- Diseases, Disorders & Conditions
Auditory Processing Disorder
Imagine someone says the word "apple" to you. The individual sounds of the word go in your ear, combine to make a cohesive whole that you then recognise as a word. That grouping of sounds then travels to the brain, where youconnect what you hear with a meaning that's been stored away for future retrieval.
At least, that's how it's supposed to work. With an auditory processing disorder, or APD, it doesn't quite happen so neatly or so regularly. With APD, your hearing is technically fine, no range of volume or pitch loss, so you may hear the actual sounds perfectly. But somewhere between the ear and the brain, what those sounds actually mean gets lost. You may perfectly, according to hearing tests, hear the word "apple", but it doesn't actually connect to meaning in the brain. Hence auditory processing disorder. You can't properly process it.
To give a more detailed example, let's assume I say to you, "I picked an apple from the tree." If you have an auditory processing disorder,you might instead hear, "I picked an ample frog tree." In cases like that, the sound connected to meaning within the brain, but not necessarily the right ones. The brain latched on to the closest thing it had to what the sounds actually meant.
Or, in more severe cases, you might instead hear the right sounds but have them essentially connect to gibberish, like, "I bigged a napple frobbadee."
Or the brain can decide to wants to actually work for a change, and you may have the sentence and meaning come across completely normally. It can all depend on the severity of the condition.
I've been living with an auditory processing disorder for quite a while now. I'm not entirely sure how long, to be truthful. Long before I ever heard the term, that much is certain. Often it led to some truly funny mishearings, such as the time my friend said, "Vending machines hate me," and I heard "Venetians hit me." Other times, it's just been frustrating. Though my hearing has been tested and found to function within normal ranges, I still often have to ask people to repeat themselves because what they said doesn't actually link up with meaning in my mind. When I watch TV shows and movies I tend to have the subtitles on, because otherwise I might end up mishearing and thus missing some crucial dialogue, and it's much easier for me to understand what a character is saying if I have the written version of it available too. Sometimes I have to watch people's lips to help get a better sense of what they're saying, a fact which makes my job of working in a call centre doubly difficult. If I'm in a place where there's a lot of background sound, I might not even be able to tell you're talking to me, as on a bad day there are times when my brain doesn't even bother to interpret speech as something worthy of attention. (This happens more often in places where there are lots of people talking. In simple terms, unless I'm facing you, I might not be able to tell that you're talking to me. I might end up assuming that the voice I hear is just part of the background chatter, because it made about as much sense as part of 50 half-heard conversations.)
There are various signs that somebody may have an auditory processing disorder, though these signs are easily confused with other issues, making APD an annoyingly difficult thing to diagnose. Many people with APD have the following signs:
- Preferring visual learning to auditory and oral learning
- Preferring written communication, such as writing letters, emails, or online chats
- Appearing to have poor listening skill, or an inability to pay attention
- Requiring people to speak slowly and clearly, or to repeat what they previously said
- Having trouble remembering information given to them orally
- Confusing similar-sounding words such as "brain" and "drain"
- Avoiding places with high levels of background sound, such as clubs and bars
- Difficulty interacting well with others, appearing shy and withdrawn
- Disliking using the telephone
People with an auditory processing disorder can and often do get by in society just fine, especially if they'e found ways to cope with or work around their hearing problem. Lip reading and eye contact are two common ways that are used to assist in personal relationships. The use of subtitles while watching TV also seems to be fairly common.
The causes of APD are as of yet unknown, though there are many theories, such as a lack of oxygen at birth (a common theory for just about any brain problem, really), or that it is linked to autism spectrum disorders (again, this seems to be an increasingly common link for people to make regarding just about any behaviorial or thinking problem). There is some anecdotal evidence that suggests it may be caused, or at least exacerbated, by damage done to the middle ear, usually via infections.
For all I know, it could be linked to my Tourette syndrome, as my brain already has a habit of misfiring and doing the wrong thing on a regular basis. Instead of registering as a vocal or motor tic, maybe the misfiring comes across as a lack of comprehension, an interruption of normal processes. After all, I don't always mishear things all of the time. (But it's frustrating enough even being an intermittant problem, let me tell you!)
There's some evidence that suggests that APD might be linked to learning problems such as dyslexia. After all, the written word is nothing more than a visual extension of spoken language, so if one is unable to hear the word properly, it's not too far a stretch to think that they might also have trouble reading or spelling a word properly too. This has not been proven conclusively, however, and many people with auditory processing disorders do not suffer from dyslexia or other learning disorders not associated with their faulty sound comprehension. However, APD is still recognized as a likely cause of dyslexia.
A diagnosis for an auditory processing disorder can be distressingly hard to get, partly because doctors, like all humans, have a tendnancy to place their own personal interpretations on what people say. When a patient says, "I can hear just fine, but I often have trouble understanding what was said to me, and sometimes it seems like people are just talking gibberish," a doctor might infer that the real problem is that the patient has a poor attention span and just aren't paying enough attention to what is being said. They might infer that the patient is suffering from an improper sleep cycle, which can interfere with the brain's ability to process information properly. They might infer that the patient is suffering from depression and is distressed over being unable to communicate their own feeling properly.
Or they might stop at "hearing problems" and refer the patient to an audiologist. The audiologist will likely find nothing wrong with the person's hearing, since the problem with APD lies in the brain and not the ear itself, and APD can be an intermittant problem rather than a constant one. The dcotor might recognise the signs of a processing disorder and refer the patient to a neurologist, but unless the neurologist is familiar with APD, then nothing may come of that either.
It can be very hard to prove to people that your hearing level and range is fine but that the problem lies in the brain rather than the ear. After all, how do you prove that you're mishearing something, especially when you, in conversations with your doctor, may appear to be hearing and comprehending everything perfectly?
A lot of the disgnoses of APD are self-diagnoses. People recognise the signs, do some research, and discover that the condition fits exactly what they're going through.While there's nothing wrong with this method in theory, it can make it hard for people to take your seriously. A lot of doctors hate self-diagnosed conditions, and tend to discourage them. And without a doctor's agreement, how can you convince potential employers, for example, that you actually have a problem that may need to be addressed?
Thankfully, more research is being done now on this condition, which may hopefully lead to improvements in medical personel recognising and giving consideration for this annoying and tricky problem. Increased awareness in the general community, of course, is a good step towards to public at large understanding it and giving their own consideration for it. The more we know, the better equipped we are to deal with it in our daily lives, and the easier life becomes on those who suffer from it.