Adult Auditory Processing Disorder and Testing in Jacksonville

As audiologists, we routinely evaluate and treat patients with communication issues that are secondary to peripheral hearing loss (i.e., damage to the ear that is found on standard audiologic testing). For most patients, communication impairments are most noticeable in difficult listening environments where there is a high level of background noise. In the majority of these cases, the audiologic evaluation reveals a peripheral hearing loss that can be successfully treated with a hearing aid. In some cases, however, the audiologic evaluation reveals no peripheral hearing loss on standard test protocols. Unfortunately, patients with a normal standard audiologic evaluation who report symptoms commonly associated with peripheral hearing loss are often overlooked. These individuals may have an auditory processing disorder (APD).

Auditory processes are mechanisms responsible for the following behaviors: sound localization, auditory discrimination, temporal aspects of audition, including temporal resolution, masking, integration, ordering, auditory performance skills in the presence of competing acoustic signals, and auditory performance skills in the presence of degraded acoustic signals (American Speech-Language-Hearing Association, 1996). APD occurs when there is a breakdown of information traveling along the auditory pathway via the central auditory nervous system.

APD can occur due to a number of things, such as head trauma, tumors, auditory deprivation, or even the normal aging process. Often, APDs are misdiagnosed for attention deficit disorder (ADD) or attention deficit hyperactive disorder (ADHD). Some common difficulties observed in adults with APD are as follows:

• Lack of music appreciation
• Difficulty following conversation on the telephone
• Difficulty following directions
• Difficulty following long conversations
• Difficulty taking notes
• Difficulty learning a foreign language or technical information where language is novel or unfamiliar
• Social issues—difficulty “reading” others/pragmatic communication issues
• Spelling, reading, writing issues
• Organizational problems

In summary, auditory processing disorders are disorders in processing information given in the auditory modality when no deficit can be found through traditional audiologic testing.

APD Evaluation

Hearing can be generally defined as the detection or perception of sound, while listening may be defined as the detection and comprehension of auditory information. In an APD evaluation, particular attention is paid to the patient’s listening skills. APD evaluations typically include a combination of tests that assess different auditory skills, such as:

• Discrimination of individual speech sounds
• Ability to identify auditory patterns
• Ability to discriminate sounds in the presence of background noise
• Auditory sequencing
• Auditory-visual integration
• Merging of sounds between the two ears

All evaluation measures are based on the basic principle of taxing the auditory system to force the auditory nervous system to work harder.

At The Hearing Center at Jacksonville Hearing and Balance Institute, we offer a comprehensive testing and evaluation to assess individuals for auditory processing disorders. This evaluation includes an extensive case history, standard audiologic testing, and additional testing that is patient-specific in order to thoroughly assess the central auditory nervous system. An APD evaluation usually lasts between one and a half to two hours.