Did you hear me?

child-covering-earsGetting kids to listen, understand and follow directions can be a challenge. But some kids have more difficulty with these tasks than others due to an underlying delay or disorder.  How do you know if there is a problem or not?

The language process

As your child grows from an infant to a toddler, he is exposed to verbal language. First he listens, soon he understands and finally he begins to imitate and speak. According to the American Academy of Pediatrics (AAP), “one in every ten to fifteen children has trouble with language comprehension and/or speech. For some children, the problem is caused by hearing difficulty, low intelligence, lack of verbal stimulation at home or a family history of speech delays. In most cases, though, the cause is unknown.” 

Sometimes a child has a language problem due to an auditory processing disorder (APD) which means it takes him more time to process language. Other names for APD include central auditory processing disorder (CAPD), auditory perception problem, auditory comprehension deficit and central auditory dysfunction.

With APD, there may be nothing wrong with your child’s hearing – that is – he can hear your voice and sounds around him just fine. It is his ability to process those words and understand the language that slows him down. He “hears” the words, but has trouble distinguishing differences in the words and interpreting the meaning.  As a result, he needs more time to decipher meanings, make sense of the language, and then more time to form his response.

What are the signs of APD?

As your child moves from toddlerhood to preschool and beyond, a language processing issue may become more noticeable. You may wonder why you are seemingly ignored when you say something to your child, or why your child does not respond in a timely manner.  In reality, he may be still processing the first sentence of your three sentence request, and has not gotten to the last part of it when you were expecting an answer. The noise in a room may distract his thought process or a combination of factors may make it hard for him to pay attention, understand and respond to you. Your child may struggle to keep up with the fast pace of his life often resorting to tears and tantrums out of frustration.

Here are some signs that your child may be suffering from an auditory processing problem:

    • Trouble paying attention
    • Trouble following directions
    • Poor listening skills
    • Trouble with language – confuses words and doesn’t understand – can’t follow  a  conversation
    • Needs more time to process information
    • Gets upset in noisy environments or bothered by certain sounds
    • Behavior problems
    • Easily forgets information that was taught previously
    • Trouble with reading, spelling, comprehension and vocabulary (when your child is in school)

What should you do?

If you suspect that your child has an auditory processing problem, speak with your pediatrician. The AAP says: “If your pediatrician suspects your child has difficulty with language, he’ll conduct a thorough physical exam and hearing test and if necessary refer you to a speech/language or early-childhood specialist for further evaluation. Early detection and identification of language delay or hearing impairment is critically important, so treatment can begin before the problem interferes with learning in other areas. Unless you and your pediatrician identify the difficulty and do something about it, your child may have continuous trouble with classroom learning.”

You can also request an Early Intervention assessment. Read my blog post on how to have your child evaluated for free if he is under three years old, or if he is age three and older. Possible interventions may include speech and language therapy, visits with an audiologist, specialized training devices, and the use of auditory training techniques.

How can you help your child?

In addition to a thorough assessment and treatment if appropriate, here are some tips:

   • Speak slowly and directly to your child – establish eye contact
   • Keep directions simple and short, and repeat if necessary
   • Have your child repeat directions
   • Wait for your child to process and respond – don’t rush him
   • Encourage your child to ask questions or request help if he does not understand
   • Provide verbal praise frequently

My daughter suffers from APD. She is now 23 years old and has learned how to deal with her auditory problems. She is an Assistant Teacher at a Childcare Center working with 2 year olds. She has noticed that a couple of the kids at the Center need more time to process and respond when they are spoken to. She urges me to tell parents to slow down, wait and don’t rush your child as he is trying to answer you. By being impatient you may cause unnecessary anxiety in your little one, which will only complicate issues.

For more detailed information, the NIH has a great factsheet on the topic as well as resources to explore. You can also read more about how APD can affect your child throughout his life on NCLD’s website.

Bottom line

Listening, deciphering and responding to language are exhausting for a child with a delay or auditory problems. If you suspect an auditory problem in your child, seek help earlier rather than later. Patience, time and therapy may help him to overcome hurdles.

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started on January 16, 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the menu on the right side to view all of the blog posts to date. As always, we welcome your comments and input.

Have questions?  Send them to AskUs@marchofdimes.com.

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