Auditory Processing Evaluation

What is an Auditory Processing Evaluation?

An Auditory Processing Evaluation is used to assess if a person can perceive sound information correctly
and if they can do so under a variety of challenging listening conditions. Examples include
understanding words in background noise or the ability to process two different speech signals using
both ears at the same time. The audiologist presents a battery of auditory processing tests where the
listener must repeat words or report something back about what they have heard. To do this, the
listener must have a language age at least equivalent to that of a typical five-year-old. Although
diagnosis of an Auditory Processing Disorder (APD) is often not officially given until a child is 7-8 years of age, behavioral test norms are available down to the age of five years. Testing children below the age of
seven years can help the audiologist understand where areas of “auditory weakness” lie so that early
intervention can begin, thereby helping to minimize learning problems later.

Children with Auditory Processing Disorders (APD) may have difficulty understanding speech in loud environments, telling the difference between similar sounding speech such as "bike" and "bite", and also following directions. Understanding how children interpret and decode information is crucial to identifying and treating auditory processing disorders.

Signs and Symptoms of APD

Adults and children with APD are often misunderstood because sometimes they perceive what they hear and sometimes they do not, even though their hearing sensitivity may be normal. Diagnosing whether their failure to hear is due to a hearing loss, APD, or an attention deficit is critical for determining the best treatment options and listening strategies. This often requires a team of professionals including psychologists, educators, audiologists, speech-language pathologists, occupational therapists, and physical therapists, to name a few. It is also common for people with APD to have multiple diagnoses because processing of sound and speech information involves the whole brain and not just the auditory system.

Here are some signs to look for if you think you are a loved one may have APD and need testing:

Frequently does not respond when spoken to or asks, “What?” or “Huh?”
Has trouble hearing in noisy places and dislikes noise or loud sounds
Mis-hears things and may substitute a similar sounding word for the spoken word, causing

misunderstandings (e.g., hears “lake” for “leg”)

 Has trouble understanding what was meant by what was said, leading to hurt feelings
Has difficulty with phonetic reading and/or reading comprehension
 Cannot follow directions well, especially when more than one step is given

Types of Auditory Processing Evaluations

Dichotic - Dichotic tests require the listener to attend to two signals, one to ear each, at the same time. This is similar to sitting at a dinner table with family members all around and having the ability to listen to more than one speaker or just focus your attention on a speaker from one side. Binaural integration and binaural separation require "cross-talk" between the two sides of the brain through a structure called the corpus callosum.
Low-redundancy Monaural Speech - The ability to understand speech that is distorted in some way. The brain has an innate ability to figure out speech information, even when parts of it are missing. Filtered words testing and timed compressed speech allow us to evaluate how well the auditory system understands distorted speech information. Specifically designed test materials allow us to look at this function of auditory processing.
Temporal Processing - Random gap-detection tests and tests of auditory sequencing, such as the pitch-patterns test help us to understand if a person can hear the order of sounds and information in a sequence. This is also related to understanding sequences of events, such as what happened first, second, and third in a story.
Binaural Interaction - Tests used to evaluate how the two ears work together as a team. Both ears process information from both sides of the head at the same time. Binaural integration allows us to listen to multiple sounds at the same time while binaural separation allows us to listen to sounds on one side of the head while filtering out sounds on the other side.