APD & ANSD Flashcards
(30 cards)
What is auditory processing disorder?
APD is an auditory deficit that is not the result of
other higher-order cognitive, language, or related disorder.
Must be auditory in nature
HOW the CNS uses the auditory information
Disorders to rule out when considering APD
- ADHD
- Autism
- Severe language impairment
- Intellectual disability and sensory integration dysfunction
ADHD and ADP
Poor listeners
Difficulty understanding/and remembering verbal info
ADHD is what causes the symptoms
Autism vs APD
Difficulty with spoken comprehension
Cause is autism
Severe language impairment vs APD
SLI is a language impairment, not auditory processing issue
ADP individuals MUST have
Normal intelligence
Normal hearing
Challenges for individuals with APD
Noisy backgrounds
Poor acoustic environments
Great distances from speaker
Speakers with fast speaking rate
Speakers with foreign accents
APD symptoms
-act like they have hearing loss
-can’t understand in noisy environment
-multi-step directions difficulty
-difficulty discriminating similar speech sounds
-request repetition or clarification
-difficulty spelling
-difficulty reading
-verbal info in classroom
-history of middle ear infection - if during critical period brain never learned how to process auditory sounds
Academic characteristics of APD
-poor expressive and receptive language abilities
-poor reading, writing, and spelling
-poor phonics and speech sound discrimination
-difficulty taking notes
-difficulty learning foreign language
-weak short-term memory
-behavioral problems
Multi-disciplinary team and roles
Physicians
Teachers - shed light on academic difficulties
Parents - description of behavior at home
Audiologist makes diagnosis
SLP-evaluates perception of speech
Pscyhologist- evaluate cognitive functioning
Audiologist role
Assess PNS and CNS with battery of tests including electrophysiological and behavioral
Assess central auditory system under different conditions such as auditory signal distortion and competition
Absent acoustic reflex
Speech testing in quiet and noise
Age a child can be tested for APD
7
Do not have neurological maturation before 7
Is there a cure for APD?
There is not one, cure-all method
Treatment must be highly individualized and deficit specific
Key to appropriate treatment: accurate and careful diagnosis
3 primary areas of focus for treatment of APD
- Change learning/communication environment
- Recruit higher order skills to compensate
- Remediation of the deficit itself
What are some environmental modifications for APD
- Use electronic assist listening devices (FM system)
- Teacher instructions how to improve delivery of information
- Other Methods of altering environment so APD can increase focus
Compensatory strategies for APD
Suggestions for assisting listeners in strengthening CNS resources (cognitive skills)
Teach to take responsibility for their listening success
Direct treatment of APD
Remediate disorder itself
Computer assisted
1-1 training
Home based programs or clinics or schools
Type, frequency, intensity of therapy needs to be individualized
Can a child grow out of APD?
Yes
What is ANSD?
Clinical syndrome characterized by electrophysiological evidence of
normal or near normal cochlear function and absent or abnormal auditory pathway conduction
Why is it called auditory neuropathy spectrum disorder?
Because it can have the same presentation but different site of lesion
Audiologist findings for ANSD
Normal OAE (cochlea is functioning correctly) - present OAE OR presence of wave I (cochlear microphonic - CM)
Abnormal ABR - absent or abnormal-**have to have ABR to diagnose
Acoustic reflexes are absent
Reported Clinical characteristics of ANSD
- Pure tone thresholds from normal to profound
- Poor speech recognition compared to degree of hearing loss
- Difficulty hearing in noise
- Impaired temporal processing
- Hearing fluctuation
- May have little to no communication issues to functionally deaf
- Individuals symptoms vary
Possible causes/associations from ANSD
Genetic Etiologies: Syndromic: Charcot-Marie-Tooth disease; Friedrich’s Ataxia; Hereditary motor and sensory neuropathy
(HSMN)
• Non-syndromic: Recessive genetic mutations: Otoferlin (OTOF), Pejvakin (PJVK)
• Autosomal dominant mutations: AUNA1 (onset of auditory symptoms in late teens)
• Perinatal Conditions: Hyperbilirubinemia
• Hypoxia
• Low birth weight
• More common in premature infants
• Congenital Conditions: Cochlear Nerve Deficiency
• Infectious Processes
• Viral Infections (e.g. mumps, meningitis)
• Head injury e.g. Shaken baby syndrome
Tests used to diagnose ANSD
ABR
Tympanometry (Acoustic Immittance measures)
Acoustic Reflex testing
OAE
Pure tone testing (VRA, BOA, play audiometry, etc)
Speech recognition testing
ASSR
