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Multi-System - BrainYou may have been told that your child has an auditory processing disorder. But, have you been told what specific type of auditory processing disorder your child has? Often, all that professionals say is, “Well, Mrs. Smith, our testing today indicates that Johnny has an auditory processing disorder.” Then, they recommend either a list of accommodations or treatments that they, themselves provide. Being concerned about helping your child, you may spend the thousands of dollars to do the programs only to find that your child is no better off after completing the work than before you spent all that money.

So, you ask, what should I do?
Well, first, you need to learn what are auditory processing disorders and how can I help my child with the specific type of auditory processing disorder he or she has. Read further and you will learn what auditory processing disorders really are all about, the different types of auditory processing disorders, some of the things you can do to obtain appropriate assessments of your child’s auditory processing and, most importantly, some of the things that may be done to help your child if he or she if found to have a specific type of auditory processing problem.

What are Auditory Processing Disorders?
You may realize that the term used above is auditory processing disorders with plurality for “disorders.” The reason is that there is no one thing called an auditory processing disorder. There are many different types of or categories of auditory processing disorders.

This approach, Lucker’s Multi-System Integrative Model of Auditory Processing, does not agree with what professionals may tell you and even what is identified by our professional associations, American Speech-Language-Hearing Association or ASHA and the American Academy of Audiology. These associations and most professionals within the associations state that auditory processing disorders (sometimes called APD, CAPD, and (C)APD) involve only what goes on in the central auditory nervous system or the pathways in our brains that conduct auditory information from the outside world to the auditory centers of the brain.

These auditory centers are in our temporal lobes just above the ears on each side of our head. The auditory pathways and brain centers of the temporal lobes are involved in the recognition and discrimination of sounds, especially speech sounds or phonemes, and the centers perform many different tasks to insure that these sounds arrive at the brain in a manner with which the rest of the brain can use that information. As such, some auditory processing problems may be due to deficits in the auditory pathways or centers in the brain. However, consider the following two examples and you will see that auditory processing goes way beyond what is merely occurring in these regions of the brain.

A person is talking to you as the two of you are walking down the street. Your ears are hearing all of the noises of the traffic and the hustle and bustle of people on the street. Yet, you can hear the person and understand what is being said and respond appropriately to the conversation. If you think about this, would you think that the auditory system of your brain is the only thing working? Well, let’s think this through carefully.

Executive Functioning
When the person begins the conversation, you make a conscious decision that you want to listen to what is said and not to all of the background noises. Thus, that part of your brain that helps you focus attention and choose what you will focus your attention on is actively involved in this listening situation. That part of your brain includes your frontal lobes, or a region called the pre-frontal cortex in which you have a function called your executive functioning. The executive functioning part of your brain is not part of your auditory system and is not looked at by most professionals as being involved in auditory processing.

Language Centers & Cognitive Decision Making
As the person is speaking and you are concentrating on what they are saying and not listening or “processing” to a higher level all the noises in the street, the person says a word that is not clear. But, you understand what they are saying. They are talking about their “cat” at home and not their “cap” or their “pat.” You figured out that the word that was not clearly heard was “cat,” not because of your auditory system, but because linguistically it made sense in the statement the person said. Thus, your language centers were brought into play as well as your cognitive decision making skills. Your language centers and cognitive decision making are not part of your auditory system, they are two different systems that work with the auditory system.

Multi-System Processing
I hope you are getting the point being made. That is, auditory processing involves much more than just the auditory system. Auditory processing may begin with the auditory system, but it then immediately involves our cognitive, thinking systems. We also have a “set to attend” so we know what we are to listen for and how to listen for that information which involves our executive functioning systems.

There are also levels of emotional processing such as when you get frustrated that you cannot understand what is being said, but you don’t take it out on the person speaking, you merely ask them to repeat what they said.

There is also our general sensory processing that allows us not to be so fearful of walking in the street, but that we can hold a conversation with the other person while taking that walk with them. Thus, in Lucker’s Multi-System Integrative Model of Auditory Processing (Lucker 2008), there are multiple systems involved in successful processing of what we hear, and auditory processing disorders occur when there is a breakdown in either one or more of these systems or in the integrative functioning of the systems working together in harmony.

Six Main Systems Involved in Auditory Processing
According to this system-integrated model developed by this professional, the six main systems involved in auditory processing are:

1. The cognitive system (we decide on the topic, the situation, to what we want to listen, and reflect on the meaning of what we interpret of the messages we process)

2. The executive functioning system (we determine how we are going to attend to and listen for the information presented and how we are going to behavior and respond to that information)

3. The auditory system (we allow the auditory system to take in and get from the outside world to the brain the information we hear)

4. The language system (we form meaning based on the messages we hear by converting those messages into linguistic representations or symbols and apply our linguistic rules in comprehending information that is not always clear)

5. The behavioral and emotional systems (we respond to the auditory message as well as other factors going on around us and inside of us on an emotional level and respond behaviorally to this information)

6. The sensory system (which allows us to heighten our auditory systems and put aside other sensory feelings so we can concentrate on what we hear)

What is important to understand is that this is not a hierarchy of systems. It is merely a brief description of what is occurring within our brains when we “listen” and process what we hear. Sometimes the sensory system may come into play first before we even have time to focus attention or think about the meaning of what we hear. At other times, the auditory system is first activated such as when we come out of a deep sleep because we heard something and then react emotionally to what we think we are hearing.

What is important to note is that auditory processing does not merely involve the auditory system. Additionally, this model indicates that a breakdown in one of the other systems or integration between these other systems may underlie a person having an auditory processing disorder or APD. This is why looking solely at the auditory system as the cause of all APD problems and using auditory system based treatments is not necessarily appropriate for every child who has APD. In this professional’s experiences, auditory based APD problems are typically the minority of all of the problems that a person can have in processing what is heard. As such, we need to evaluate the specific types of auditory processing problems your child may have and address the specific system(s) that is(are) working deficiently.

This article is the first of a multi-part series.  Stay tuned for next week’s article – Evaluation of Auditory Processing.

References

Lucker, J.R. (2008). What are auditory processing disorders? In, H. Edell, J.R. Lucker, & L. Alderman. Don’t You Get It? Living With Auditory Learning Disabilities. Wood Dale, IL.: Stoelting Co.

Lucker, J.R. (2013). Auditory hypersensitivity in children with autism spectrum disorder. Focus On Autism and Other Developmental Disabilities, 20 (10), 1-8.

Lucker, J.R., Doman, A. (2012). Auditory hypersensitivity in children. Autism Science Digest, 4.