Auditory Processing Disorder: The World is Not as Accommodating as We Moms Are

Since Hailey has been taking classes at the homeschool center once a week, I am getting to sit back and just watch her experiences and interactions in ways I haven't before.  I have always been right there beside her, helping her throughout it all.  Now, I see her sit in her class and listen to the teacher (I got to sit in on a class today).  I see her in the hallways.  I see the other children in the classrooms.  I see the other children in the hallways.

I am starting to feel emotions that I haven't felt for a while now.  I am realizing just how much we have organized our family and our homeschooling and even our socializing to accommodate her needs as a person with auditory processing disorder.  We don't even realize we are doing it anymore!  It has become so natural to us.

At "school" (the homeschool center), no one accommodates her needs (not that some of them don't try - they do).  The teacher talks and walks around the room, rambling in long sentences that are circular in theme and connected by only simple threads and tangents as she weaves her web of a story to showcase the point she wants to make.  There is nothing wrong in this way the teacher is talking; in fact it is a very common way people talk when they are just "speaking off the cuff" or rather just talking without a plan of what exactly they are wanting to say and how to get to it.  The other children just listen and seem to follow along to some extent.  Some of the kids jump in with responses to her story or sharing of their own similar experiences.  It is casual and free and a lovely open discussion.  However, for someone with auditory processing disorder, it is too hard to follow. The linearity of the story is lost as moments and details are remembered and added in.  The purpose for listening is lost as it is told at the end rather than the beginning.  The jumping in of others (which brings an interactive component for the other children) just makes it that much more confusing as new stories are presented in the middle of the unfinished original one.  I felt sorry for my sweetheart sitting there lost and bored, I imagined.  The other kids could appreciate the conversational style, but my child with auditory processing disorder found nothing but confusion in it.

In the hallways, the children stand and chat with one another.  Their voices mix and mingle like a choreographed dance of speakers seeming to talk over one another and yet all seem to still be able to follow and understand.  They laugh and smile and seem genuinely happy to be there with one another.  My sweetie with auditory processing disorder stands there lost, with vacant eyes and in silence. Someone will smile at her or touch her shoulder and she will momentarily smile and her eyes will light up, only to hide again in the din of the conversation.  When I ask her about it, she says she likes the kids, but she doesn't understand what they say.

Inside my momma bear wants to barge in to every situation and say "Talk slower.  Talk in phrases. Make sure she understands before you move on.  Don't talk over one another. Use visuals." Yet, I know this is not the right approach.  My sweet girl is almost 13 and she will run into this her entire life!  She has to decide how she wants to handle it, if she wants to handle it.

For classes, of course, we can ask for accommodations that will help her to learn what she wants to learn and do the assignments.  In social exchanges, she will have to speak up and ask others to slow down when she wants or just not understand when she doesn't feel the need to understand but simply to just be there. With her good friends, she does ask them to repeat themselves or speak slower or explain things if she doesn't understand.  In just the group-you-find-yourself-in situations, she says she doesn't really care.

So all this long ramble is to say that I, the mom, am feeling distressed by her situation.  She, the one with auditory processing disorder, is actually handling it all better than me.  She doesn't expect to understand everything and she's okay with that.

Meanwhile, I'm hiring a private sign language tutor to see if this will help her in any way.  She likes the sign language she has taught herself through books and videos, so we're going to try diving more into this as a possible option.  (Update:  I have been reading that "language disorders" (such as Mixed Expressive Receptive Language Disorder which Hailey was diagnosed with at age 6) often cross over into sign language as well as oral language.  Bummer!  We will still pursue the sign language, though, as it might prove helpful all the same.  I'll be sure to let you all know.)

APD Makes Classroom Learning Hard: Having Auditory Processing Disorder and Taking Classes after Homeschooling

As many of you know, Hailey (7th grade) wants to take community college classes as a high-schooler, which is in two years.  So we found a local homeschool center that offers classes to homeschoolers and she signed up for tennis, 3-D art, theater improv, and creative writing.  This way she will have some exposure to taking classes before taking college level classes. (And she really is loving just having the experience of going to school and taking classes and eating lunch with her friends.)

This experience is really showing her and us just how much her auditory processing disorder affects her in a classroom environment.  None of us really could have guessed how difficult some aspects of a classroom learning experience would be.

As Hailey has some great coping skills and really relies a lot on the visual information she is inputting, she is doing very well in the tennis and 3-D art classes.  She says that although she doesn't necessarily understand what the teachers are saying, she can see what they are demonstrating and so knows what to do.  She has always done well at both art and anything physical.

The problems for Hailey are in the creative writing class and the theater improv class.  The areas of difficulty so far are in understanding what is being taught orally, clearly knowing the directions told, and reproducing the spoken or written work under the pressure of time.

The creative writing class is taught by the teacher reading a poem and talking about the use of literary devices such as metaphor, simile, personification, etc.  She tells the students what a quatrain is and reads an example.  So everything is being told to them and at most, they have a sheet in front of them.  The problem is that the sheet is just of the poem being read and so it helps, but it doesn't teach Hailey what a metaphor is for example; she would have to understand what the teacher is saying to get it.  The homework is also told to the students at the end of class.

The theater improv class has the students working in groups and doing improvisational type skits; although not completely improv as they do get to do some planning and preparing before they do their skit.   This is very fun and Hailey is enjoying it, but again she is not processing everything and so tells me that she just lets the others take the lead and she has very few lines.  She says that she can understand the themes and emotions by the body language and so uses that as her guideline as well as in the groups, the other students do make sure she knows what is going on so that she can perform her part.

In creative writing, she has to write in class as well as at home. The writing at home is something she actually looks forward to doing and does well.  She has all the time she needs and she can get help as needed.  In class, she feels pressured to write in the limited time frame given and this worry makes it so that she cannot remember how to spell even simple words and she says she even has trouble just making it look neat on the paper. This was shocking to me as she has good handwriting and has always taken great strides to make her handwriting neat and legible.  She is also a good speller (which is not that common in people with APD it seems) and so I think her and I were both shocked that she would have these problems.

In theater improv class, the teacher has them practice things like accents and tongue twisters and speaking backwards and really fun things like that which makes a lot of sense for a theater class. However, Hailey's APD makes it even more difficult for her to process these and forget having her try to do them; she can say a tongue twister for example if she practices it a lot and even then she has to say it slowly, but on the spot and fast is simply impossible.

So we are taking advice from all our schooled friends with APD (those on the Facebook APD support groups) and asking for accommodations that may help Hailey in her classes.  My hope is that we can do all the experimenting at these homeschool center classes and then be prepared and ready for community college in a few years.

So far we are going to record the creative writing class so that Hailey can bring it home and we can go over it together.  I can then teach her whatever was taught in class.  She is also going to type her in-class writing and e-mail it to her teacher so that she feels less constrained by time, because typing is faster than handwriting and she doesn't have to worry about making it neat.

In theater improv class, the teacher is now aware of the APD issues and will hopefully make sure Hailey works in a group that helps her be her best as well as she won't keep asking her to do tongue twisters; maybe she can focus on more gestures and body language in acting skills.

I'll certainly keep you all updated on what we discover works and what doesn't.  I do feel very grateful that Hailey has her background of being homeschooled and knowing that she is very smart and capable of learning and accomplishing whatever she wants to do.  I fear that if she hadn't had this successful background to discover herself and feel assured of herself, these experiences of not understanding in class would be too hard on her.

My heart goes out to all the children with APD who go to school everyday to sit in a class where they do not understand what is being taught.  My hope is that more and more teachers are using a multi-sensory approach to teaching and not relying on auditory input only.  Our children with APD are smart and capable and just need to be taught in a way that works for them.

Going to a Concert with APD: Don't Forget the Earplugs!

"My ears felt like they were going numb because of how loud the noise was. Did you feel that too?"  Hailey had been bent over, squeezing her eyes tight and holding her ears with her hands. She looked like someone in pain and I knew I needed to get her out of there quickly.

For weeks Hailey had looked forward to going to a concert with her two closest and dearest friends. As we were going to see the Go-Gos and the B-52s, the girls all bought 1980s prom style clothes and fixed their hair up with 1980s styles (Hailey had a side pony tail.)  Us moms sat behind them in seats close to the stage, so we could all see very well.  However, the NOISE was incredibly loud!

Hailey desperately wanted to be with her friends and enjoy the show together, but she just couldn't handle the noise and mommy over here neglected to bring any earplugs.  So I escorted her from our close-to-the-stage seats to the farthest corner of the lawn, away from the noise as we could get and still be in the amphitheater.  This made the noise at a tolerable level and she felt immediately much better.  However, even there after a time she got to her threshold of bearability and started to melt; tears welled up in her eyes and she needed hugged and cold water and to leave the amphitheater. She missed being with her friends, but just couldn't handle the noise.

Hailey's thoughts:

"I couldn't understand the words.  All I heard was blah, blah, blah."

"I liked eating a turkey leg". (They had them there to purchase.)

"Even though I couldn't hear the words, I could still tell the difference between the Go-Gos and the B-52s by the way the beat sounded.  I liked the beat and the sound of the B-52s better."

"My friends didn't think it was too loud."

"If I ever go to a concert again, I will bring very good ear plugs or something even better than earplugs because even blocking my ears, it was too loud."

Do Children with APD Have More Fears than Their Peers?

My spouse and I were talking the other day about how our sweet girl with auditory processing disorder has always needed more reassurance than our two non-APD boys.  She asks five, six, seven times every night if we've locked all the doors.  She tells us all to have safe dreams before sleeping and insists we tell her the same thing and it can't be "good dreams", it has to be "SAFE dreams".

It's not just the night time sleeping that brings concerns for her.  Whenever I (being mom) leave the house without her, she looks at me deeply in the eyes and tells me to drive very, very safely and be very, very careful to not get hurt and come home to her safely.  Then she gives me at least three hugs and longingly waves me off.  She is worried that something will happen to me and she will never see me again.  I think this is because she still relies very much on me for support; I'm the one person in her world that truly understands her.

My spouse gets concerned that maybe this is not the APD, but I really feel that it is.  I imagine that if I lived in a world where I understood sometimes as little as half of what I heard each day, I'd feel pretty lost and confused and scared.  I would rely that much more on those I trust would support me and care for me and always be on my side.  It just makes sense to me.

As our sweet girl gets older, she does make strides in her comfort level with living in this world.  She used to never be able to be away from me at all without acting fearful; now she does let me leave for several hours away without her and she functions just fine, enjoying her life.  She used to need constant sensory support such as something to chew on and her little blanket "Nonny" to hold for support, but she stopped carrying Nonny and she stopped needing to have something in her mouth. She used to need me to do things like go into the locker room with her at ice skating and now she asks me to stay out so she can be on her own like her peers.  When she was little, she did sleep in our room with us until she was seven years old; we let her decide when she wanted to sleep in her own room. (We did the same for our boys of course.) Now she always sleeps in her own room and even feels comfortable staying the night at her friends' homes.  So as time goes on and she gets older, she does feel more "safe" and doesn't need as much support as she once did.  Maybe she hasn't been on the same path as her peers and maybe her time frame  has been different, but it is her path, and in her time, and therefore it is what works best for her.

I am a firm believer that children grow in the times and ways that work best for them and if she has more fears, then I will help her through them by providing the support she needs now, showing her how to support herself but not taking that support away from her until she has asked for me to do so; she knows herself even better than I know her and I respect that.  I want her to know without a doubt that I am there for her whenever she needs me, without judgement and without fear that I will suddenly just stop when she isn't ready for me to do so.

Processing Conversations with Auditory Processing Disorder: You Don't Always Understand

A few days ago I posted on Facebook a quote from a young woman* with auditory processing disorder.  She described how she understands maybe only a few words in a conversation and uses body language and context to try to figure out what the other person is saying.  Well, I knew my daughter did this to some extent, but I hadn't really been paying as close attention to this in a long time.  

At home, in an ideal environment with people she is very familiar with, my Hailey actually does very well at understanding most things; her only real difficulties at home seem to be in watching television as she often misses the conversations there.  That really isn't a problem though as we just pause the tv (we use a dvr and it is wonderful for this reason) and help her understand if she wants the help.  Of course most of the time she is content to just half-understand the words spoken, because let's face it, television is not usually very complex and is highly visual.

So we were going along in our nice little world of home without thinking too much of the real difficulties Hailey has with understanding what people say.  Socially, she has friends and the group aspect of conversations still make it too difficult to follow a conversation, so she just follows along at the edges of the group.  With her close friends, she has one-on-one conversations and that works well. We knew this and felt okay with it all.  However, with the information from the young woman that I posted on my Facebook page, I started paying more attention to where maybe her lack of understanding is causing her real problems.

As many of you know, Hailey ice skates.  She is also in a theater on ice class, which she really enjoys.  Mostly, she just has to follow along with what the others are doing and takes in her input visually.  Yes, she has to follow the music to stay on beat, but luckily she does not have the prosodic form of APD and so can hear the beat of the music well enough.  Well, her troupe is starting to learn a new program and her coach has decided to allow each skater some more individual input.  With this is mind, her coach took her aside to talk to her about what character she would like to be in the upcoming program; her coach has become aware that Hailey does not comprehend well in the group setting and so kindly spoke to her privately, making eye contact.

Hailey didn't want to make eye contact, kept shrugging her shoulders, and desperately wanted me to speak for her.  I tried to help without interfering and tried to encourage her to speak for herself; she is 12 years old and can handle these things. She did okay, but it was clear that she doesn't understand as much as I would have thought.  Later in the car, alone with me, she said some things to me about the conversation she had with her coach and she got quite a few things very wrong; she thought she heard things that were never said.

So even though her coach spoke to her one-on-one and she had me there to help, Hailey still didn't process it all.  The surrounding factors, I believe, were:

• she was already worn out from a full day of skating and socializing to her ability in a group;
• her coach has an accent;
• she is somewhat intimidated by her coach even though she really likes her a lot - she sees her coach as someone with a lot of authority and also as someone she wants to please and yet doesn't always understand; 
• and she is afraid that she might choose the wrong character in this particular scenario and end up in a situation that is too hard for her. (Talk about anxiety!)

All of this just helps me to realize that my sweet Hailey works really hard to make sense of what she does hear and unfortunately, she still misunderstands quite a bit if not in an ideal situation with a familiar context.  Being homeschoolers, I forget how much this is a problem because she is in an ideal environment most of the time and she is very familiar with our speaking styles and not at all intimidated by us. 



*Kendra Ross: "I have been called a liar by teachers, students.... I understand that APD is so hard to deal with and not understanding what someone is saying to you; the best thing I do that helps me when someone is talking to me and I have no idea what they are saying is reading their body language. If that doesn't work even if I don't understand what someone is saying, I use whatever words I do hear, and replay that back to them. Like today this one girl in my class was telling me about what she is going to do for her video, and it was a long hallway, she slurred. I had no clue what she was talking about until i got these words "needed.........talk.......teacher". Even though it was just 3 words, I got that she needed to talk to our video teacher about what she is going to do for her final. Then I wished her good luck. Now if I'm having a bad day, then I will just nod at the appropriate times until the conversation is over. Which happens, but it's best to try and understand the situation, even if it only 1 piece of info. It is key to have your [children] develop the skill of understanding a situation even just on body language. And the most important skill is understanding the situation and filling in the blanks. Hope this helps."

Accommodations for Chewing Gum and Other Sensory Needs Kids Have

Chewing gum and other things that help people lower their anxiety and process information better are finally getting recognized!

Remember when everyone in school was supposed to sit still and be quiet?  Well some teachers and schools are starting to realize that this does not work for all children.  Some need to move to think.  Some perform better with classical music playing in the background.  Some need to chew gum to lower their anxiety levels.

I am a homeschooling momma and I know that each of my three children are very different in their needs:

•  My daughter uses gum to lower her anxiety and focus better. She also requires absolute silence to read, do math, or basically anything that requires a lot of concentration. Noise is a horrible distraction for her and it raises her anxiety level tremendously. (Sit still and be quiet would be fantastic as long as she could chew her gum and fully understand the directions.)
• Her twin brother likes to pace as he processes and recalls information.  He says his brain just works better when he moves.  Making him sit still causes his brain to just freeze up; he’ll actually sit and stare at you while his body tenses-up in frustration.  (He would have been one miserable child in the classrooms of sit still and be quiet.)
•  My youngest child is so full of energy that he needs to be able to jump around, be loud, and move a lot during the day or else he explodes – like that extra energy is just boiling inside of him and needing a way out.  (If in school, I would say he would benefit from extra recess as his body needs that time of physical activity and being loud.)

wiggle seat

If your child needs something different than what your school is providing, talk to them.*  See if you can get a permit for your child to chew gum, move (walking or using a wiggle seat), have some sort of extra physical time (maybe a 3 minute break to run around), listen to classical music in head phones while working, use noise cancelling headphones for more quiet, have a visual blocker of some sort if he/she is visually distracted, or whatever else you think would be of benefit.

*There are parents whom have been successful in getting their schools or teachers to permit their child to have accommodations that make sense for that child.  These are usually granted with an IEP or 504 plan, but sometimes they will accommodate even without one of these.  For instance, neither of my boys would qualify for a 504 plan, but they still could use these accommodations if they were in a classroom environment.

Coping Strategies For Auditory Processing Disorder in Everyday Life

I promised to write a post about coping strategies for Auditory Processing Disorder in terms of just living everyday life.  This is something we have come to over time and developed and changed according to Hailey’s needs at each stage of her life.  Some we learned from therapists, some from experimentation, and some from the helpful advice of other people dealing with APD in their lives or that of their child’s. 

As an almost twelve year old girl, here are some strategies she employs today:

1. She had to learn to not compare herself to children who do not have learning disabilities and to realize that she is incredibly smart and capable to be able to learn all that she does and do as great as she does even with her APD.
2. She had to learn how to manage her day to not be too overwhelmed: not too much socializing or too much having to listen to things. She takes quiet breaks and alone time as needed.
3. She had to learn destressing techniques that help her such as chewing gum (it relaxes her), or smelling something beautiful (she really likes lavender and has some oil she can place on anything to carry around and smell as desired).
4. She focuses on spending one on one time with friends so that she can manage the conversations and feel comfortable and confident.
5. When she has to be in a group of friends, she tries to focus on one kid if possible, and if it is too overwhelming, she finds a way to leave the group without appearing rude. (This is a new one for her and not always easy, but she is trying.)
6. We do math in small increments so as not to be overwhelming, use visuals, and I do not talk too much (We homeschool).
7. We watch documentaries and do hands on learning for a lot of science and social studies.
8. My daughter loves graphic novels/manga books and this has greatly advanced her reading confidence, skills, and she feels like it is a typical pre-teen/teenage girl thing to do as the topics are geared towards that age group.
9. She found an activity that does not require processing auditory input so much and she has a level field with the other kids. This helps her to feel "normal". (It is figure skating for her.)

As a young child, we the parents had to employs strategies to help her cope with her days.  We had to regulate her activity level, environment, and stress levels.   Here are some strategies we used then:

1. We scheduled her day to have auditory breaks where she did not have to listen.
2. We used a sensory diet throughout her day to manage her stress levels; when overwhelmed she would check out from reality and sit in a dazed like state or have major meltdowns.
3. When we had to go to a noisy environment, we used noise reducing headphones, made sure to massage her legs or arms to keep her focused, and protected her from the demands of others. (For example, when the lady at the checkout wanted to ask her questions and she just could not process them, we would answer for her while smiling at her, rubbing her legs, and reassuring her as she got extremely anxious when people spoke to her.)
4. We used picture cards, eye contact, and small phrases only to communicate with her so she would know what we were talking about.(She also required a physical touch to make sure she was aware we were talking to her.)
5. We planned for transitions (going from one activity or environment to the next) by interacting with her at her level, using picture cards, doing sensory diet activities to help her deal with her anxiety, and making sure we brought whatever she needed to bring with her to help her remain calm. (She had a special blanket that we put scents on that she carried everywhere.  We also had chewy toys and strong tasting mints or candies (a sensory calming strategy for her) to give to her as needed.)
6. When it came to academics (or just learning things like language when she was very young), we limited her time to just what she could handle; we used a lot of visuals and kinesthetics to help her understand; we made sure to give her a long amount of time to actually process what she learned; and we repeated things as often as necessary until she got them.
7.  In social situations, we always stayed with her to provide support as needed, and we gave her tools to help her navigate them.  For example, she needed to have the practiced phrase, “Hello, My name is Hailey.  What is your name?” at first.  We also taught her other stock phrases that helped her tremendously like “Do you want to play with me?” and “I like your ______”. (As she got older, we were able to communicate with her how to go with the flow more in socializing and as her receptive and expressive speech skills grew, she was able to not have to use stock phrases anymore.)
8. We made sure all our family and friends were aware of her needs and did not place expectations on her that would create anxiety for her. (This was not readily accepted, but over time it was.)
9. We worked with specialists such as a speech and language therapist, an occupational therapist, an audiologist who specializes in auditory processing disorder, and a special education preschool to implement therapies to help her.

As I read about the experiences of teenagers and young adults, I know that she will have to learn and incorporate more strategies as well as alter the ones she has now to fit new situations.  So as new situations and environments arise, we'll do research, ask others for advice, and do what we can.

Helping Our Children With Special Needs Deal with Anxiety

Anxiety displacement is something I have been thinking about lately.  I’ve been researching what I can find about it with very little success.  There’s huge amounts about anger displacement, but what about the very real existence of people taking anxiety from one situation and displacing it onto anxiety about everything that ever happened or will happen.

The Problem:

You see, I’ve run into a pattern in my daughter’s life.  Whenever she has anxiety about something, it spills onto everything else.  If she has a dentist appointment, she’ll have an entire day of thinking about all the ills she has ever suffered in life and worries about them happening again.  She will get into that old stuck needle on the record place where no matter what anyone says or does, she is incapable of not worrying about everything.

I’ve read account after account of other parents discovering the same pattern with their child – particularly with children whom have special needs.  The intensity of the anxiety seems to be so overwhelming, that I believe the child displaces it onto familiar scenarios in an attempt to manage it.   Therefore, I think it is anxiety displacement.  Here is an example of how it goes:

What I’ve learned over the years is that my daughter is displacing the anxiety of going to the dentist onto everything else.  She doesn’t know how to handle the intensity of her fears and she goes to the old stand-bys that she has grown used to.  She has worried about her weight, her reading, misunderstanding, being bullied, having people not understand her, etc.  These are old pains and old worries that we have worked through repeatedly.  She knows the response she will get when she brings them up, and she hopes these responses will make her feel better – make the current fear go away.  The only problem is they can’t.  Hearing me remind her how well she reads now doesn’t make her fear of going to the dentist go away.  So she moves on to the next old fear or pain with the same result.  As you can imagine, this is exhausting and futile for both her and me. 

My Solution:

So what I have finally learned is to not go down that path with her.  I simply tell her that she is bringing up old worries and that they are not her problem right now.  If I know what she is most likely having anxiety about, I talk to her about that and that only. I tell her that we can talk about those old worries later if she still wants to, but not now.  For instance, when she had a dentist appointment, I told her we could talk about her worries about going to the dentist but those old worries would have to wait until after the dentist appointment, because they were probably not real worries today – just triggered from her current worry about the dentist.  (Of course after the dentist appointment was over, she felt fine and no longer wished to talk about any worries.)

We also focus on feeling better right now.  We have talked extensively about how all people’s brains don’t work well when we are in the middle of intense emotions and how we need to calm our mind before it will work well.  Therefore, we focus on doing things that calm our minds.  For my daughter, this is chewing gum, smelling lavender, being squeezed, and doing relaxing activities like singing, dancing, or watching a fun show.

Prevention Works Best:

Furthermore, I’ve found that if I can prepare for the anxiety inducing event ahead of time, life goes more smoothly for all of us.  What this means is as mother, I know an event like a dentist appointment might provoke anxiety, so I plan on doing non-stressful fun events and calming things that day.  I don’t plan other things for that day for her or myself, and I make sure I get enough rest and sustenance to manage the emotional day I have ahead of me.  As my daughter gets older, she learns more how to do these calming things for herself and how to plan her life herself to allow for such things.  That is our goal: to help her learn how to calm herself, deal with anxiety, and prepare for stressful events whenever possible.

Strategies for Managing Auditory Processing Disorder

The management of Auditory Processing Disorder (APD) consists of three main categories: 1) Environmental Modifications; 2) Remediation (Direct Therapies); and 3) Compensatory Strategies.

As not every person with Auditory Processing Disorder has the same exact problems to the same exact extent, it is important to keep in mind that not all strategies work for everyone nor are all needed for everyone.  Moreover, many times Auditory Processing Disorder is one disability/difference of many for an individual; some conditions such as Dyslexia, Sensory Processing Disorder, Visual Processing Disorder, Attention Deficit Disorder, and various language disabilities are common co-existing conditions.

Environmental Modifications:

Environmental modifications are things that are done to make the environment for a person with Auditory Processing Disorder most able to function at his or her best for learning, working, and/or living.  Some examples of these are*:

• Preferential seating to be nearest the speaker and away from environmental noises such as heaters or fans;
• Visual cues and aids used in presentations to assist with comprehension of the material being covered;
• Written notes provided so that full attention can be on the speaker and not on trying to take notes at the same time;
• Study guides or outlines provided before the lecture so that the person with APD can become familiar with the material and vocabulary ahead of time;
• A school FM sound system or a personal FM system to allow the person with APD to hear the speaker directly without as much environmental noise;
• The speaker pausing at phrases rather than speaking in long, complicated sentences;
• Always insuring that the person with APD has the ability to see the face of the speaker;
• Permitting the person with APD more time to process information - both input and output;
• Provide or allow the use of lists or other devices (such as recording devices) to assist with auditory memory problems; 
• Noise reducing headphones for the person with APD who is sensitive to sound when direct listening is not necessary - such as during a test or when reading;
• For the young child, picture cards are a valuable asset to assisting the child with communication. These can be made at home or purchased; and
• Many publishers of textbooks (Harcourt Brace, Houghton Mifflin, Pearson, Macmillian/ McGraw Hill, Holt McDougal & Houghton Mifflin Harcourt, Pearson Prentice-Hall, Pearson K-12) also have electronic textbooks that are available.  They are interactive and play on a computer.  I've been told that school districts are the only ones that can order them at the k-12 level.  I've also been told that some are accessible to be read by a text to speech reader application such as Adobe Acrobat 6. This is something to look into if reading speed is a problem for the student with APD.  

Remediation (direct therapy):

Remediation is controversial for Auditory Processing Disorder.  There are a number of therapy programs available and all have mixed results.  Some people may find one therapy incredibly helpful while others may find that same therapy to be useless.  

Remediation should also be aimed at the particular needs/circumstance of the individual with Auditory Processing Disorder.  Therefore, if a child is having problems processing speech, a speech therapist would be advisable.  If a child is having difficulties learning to read, a reading intervention program would make sense. Keeping this in mind, here is a list of some possible therapies*:

• Auditory Integration Training: Berard, Tomatis, and Samonas
• Fast ForWord;
• The Listening Program;
• Neurofeedback;
• Speech Therapy;
• Occupational Therapy;
• Movement Therapy/Kinesiology (Brain Gym);
• Interactive Metronome;
• Earobics;
• Lindamood Bell: Lindamood Phoneme Sequencing Program (LiPS); 
• Easyread; 
• Phono-Graphix; and
• Games and computer applications that encourage auditory processing such as Simon, Bop It, Musical Chairs, etc.

Compensatory Strategies:

Compensatory strategies are ways in which the person with Auditory Processing Disorder uses other skills to help him or her best cope with his or her auditory processing problems.  These are language, conversation, organizational, and social skills that have been taught or encouraged and practiced.  Some examples of these are:

• Identifying body language and facial expressions;
• Lip reading;
• Social skills training such as role playing different scenarios;
• Using the practice of rephrasing what someone says as a way to halt the conversation and use that time to better process what was said and compose a response;
• Speaking up for oneself and one's needs such as asking people to repeat or clarify something;
• Utilizing environmental modifications such as making a point of positioning one's self near to and looking at a speaker as much as possible;
• Using texting or e-mail to communicate;
• Using written reminders or lists to compensate for auditory memory problems; and
• Use visualization techniques to remember things: make a picture in one's mind of the event or concept.

* All links posted here are only one company providing the service or product listed.  Please research to find which provider you prefer.

Preparing for Daily Transitions Helps Children with Special Needs

Back in the day when I was a student teacher in a kindergarten classroom, I learned a lot of songs and games to use to help my students transition from one activity to the next.  They were fun ways of getting the children to pay attention and do what was needed to clean up and get ready for the next thing.  Like spraying magical dust upon them, it worked miraculously!  At the time, I had no idea what I was doing was assisting the children with transitions by providing them a secure routine which they understood and knew what was expected of them.  In my new teacher mind, I was simply doing what I knew worked to keep those thirty little munchkins from chaos!

Children do not like chaos!

As a parent of a child with special needs, I truly learned that children don’t like chaos any more than anyone else.  Since their worlds are mostly controlled by the adults in their lives, they might feel like the world around them is chaotic when things suddenly seem to happen and everything changes quickly – too quickly - and they don’t know why or what is going on.  These changes are transitions.  Every day we go through multiple transitions; some go smoothly and some knock us around a bit.

It only goes to reason that if all children can feel the world around them is moving quickly and unpredictably, how much more so does the child who processes things slowly or differently.  For the child with Auditory Processing Disorder or Mixed Receptive Expressive Language Disorder, language may be less than 50% understandable at times. Noises and movement in the environment may make things seem encroaching upon a child and always worrying that they just don’t understand can make the world seem out of control – chaotic.  So when a transition, a change from one activity or place to another, is suddenly thrust into the middle of an already somewhat chaotic feeling world, it can simply be too much.  The child understandably reacts with a meltdown.

Case Scenario:

When our daughter was very little, before we realized the significance of transitions, she would cry, get scared, panic, and grab me with such intensity her fingernails would embed into my skin.  In our adult minds it made no sense.  We had told her we were going to the store.  So when we put her shoes on and put her in the car, why did she suddenly freak out?  If we had only stopped to think about how it might have seemed from her point of view, we wouldn’t have been so shocked, and we would have been able to prevent it.  Eventually, with the help of our occupational therapist, we did.

From her point of view, she was sitting playing nicely with her toys in the comfort of her living room.  She heard some blah, blah, blah talking, but who knows what that was.  Then we came with shoes and put them on her feet.  She never had to wear shoes in the living room before, so that seemed weird. Besides, shoes aren’t comfortable.  Somewhere in the recesses of her mind she remembered wearing shoes before and it involved going outdoors, but maybe she sort of remembers this and maybe she doesn’t.  Suddenly we are picking her up and putting her in the car.  She was in the middle of playing and she didn’t want to stop playing.  She hates car rides because they are loud and sometimes there are weird smells.  Cars stop and go and things whiz past outside.  Moreover, she doesn’t want to go anywhere: home is predictable, usual, has the same sounds, smells, people, etc.  Other places are stressful, loud, smell funny, and may be too cold or too hot.  Even more frightening, what if people try to talk to her?  What if they touch her?  What will be expected of her?  Leaving home is always stressful and she wasn’t prepared.

Preparing for Transitions Does Wonders!

So we learned how to best prepare her for transitions.  We learned to use picture cards to show her the car and the store.  We told her we would be going in the car to the store.  We gave her time to process this information.  We helped her put away her toys.  We made sure she had her special blanket and her special chew toys.  We showed her the pictures again.  We encouraged her to repeat to us what we were doing. We reassured her that she was safe and we would be with her with our words and with pictures of us at the store with her safely sitting in the cart seat with her blanket and mommy beside her.  Yes, it took some time.  Yes, we had to plan and prepare for transitions.  It was well worth it!  They went smoother and without meltdowns – visibly she was still stressed, but they weren’t full-on panic meltdowns.

She still had to deal with the stress of being in the car and at the store.  She had to feel the panic when the cashier made eye contact and tried to talk to her.  We also learned sensory calming techniques to help with these things as well – her special blanket with scents on the corners and a vibrating chew toy or spicy candy, rubbing her hands, and speaking for her to the cashier (yes, she is a sweetheart – do I swipe my card here?) while comforting her all helped significantly.

It Gets Better With Time:

Okay, for all you poor panicked souls who are fearful that life will always be this difficult with your young, sensory sensitive child who processes things differently; I have some hope to offer.  This scenario I just described was our daughter at 2-3 years of age.  Today, at 11 years old, she is nothing like this!  She rides well in the car, she loves to go shopping, and she mostly does well responding to the cashiers.  She still hates to be rushed (she needs time to emotionally prepare she tells us) and wants to be told exactly what and when we are doing things.  Mostly we can tell her in words, but if it is a long list or complicated, we usually draw/write a flow chart or list.  And I have not had fingernails or teeth embedded into my skin for at least 7 years!

"Sometimes, it just drops."

My ten year old daughter with Auditory Processing Disorder wants me to let people know that sometimes the things she knows just "drop" from her head.  She says this especially happens with math.

So I thought today I would try to explain what she is talking about.  With Auditory Processing Disorder (APD), the short term memory is affected.  Recalling information can be extremely difficult and to the outsider, it can appear as if the person with APD knows something, then doesn't know it, then knows it again, only to seemingly forget it the next second.  

I remember when Hailey was younger and I just didn't fully grasp this concept yet.  I would be dumbfounded by the things I could swear she knew just a second ago and she would act like she'd never seen/heard of it before.  Frustrating is an understatement!

So now that Hailey is 10, she herself understands that this is just a part of APD.  She gets frustrated when she can't remember something that she feels she should know.  I reckon it is like the expression "on the tip of one's tongue" where you just can't remember despite all your attempts to do so.  

So our best method of dealing with these moments is to say "oh, it must be dropped" and try to not worry about it, knowing that it will be found again.  With math, I can usually start to re-explain it and her brain will suddenly remember before I even get finished. When it is something she wants to say, well, we just have to wait until she remembers.

Luckily, eventually things make it into her long term memory where she can remember them and utilize them much easier.  We just have to be patient.

Our Brave Daughter: Auditory Processing Disorder Doesn't Stop Her From Jumping Into Social Situations

If you've been following my blog or are at all familiar with my family, you know that our daughter has Auditory Processing Disorder.  In simple terminology,"People with APD intermittently experience an inability to process verbal information. When people with APD have a processing failure, they do not process what is being said to them. There are also many other hidden implications, which are not always apparent even to the person with the disability. For example, because people with APD are used to guessing to fill in the processing gaps, they may not even be aware that they have misunderstood something." (Wikipedia)

So today I dropped our daughter Hailey off at summer camp.  It is a one week girls' overnight camp with a variety of activities including horse back riding and bike riding, which are the two things Hailey is most looking forward to, other than meeting new friends.

Once Hailey got settled into her cabin, one of her cabin mates came over to say hello.  Her name was Brooke and she was a darling red-headed 11 year old with a very cute asymmetrical hair cut.  Over in the corner, her mother was prompting her with hand signals and mouthing the words "Go ahead".  In turn, I turned Hailey around to be looking at Brooke; she had been facing the other way and hadn't realized Brooke was talking to her.  The two girls started making introductions and Brooke's mom quickly waved good bye while exiting the building.

Being the mom that I am, I stepped back a few feet from the girls and tried to inconspicuously watch the conversation that ensued.  Brooke was telling Hailey all about her knowledge of the camp as this was her third summer.  She was also expressing her hope that the theme this year will be Harry Potter as Brooke is a huge Harry Potter fan.  I could tell that Hailey was getting most of what Brooke was saying, but she wasn't catching all of it.  You see, Hailey has a "tell" when she is having difficulty processing what is being said; she repeats the last few words she heard.  This serves double duty as it makes it appear as if Hailey is understanding what is being said, while it slows down the speaker from moving too quickly onto the next sentence.

When I saw Hailey's "tell", my Momma's instincts made me want to jump in and rescue her.  I wanted to get into the conversation and control the flow so that I could ensure Hailey was processing all of it.  However, I am wise enough to know that this would do way more harm than good to Hailey.  Hailey is ten, and a ten year old girl does not want her mother jumping into her conversations.  I am sure this would not do well for her socially. So as hard as it was for me to watch her struggle, I knew I must let her work this on her own.

So like Brooke's mom before me, I took my cue to leave the girls to their own and quickly said my good-byes.  While I walked away, I realized just how immensely proud I am of our daughter.  Despite the difficulties her auditory processing disorder causes her, she bravely jumps right into social situations. She's learned coping techniques, and she doesn't let APD stop her from doing everything and anything she wants.


- originally written July 17, 2011 in my personal blog