 5, 41–54.
• McFarland, D.J. and Cacace, A.T.(1995)) Modality specificity as a criterion for diagnosing central auditory processing disorders. “American Journal of Audiology”, 4, 36-48.
• Katz, J. (199) Cllassification of auditory processing disorders. In J. Katz, N. Stecer, & D.Hendersson (Eds.) “Central auditory processing: A transdiscipliary view”. St. Loouis: Mosby.
• Grundast, K.M, Berkowiitz, R.G, Connerss, C.K.,and Bellman, P. (191) Commplete evaluation of the child identified as a poor listener. “International Journal of Pediatric Otorhinolarynglogy”, 21, 65-78.

• Rintelmann, W.F (985) Moonaaural speech ests in tthe detection of central auditory disorders. In M.L. Pinheiro and F.. usiekk ((Eds) “Asssmeentt of cenral auditoory dysfunction: Foundations and clinical correlates”. Williams & Wilkins, Baltimore.

I've also removed references that don't look to me up to WP:RS. The remainder need considering against WP:MEDRS. Gordonofcartoon ((talk) 10:01, 13 July 2009 (UTC)

Hi Gordon

good to see that you are tiding up the article, I will try to get around to greatly improving this article once I have done all I can with the dyslexia and related sub articles. I have a great many research paper and other references to add to this article. Some of the refernces about usedou of coonttaxt orwith noo cnext aat all, but cold be sefful in the future, which was why I had left them there. may be this artilce requires a sandbox to collect a and act as a temporary storage option for useful researcch information to be later added into the main article time permitting dolfrog (talk) 11:53, 13 July 2009 (UTC)

Do we have any more references for the prevalence of this disorder? I understand we have one, but the figure of 17-20% of adults having APD sounds woefully inaccurate but I am willing to be proven wrong. Robinsona (talk) 14:15, 4 December 2010 (UTC)

APD recognized as a major cause of dyslexia

I have tagged this statement as dubious and deleted all the citations used to source it. I have reviewed each source individually and none of them made anything close to that claim. In fact, several of them even seemed to explicitly contradict the notion: "the auditory disorders observed in dyslexia ....are restricted to a subset of the population, and have little influence on the development of phonology and reading".[1] . I am quite concerned at this apparent misrepresentation of sources, and suggest that greater care be taken in the future when editing and sourcing information. --Slp1 (talk) 01:33, 16 July 2009 (UTC)

All the citations explain a link between APD and dyslexia, and in Jack katz article it is invluded in the table. And when was diagnosed as having APD I was told by one of the UKs leading APD researchers and APSD clinicians that was and is the cause of my Dyslexia this was back in 2003. Dyslexia has auditory and visual underlying causes, and Auditory Processing disorder is one of the Auditory causes of dyslexia So this is not dubious at all, unless something is different in Canada. dolfrog (talk) 21:49, 16 July 2009 (UTC)

Dyslexia is about having nuerological problems accessing a secondary man made communication system, the visual notation of speech, which has evolved in the form of various writing systems. Dyslexia is about having problems processing information from a writing system, which is visual notion of speech, so dyslexics will have at least some combination of Visual and or Auditory Processing disorders, which in alphabet writing systems may be called phonological processing problems. So Both Visual Processing Disorder and Auditory Processing Disorder are component parts of both phonological processing problems and dyslexia. Although some diagnostic professionals may disagree on purely to protect their careers not wishing to participate in multi-discipline assessments. dolfrog (talk) 22:12, 16 July 2009 (UTC)

The other problem is the definition of dyslexia that you want to use, one 2004 review found 28 different definitions of dyslexia. The most recent research from Germany has for the first time compared the different cognitive causes of dyslexia compared with a non-dyslexic control group, which should have been done years ago instead of just comparing dyslexic with non-dyslexics. Probably due to the influence of the dyslexia industry. dolfrog (talk) 22:31, 16 July 2009 (UTC)

I've answered some questions from you on my talkpage as well. I don't doubt your good faith, nor what you have been told by those who assessed you. I'm sure they did a good job and don't doubt that they were correct in the information they gave you. However, when it comes to editing Wikipedia, we have certain constraints (ie policies/guidelines):

• we can't include information based on your personal opinion, and those of people you have met; unfortunately, much of the above is exactly in that category.
• Instead, we need to focus on the highest quality reliable sources, preferably review articles, that summarize the work in this area.
• for a sentence saying that "APD is a major cause of dyslexia" we need citations saying that "APD is a major cause of dyslexia". None of them did and some said exactly the opposite. Links that "explain a link between APD and dyslexia" are not good enough for the purposes of sourcing the statement. And BTW, here is an interesting review study (by a British academic, no less) [2] that also specifically concludes that auditory deficits are not causally related to language disorders (including dyslexia) but only occur in association with them. I can send you (or anyone else) the full article if you send me an email.
• I don't have a definition of dyslexia that I'm trying to use. All I care about is that WP articles accurately reflect the best sources available, and I certainly agree totally that the research suggests that reading disabilities result from multiple causations.

--Slp1 (talk) 23:37, 16 July 2009 (UTC)

Some Research papers which may prove useful to editors wishing to edit this article

Over the last 6 months i have been collating a series of research paper collections, mainly for my own use, but also by the request of others. like all personal collections they are not all inclusive, but try to give a true representation of the research information available. All of my online PubMed based collections can be accessed via user:dolfrog dolfrog (talk) 23:08, 12 November 2009 (UTC)

"It is recommended"

It is recommended , and in some areas a legal requirement, that Auditory Processing Disorder is assessed and diagnosed by an audiologist (better still, an assessment team composed of an audiologist, a speech and language Pathologist, and an educational psychologist).<ref> http://www.infolinks.apduk.org/international_page.htm from where you can still download a copy of Arkansas Department of Education GUIDELINES FOR DETERMINING A CENTRAL AUDITORY PROCESSING DISORDER </ref>

Moved here for improvement or disposal. Citation to a document on policy in one US state is not sufficient citation for the detailed generalisation in this paragraph. Gordonofcartoon (talk) 23:19, 8 March 2010 (UTC)

Merging Listening problems" into Auditory Processing Disorder

Auditory processing disorder (APD) is about having problems processing what you hear, or having listening problems. APD is the listening disability dolfrog (talk) 17:38, 24 April 2010 (UTC)

• And the listening problems described for cognitive reasosns are the result of having APD dolfrog (talk) 16:15, 5 May 2010 (UTC)

Not worth merging. Firstly, the Listening problems article is largely about a different entity: people whose processing is fine, but who aren't focused on the task because of personal agendas or acquired bad listening habits. Secondly, I'm not even sure the content is worth keeping; it's not a multiply-sourced neutral take on listening problems, but gives a presentation of the main theories of a single book - J. Dan Rothwell's In the Company of Others - as if they were generally accepted fact. Gordonofcartoon (talk) 23:44, 6 May 2010 (UTC)

• • Gordon I would go along with that dolfrog (talk) 18:55, 7 May 2010 (UTC)

Behavioral problems

I 'removed tend to have behavioral problems' as I question the accuracy of that statement. my understanding is that behavioral problems tend to only come in to play when its co-existing with something like ADHD and Autism can we verify that this characteristic exists with people that only have CAPD Tydoni (talk) 20:40, 4 July 2010 (UTC)

I'm not going to revert, but if someone tells you "turn left into the station" or "lift higher above the washer" and you listen "turn right into the station" or "lift lower above the washer", you're going to be accused of behavior problems. Your confusion may well lead to other problems; lacking proper reinforcement, I can see how APD could lead to a poorly developed Executive Function skillset, resulting in a (somewhat correct but misleading) diagnosis of ADHD. htom (talk) 02:13, 7 January 2011 (UTC)

Confusing cause and effect?

Those who have APD tend to be quiet or shy, even withdrawn from mainstream society due to their communication problems, and the lack of understanding of these problems by their peers. -it's uncited and it can be the opposite - shyness and withdrawal causing hearing problems, not the other way around. This problem looks very similar to problems faced by language learners who cannot recognize sounds of the foreign language, simply because their ears are not trained to recognize them.--Ancient Anomaly (talk) 01:49, 7 January 2011 (UTC)

It's not a hearing problem, it's a listening problem. The ears are working fine, the mixups occur later in the language processing center -- and it can have the consequences you describe. Hearing (loud, quiet sounds; high, low pitchs) will test fine. htom (talk) 02:17, 7 January 2011 (UTC)

So? Are you trying to refute my argument or are you just nitpicking?--Ancient Anomaly (talk) 01:47, 9 January 2011 (UTC)

Or if I wasn't clear enough - I meant that being a loner can cause problems with language processing, because recognising the sounds and words of the language needs practice like everything else.--Ancient Anomaly (talk) 02:37, 9 January 2011 (UTC)

I agree that a lack of exposure can cause the auditory system not to recognise phonemes (and thus words) correctly. That's not the problem with APD. Words that are known and used by the victim, both in listening and speaking, are mis-recognised when presented to the ear as other words (sometimes words with tangential association) in the victim's vocabulary that were not presented to their ear (their ear (and ours) hears the word "left" and their mind listens to the word "port" instead, to make an example, or hears "port" and listens "wine"), or words are not "listened" at all, they are just deleted from the data stream. If the external ear is at the lowest point of the processing tree, the problem (seems) to be occurring at a level (or levels) higher than that of phoneme recognition, at or above the level of word recognition. There's a similar problem that people can have of word confusions and omissions in reading and writing, and whether this is the same problem and/or cause as APD is unclear, at least to me. Clearer? htom (talk) 04:52, 9 January 2011 (UTC)

You are obviously talking about some different disorder. --Ancient Anomaly (talk) 04:11, 11 January 2011 (UTC)

APD is an umbrella term, covering a number of particular problems with a number of causes. I'm pointing out a flavor of it that doesn't fit your description of cause, but does fall into the APD diagnosis umbrella (at least the hearing form of it.) I think you're trying to over-simplify the complexities involved, which will not help any of the patients trying to learn about what their doctor told them, especially if they know they do not have the particular cause you describe. Yes, that can be a cause; it is not the only possible cause, and not the only possible effect, either. htom (talk) 22:07, 11 January 2011 (UTC)

I'm sorry, but all sources and everything I was able to find supports my version i.e. the problem with recognizing sounds and words, not hearing synonymes instead or anything similar.--Ancient Anomaly (talk) 22:16, 11 January 2011 (UTC)

[[3]] htom (talk) 01:05, 12 January 2011 (UTC)

So?--Ancient Anomaly (talk) 19:38, 22 January 2011 (UTC)

I'm sorry that your research shows that it's all phoneme recognition. You'd think that if that was the case that they would call it something like that, rather than saying it was a general descriptor including that. You could look at Aphasia or Paraphasia or (especially, perhaps) Transcortical sensory aphasia. htom (talk) 23:53, 22 January 2011 (UTC)

Why? This article is not about aphasia. As I said before, you are talking about something else.--Ancient Anomaly (talk) 17:42, 23 January 2011 (UTC)

APD is an umbrella term for a variety of disorders that affect the way the brain processes auditory information. It does not include language disorders. People suffering APD have trouble with understanding spoken language, because they can't hear the phonemes. It's not aphasia, paraphasia or anything of the sort.--Ancient Anomaly (talk) 17:52, 23 January 2011 (UTC)

And I could not find anything about the "variety of disorders", so I'm tagging it with {cn}--Ancient Anomaly (talk) 17:57, 23 January 2011 (UTC)

<out You should really read the entire paper, already cited: http://www.asha.org/docs/html/TR1996-00241.html htom (talk) 03:01, 24 January 2011 (UTC)

You should read it. It indeed mentions aphasia, but not as a part of APD.--Ancient Anomaly (talk) 19:03, 24 January 2011 (UTC)

From the cited paper:

A Central Auditory Processing Disorder (CAPD) is an observed deficiency in one or more of the above-listed behaviors. For some persons, CAPD is presumed to result from the dysfunction of processes and mechanisms dedicated to audition; for others, CAPD may stem from some more general dysfunction, such as an attention deficit or neural timing deficit, that affects performance across modalities. It is also possible for CAPD to reflect co-existing dysfunctions of both sorts.

and:

Language Use

The impact of CAPD on language use is particularly evident in spoken language comprehension. Adults with CNS pathologies and children with developmental language disorders or learning disabilities frequently have difficulty comprehending spoken language, even when they have the necessary language knowledge. If an individual with one of these conditions were to have a central auditory processing disorder, such a disorder would certainly contribute to the comprehension difficulties. For example, patients with right hemisphere lesions of temporal-parietal areas have difficulty analyzing spectral information and thus may lack the intonational information that assists in language understanding.

It is important to note, however, that in contemporary models of language use, the eventual comprehension of a spoken utterance depends upon much more than the processing of acoustic signals. The listener must not only identify, or estimate, the acoustic aspects of the signal, but also must interpret its linguistic value. This requires the activation of lexical representations, grammatical analysis, and judgments of meaning-in-context, to name just a few of the operations invoked in typical language processing models. Working with such models, aphasia researchers point to deficits in resource allocation (McNeil, Odel, & Tseng, 1991), attention (Robin & Rizzo, 1989), or computational inefficiency (Shapiro & Thompson, 1994), as well as temporal processing, in their explanations of language comprehension difficulties. A similar range of explanations can be found in the developmental language literature as well.

The relative importance of “bottom up” (i.e., signal-related) processes and “top down” (i.e., centrally emanating) processes undoubtedly varies among individuals and utterances, depending upon such factors as brain organization, content familiarity, and signal competition (Cole & Jakimik, 1979; Klatt, 1979; Lass, 1984; Marslen-Wilson, 1987; Marslen-Wilson & Welsh, 1978).

Because language comprehension is determined by a number of different factors, clinicians should be cautious in attributing language comprehension difficulties to CAPD in any simple fashion. Likewise, diagnoses of CAPD require comprehensive audiologic assessment and cannot be made solely on the basis of poor comprehension of spoken language.

and

Approach #1: Enhancing Language Resources. Understanding spoken language depends not only on the acoustic signal and its properties, but also on what the listener brings to the listening situation. Listeners routinely use their knowledge of phonology, grammar, and vocabulary, as well as their world knowledge, to “fill in the blanks” of a speech signal. This capacity becomes even more crucial when signal properties are degraded because of auditory system deficiencies. For example, knowledge of comparatives, conjunctions, and other cohesion devices may be particularly useful in the processing of spoken discourse, and intervention could be directed to the learning (or recovery) of these forms (Wren, 1983). It may also prove useful to prepare clients for upcoming lessons, conferences, and the like by teaching any new vocabulary they will need. The information obtained from a speech-language assessment will help the clinician to determine what areas of language to target in intervention.

Once language forms are learned (or recovered), clinicians must also help clients use this knowledge, reliably and automatically, to interpret acoustic signals. Because much of what constitutes central auditory processing is preconscious, occurring without effort or awareness, this intervention goal cannot be met simply by encouraging clients to use what they have learned. Clients will also need opportunities for extended practice with newly learned (or recovered) grammatical patterns or words in order to improve their efficient use of this knowledge in speech processing (Casby, 1992; VanLehn, 1989).

There are some processing difficulties that cannot be addressed by increasing the availability of, or access to, language knowledge. Virtually all individuals with CAPD, in some or another situation, experience such signal degradation that their language resources are not automatically triggered. To assist with these occasions, clinicians can help clients with CAPD learn explicit comprehension strategies. By consciously focusing on crucial aspects of the spoken signal such clients can improve language processing. For example, they can learn to monitor their level of comprehension, pay greater attention to specific speech sounds, use prosody and sentence structure to predict degraded message elements, or deduce word meaning from context (Miller & Gildea, 1987).

Approach #2: Improving signal quality. The second approach to intervention for individuals with CAPD is directed towards improving the quality of the acoustic signal. One way this goal can be achieved is by reducing competing acoustic signals in the listening environment — that is, by reducing background noise and reverberation time. Another way signal quality can be improved is by boosting the intensity of the signal through preferential seating and the use of assistive devices such as FM systems or soundfield amplification. Devices such as these should be evaluated by an audiologist to ensure optimal fitting and to minimize possible detrimental effects (American Speech-Language-Hearing Association, 1994a).

Finally, the quality of linguistic signals can be improved by having communication partners, such as teachers or spouses, speak more slowly, pause more often, and emphasize key words (Ellis Weismer, & Hesketh, 1993; Keith, 1981). Visual aids such as gestures or graphic displays may also prove useful to speech understanding as long as the cues are readily interpretable. Although there has been some enthusiasm for sound control approaches (e.g., occlusion of the weaker ear), there is no theoretical or empirical support for their use.

and:

Parallel difficulties in clinical decision making arise in the treatment of the adult with cognitive/linguistic disorders, (e.g., aphasia). Language comprehension problems in this population could result from memory and attention deficits, from impaired access to language knowledge, or from difficulties in registering the temporal properties of the speech signal. In fact, all of these factors may be combining to produce the behavioral outcome.

One might argue that if the client performs normally with nonverbal stimuli in tasks with competing signals, basic signal processing capabilities are not likely to be the problem. This argument assumes, however, that verbal and nonverbal assessment tasks are perceptually equivalent and are processed by the same auditory processing mechanisms—an assumption that is still a matter of debate. The situation is no better if the client has difficulty with the nonverbal stimuli. One cannot conclude that signal processing is therefore the primary explanation for failure to comprehend spoken language. Inadequate mastery of language could still be a major contributor.

Relative measures of auditory function, such as ear differences, monaural versus binaural differences, and message-to-competition ratio differences, may assist the clinician in determining the relative contributions of auditory-specific versus more generalized processes. For example, auditory dysfunction that is limited to one ear may manifest as an ipsilateral or contralateral ear deficit, whereas deficits in general processes would be likely to affect performance from both ears. In many cases, however, the evidence is not clear, and decisions about the relative contributions of auditory versus language or other general processes must remain uncertain.

I'm trying to maintain good faith, but it really seems to me that your understanding of the problem is very different way than the experts. You seem think it's solely that people have not been trained to hear language elements; they seem to think that that is one of many potential problems involved. htom (talk) 21:38, 24 January 2011 (UTC)

It isn't. You seem to think that this is a language problem. It isn't. People with APD have problems with comperhension because they can't hear well. Everything, including this "paper" agrees with me on that. Yes, they don't know what causes it, but everyone except you seems to agree that APD is a hearing problem.--Ancient Anomaly (talk) 03:02, 26 January 2011 (UTC)

Compare and contrast, please, the bold and italic parts below of the first quote above. You seem to be saying the italic part is not there:

A Central Auditory Processing Disorder (CAPD) is an observed deficiency in one or more of the above-listed behaviors. For some persons, CAPD is presumed to result from the dysfunction of processes and mechanisms dedicated to audition; for others, CAPD may stem from some more general dysfunction, such as an attention deficit or neural timing deficit, that affects performance across modalities. It is also possible for CAPD to reflect co-existing dysfunctions of both sorts.

Auditory Processing Disorder (APD) is a listening disability or having problems processing what you hear all sound which includes the human sound communication system speech, sounds of nature, sirens, alarms etc. APD is not a hearing impairment. dolfrog (talk) 00:11, 21 June 2011 (UTC)

No VPD?

Where's the visual equivalent of this condition, visual processing disorder? Strangely enough there's not an article for it on here. 70.29.244.213 (talk) 06:34, 10 February 2012 (UTC)