Gifted Issues Discussion homepage Forums Twice Exceptional APD suspected for 3 y.o. Treatments?

I suspect my DS3 may have auditory processing disorder (trouble with auditory discrimination even when next to me at home with a competing noise such as running water or fan, sensitivity and anxiety related to sounds).

I read with interest the Tomatis thread below, since we were recently referred by our OT (for SPD) to the Sacarin Center, which uses the Tomatis method. I know most audiologists don't recommend treatment for children younger than 6 due to lack of norms established for that age and that the auditory sense is still developing.

I want to help my DS now instead of waiting, since this issue seems to cause him the most distress. I've heard that the time commitment may be too much for a very young child. Any suggestions?



http://giftedissues.davidsongifted....atis_Listening_Therapy_O.html#Post174993

The center says that treatment has been successful for children as young as 2 1/2, but that they evaluate each situation individually during the initial consultation. That approach makes sense to me. This is the beginning of the next learning curve for me, and I will attend their open house next month to learn more.

Disclaimer…I am an audiologist and there are valid reasons not to recommend this testing until the older age.

I'd be very cautious about dx and treating CAPD or APD at age 3. Typically testing isn't recommended until age 7 (and only with certain parameters…must have absolutely normal hearing, no middle ear infection or fluid etc) for a variety of reasons.

Not my area of expertise per se but I know there are expensive programs that are recommended for a variety of dx (including APD) without a lot of research backing their use and I would be very wary of pursuing any of that at age 3, regardless of how gifted.

If there are specific areas of concern, I'd address those, possibly with an SLP, after having a full hearing evaluation.

AudioMommy, thanks for your input. My understanding is that a full hearing evaluation is performed by an audiologist. Is that what you mean? He has never had an ear infection or hearing problem detected when examined by his pediatricians, and I specifically asked his latest one to check the middle ear area. I've had pediatricians check his hearing since he was an infant due to my concerns. He does seem to frequently be congested especially at night and says he has trouble breathing, and I've often wondered if there's a connection there.

My specific concerns are auditory discrimination in the presence of competing background noise and oversensitivity. You mention using an SLP. I thought an audiologist was the one responsible for treatment of those types of issues.

My son saw an audiologist to check his hearing due to a speech delay. They do a thorough hearing exam. Several years later, someone suggested that she thought he had APD. I talked with his audiologist, who put me in touch with the APD team at a large, reputable children's hospital. The team consisted of an audiologist and an SLP. They told me that there was really no point in checking earlier than 7 because the auditory system is still developing and because the evaluation couldn't be done well. They also said that there was no real therapy anyway, just accommodations, so we could try appropriate accommodations to see if they helped regardless but didn't need to worry about an early start on therapy.

I know there are therapeutic programs out there. The specific team I spoke with did not recommend them. My son did not go on to have any problems and we never looked into any of those programs in more detail, so I can't give any advice. However, that is what we were told when we looked into it. I was reluctant to post on this thread because I have so little knowledge of these issues, but wanted comment that an audiologist and SLP are often both involved (from my small experience).

Sorry for the delayed response…swim meet all day LOL

Yes a full hearing evaluation from an audiologist is often more encompassing than what you'll get in a pediatrician's office and will include things like immittance/acoustic reflex testing and otoacoustic emission testing in addition to the typical pure tone and speech testing. That will let you know that the entire peripheral auditory system is working correctly and is necessary before you can even attempt to evaluate the central auditory processing system. Especially with your concerns regarding his congestion, it is important to make sure there aren't underlying middle ear issues.

Many people have issues understanding in noise (middle ear issues can definitely contribute to this). But at age 3 it is very difficult to tease out what is normal or an issue…in fact I would say almost impossible. I strongly support parent intuition in many cases. But a lot of 3 year olds (gifted or not) would likely have these issues. Heck, I have these issues. It might be that you are just more in tune to the problem b/c your child is able to describe the problem/issue while others are not capable of doing so.

I agree with everything amp221 said above. In my experience in the midwest, audiologists diagnose but SLPs treat. Every once in a while you'll find an audiologist that can treat too. Developing these auditory skills takes time for kids and it is difficult to interpret auditory stimulus in noise (for adults and children)…

Also, the recommendations really are symptom based, so even if someone ends up testing normal auditory processing, you'd still recommend treating the symptoms. Sometimes people need the dx for an IEP or some other reason, but otherwise, usually the recommendations will be the same. Again, age 3 is really too young to dx.

If I was you, I'd definitely keep my eye on it, reduce noise and improve the signal to noise ratio whenever possible. Since your child is bothered by it, I'd talk with him about how it is very normal to have difficulty in noisy environments and it isn't anything that is wrong or bad about him. And I'd try to wait a few years to see how this issue plays out.

Again, this all is just related to purely auditory processing. Other sensory issues/sensitivities are out of my professional realm so cannot comment on them with any authority LOL. Some may be co-existing too.

good luck with this process and be wary of specific expensive programs without fully understanding the research behind them as it applies to a 3 year old.

Thanks you Portia, Apm221 and AudioMommy for generously sharing your experiences and expertise. AudioMommy, I really appreciate the depth of your reply and it gives me a lot to consider moving forward.