Signs and Symptoms that Your Young Child Might Have Auditory Processing Disorder

We noticed at a young age that our daughter was different.  She was easily overwhelmed and didn’t seem to understand language.  Of course, we had never heard of auditory processing disorder but in hindsight, we realize what we were observing in her were early signs of her auditory processing disorder.*

Here are some snippets of what we saw in her as well as what others (therapists and educators) noticed:

Infancy:

• Cries whenever her twin cries and won’t stop until he stops.
• Has staring spells and sensory needs (prefers to sit in her vibrating chair and suck her fingers)

Interventions:  Mom created physical therapy to encourage play, cross body movements, scooting, crawling, and walking.  I also provided visual stimulation, tactile and sensory experiences, and the usual best practices for infant development. (I'm a teacher turned stay at home Mom who likes to study and implement the best practices for raising my children.)

Age 2 1/2: 

• Has staring spells
• Petrified of loud sounds (screams, digs fingernails and teeth into Mom’s skin to hold on)
• Stares blankly when spoken to or responds inappropriately (ex: wipes hands on grass when told  to wipe feet on mat)
• Complains “baby,baby” when a baby can be heard crying in the distance
• Complains “rain” and spaces out, sucking fingers with a terrified look on her face when we are in the car and it is raining
• Cannot listen to a story be read: just points to pictures and names objects, getting frustrated from   Mom trying to actually read the story
• Repeats last word said to her (echolalia)
• Doesn’t like television
• Confuses words (ex. Says “juice” for “milk”)
• Speaks only 1 word utterances

Interventions: In home speech therapy (Diagnoses of Speech and Language Delay) and occupational therapy (Diagnosis of Sensory Integration Disorder) 1x per week with daily reinforcement at home, listening therapy (“The Listening Program”), special education consultant (Diagnosis of At Risk for Learning Delays) 1x per month, a daily sensory diet was implemented, and we used picture cards to help with communication.

Age 3 1/2:  (Special Education Preschool: IEP Evaluation: Diagnosis of Young Child with a Developmental Delay in the areas of Communication and Adaptive Behavior):

• “Hailey demonstrates difficulty with sensory processing and modulation.  She received scores in the definite different range for auditory processing, touch processing, multisensory processing, oral sensory processing, modulation related to body position, modulation of sensory input affecting emotional responses, emotional/social responses, and behavioral outcomes of sensory processing.  Hailey spaces out and stares when she becomes overwhelmed.  She chooses to play with children who are calm.  She becomes overwhelmed by large groups of people and in noisy environments.”
• “Hailey’s speech is 50% intelligible to an unfamiliar listener when the context is not known and 70-80% intelligible when the context is known.”
• “Hailey does not show understanding of part/whole relationships, follow two step related commands without cues, or identify pronouns.  Hailey has difficulty understanding negatives in sentences, making inferences, and difficulty in categorizing objects in pictures….She does not tell how objects are used, answer questions logically, or use words to describe a physical state.  Hailey is very quiet and withdrawn at school.  Hailey rarely talks to peers or in a group.  She needs to be encouraged to use her words and not just nod her head.  Questions need to be repeated for her.   She has trouble blocking out background noises.  Hailey has word retrieve, decoding, and short term memory issues.”
• (I have to add that she was noticed as being "great at puzzles", "hard working", "kind", and "interested in new things".)

Interventions:  2x per week special education preschool (1/2 day) with focus on speech therapy, occupational therapy, and social skills training; continued sensory diet.

Age 4: (Special Education Preschool: IEP Evaluation: Diagnosis of Speech or Language Impairment):

• “Hailey continues to use incomplete sentences, which contribute to some of her unintelligibility….Hailey has not yet mastered her goal to initiate contact with the other children in her classroom and socialization skills are one of her biggest concerns.  She has not been observed consistently responding to other children’s initiative and chooses to play alone or alongside other children with little verbal interaction.  Hailey rarely verbalizes in large group activities unless prompted to do so and when she speaks she uses a very quiet voice.”

Interventions:  4x per week special education preschool (1/2 day) with focus on speech therapy, social skills training, and academic preparations; continued sensory diet.

Age 6: (Private Speech and Language Evaluation: Diagnosis of Mixed Expressive/Receptive Language Disorder):

• “Hailey’s overall speech intelligibility is approximately 75% in a familiar context and around 65% in an unknown context.”
• “Hailey successfully completed tasks with one or two commands and location concepts.  She had difficulty when the commands increased in length, with sequence concepts (ex. second, middle, fourth), and with inclusion/exclusion concepts (ex. all but one, neither)."
• “She demonstrated significant difficulties in recalling sentences.  She was able to recall sentences of up to 5 words successfully however she was observed to paraphrase sentences (ex. The given sentence: “The rabbit was not put in the cage by the girl.”  Hailey said: “The rabbit didn’t got in the cage because the girl.”)  She had difficulty imitating sentences of 5+ words in length. “
• “It was observed that when Hailey had difficulty retrieving a word, she would often use the word “helicopter"."
• "Hailey is a great little girl who enjoys interacting with people and exploring items in her environment.  She demonstrated appropriate eye contact and enjoyed carrying on conversations with the therapist.  She was observed to have difficulty answering questions and maintaining topics.  Hailey would often look to her mom for support when answering questions, ex. “What did you do at the birthday party?” and “What is your friend’s name?”
• “Hailey has significant difficulties with working memory tasks.  She was observed to recall the last number of a 2 number sequence (ex. “3-8”, Hailey: “8”).  However, she was able to recall a number sequence of 3 numbers when movement was included (ex. she could recall three numbers accurately when she walked one step for each number). She was able to recall a number sequence backwards of 2 numbers when incorporated with walking backwards.”
• “Hailey was able to blend syllables (ex. sail   boat = sailboat) with maximum cues and model with 1/5 accuracy.  She was able to detect rhymes (ex. cake-lake) with maximum cues and a model with 3/6 accuracy.  Hailey was able to identify the initial phoneme in a word given maximum cues and a model with 2/5 accuracy.  She was unable to participate in two syllable detection (ex. starfish, take away the fish = star).  These difficulties indicate a phonological awareness deficit.”
• (I have to add that she scored really high on determining the relationships and associations of objects meaning she understands the meanings behind words: vocabulary.)

Interventions:  Private speech therapy 1x per week (utilizing movement and visuals) with daily reinforcement continued at home, listening therapy (“Sonomas Listening Program”), continued daily sensory diet.  Homeschooling for academics and small playgroups with parental support for social skills.

(From that point on we continued speech therapy until Hailey was almost 9.  She was diagnosed with Auditory Processing Disorder and we still continue to use strategies for accommodating auditory processing disorder.  She was further diagnosed with Dyslexia and Visual Processing Disorder.  She did visual therapy to help with the visual processing disorder and we hired a private reading specialist to teach her the Lindamood Bell LiPS program.  We pulled her out of public school after the special education preschool program ended and they wanted to mainstream her into kindergarten without support.  She has been homeschooled ever since and continues with her sensory diet as needed.)

*As you probably noticed, Hailey’s receptive and expressive language skills were noticeably problematic for her from a young age.  Not all children with auditory processing disorder have such extreme problems with language.  However, for her, we believe her extreme auditory processing problems were the reason she had such difficulties with language.

So this is NOT a portrait of what all children with auditory processing disorder look like at a young age.  It is one portrait and maybe it will help others who see similar things in their young children to find some help and start on a path to answers for them.