This next post in the series on Psychoeducational Assessments (Background History, Testing Observations, Intelligence/Cognition, and Visual-Motor Integration,) has been extraordinarily daunting for a number of reasons:
1) I have a hojillion actual psychoeducational assessments to complete before my darlings all leave school for the summer.*
2) Every single area of “processing” is so much more complex and multidimensional than it seems at first glance.
3) Low scores on measures of “Auditory Processing” can sometimes not be due to “Auditory Processing Deficits” but rather attention, social-emotional distraction, second-language acquisition, phonemic instructional casualties, motivation, hearing loss, etc etc etc.
4) An “Auditory Processing Disorder” is an umbrella term used by a hojillion* different professions in a hojillion* different ways. Sometimes, the diagnosis falls in the realm of a Speech Language Pathologist (especially when called “Central Auditory Processing Disorder”, or CAPD), though a multidisciplinary approach is the best for these reasons.
With those caveats, here’s my best attempt. I’ll start with the “classic” cases I see as a school psychologist working under the guidelines for Special Education law. I’ll explain them like I do in my everyday job, to students and parents. It’s just what I’m used to.
Phonological Processing: This is the way the brain hears the sounds in words and is able to take them apart and put them back together again. For example, you use phonological processing to hear that the word “Cat” is three different sounds, or when I say three sounds (/c/ /a/ /t/), you can tell me that the word is “Cat.” When you have a “phonological processing deficit,” it can look like a number of other things, such as not hearing the difference between “card” and “cart.” So when a teacher is helping the student look at an unfamiliar word and says, “Sound it out!” it is very difficult because the student doesn’t hear the sounds the same ways as others. It can also be hard to remember which letters make which sounds. This is why it takes students with this problem longer to read.
Short-Term Auditory Processing (aka Auditory Working Memory):**This is the ability to hear and remember what is said long enough to do something with it. It’s the same process we all use when someone gives us a phone number and have to remember it long enough to dial it (without the benefit of pencil/paper or punching it in your cell phone), or doing mental arithmetic at the store. You also need your auditory working memory to listen to directions, especially multi-step directions, such as “Get out your book, turn to page 247 and start on section B.” Kids with auditory memory problems may get out their books and have forgotten what to do next.
Language Processing: Language processing can be subsumed under “Auditory Processing” for the purpose of IDEA definitions, but certainly is more in the realm of Speech and Language. Please refer to “Notes from the Speech Pathologist,” if it exists. What? It doesn’t? Okay, here goes, from a School Psychologist’s perspective: Difficulties with overall language processing can be as varied as taking a long time to come up with the word you need (“Lexical Access”) to not being able to make links between verbal concepts (“Abstract Verbal Reasoning”).
For example, a student with language processing problems might have a hard time coming up with answers to inferential questions, where the answer is not stated, but implied. This type of learning happens all the time in reading comprehension or listening comprehension tasks (e.g. Why do you think the character did that? What do you think will happen next? Who do you think is the bravest in the story?). If it wasn’t exactly stated that the bravest character was Judy, the student may not make the connections between all the other bits of information needed to make that assumption, like “Judy raced out of her house as soon as she heard about the crisis” and “Judy had a card up her sleeve.” Sometimes the student has difficulties interpreting the non-literal language, as in the “card up her sleeve” idiom. It does not explicitly say that Judy is brave, but one can infer it. This type of verbal reasoning can be impaired in students with language processing problems.
Overall, “Auditory Processing Deficits” are the hallmark of traditional “Learning Disabilities” sometimes referred to as “Dyslexia.” Contrary to popular belief, reading disabilities are not typically visual in nature (e.g. seeing “b” for “d”) but are typically a problem with the auditory processing channels. And as the length of this post suggests, the variations in what constitutes an “Auditory Processing Deficit” is not exactly cut and dry.
And if I ever want to finish my actual psychoeducational reports I need to write, I might want to look into abandoning the blog for Twitter, where there each post is required to be 140 characters or less. Somehow, ”Auditory processing is complex. It involves sounds, memory, and language” doesn’t really satisfy me.
*Hojillion (hoh.jill.eee.on). (Adj.) A large and exaggerated number somewhere between a hundred and a million, typically used at the end of the school year to purport an overwhelming sense of a ticking time table for work completion.
**Ug. Such a huge topic. So much overlap with other disabilities, such as Attention Deficit Hyperactivity Disorder. Distilling it to a paragraph makes me queasy, but here goes.