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Managing, Assessing, and Treating APDTerm Paper

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Auditory Processing Disorder

Nature of the Disorder

Auditory processing disorder, abbreviated as APD, is also central auditory processing disorder. APD is a group term covering various disorders affecting the manner in which auditory information is processed in the brain. Individuals suffering from APD have normal function and structure of middle, inner and outer ear through peripheral hearing. However, such persons are not able to process information heard in similar ways as people with normal processing capabilities leading to difficulties in recognition and interpretation of sounds. The sounds include composition of speech and well-thought approaches to addressing difficulties arising from central nervous system dysfunction, especially the brain (Musiek & Chermak, 2007). APD is not featured within mainstream diagnostic classifications of mental disorders. Scientists note that APD can be diagnosed through difficulties across various auditory processes popular for the reflection of the central auditory nervous system function.

APD affects both adults and children even as the actual prevalence remains unknown. Studies show that males have twice as high probability of contracting the disorder as the females. Auditory processing disorder is both an acquired or developmental condition. The disorder may come from ear infections, neuro-developmental delays or head injuries affecting auditory information processing (Holland, 2011). The concept includes problems with sound lateralization and localization; temporal aspects of audition, auditory discrimination; auditory pattern recognition such as temporal integration and discrimination through gap detection. Other aspects include temporal ordering and masking, auditory performance for competing acoustic signals such as dichotic listening as well as auditory performance for degraded acoustic signals.

Acquired APD comes because of possible dysfunction or damage to central auditory nervous system, which causes more auditory processing problems. Auditory Processing Disorder can arise from genetic and hereditary characteristics. An individual's ability to comprehend and listen to multiple messages at a given time is a characteristic trait that has the heavy influence from personal genes (Musiek & Chermak, 2007). The short circuits in neural systems run through familial generations, results from difficult births, and compares to other learning disabilities. Auditory processing disorder is linked to conditions that are influenced by genetic traits including various developmental disorders. Auditory Processing Disorder inheritance refers to elements of whether such conditions are inherited from parents or are enshrined in the family tree. Auditory Processing Disorders cold include inherent neurological traits from the father or the mother (Holland, 2011).

Effect of the Disorder

APD is one of the most difficult disorders to diagnose and detect. Subjective symptoms leading to APD evaluation include intermittent inabilities of processing verbal information that lead to individuals guessing to address the processing gaps. On the other hand, there are disproportionate problems associated with decoding of speech across noisy environments. APD is defined in anatomic terms based on integrity of auditory areas across the main nervous system. Children with APD symptoms do not have evidence pointing to neurological disease as well as making a diagnosis on grounds of performance and behavioral auditory tests. Further, auditory processing is translated as what people do with what they hear. APD presents a mismatch between ability to discriminate or interpret sounds and normal peripheral hearing ability. Therefore, those components do not engage neurological impairment signs, and APD can be diagnosed based on auditory tests. Modality-specificity issues lead to considerable arguments across different experts in the field.

The concepts of the representation argue that APD is best defined as perceptual dysfunction that is modality-specific and not based on peripheral hearing loss (Roeser & Downs, 2011). Critics add that inclusive APD conceptualizations include the lack of diagnostic specificity. Modality-specificity requirements could potentially alternate the inclusion of children with poor auditory performance due to outlines factors of poor memory or attention. However, others argue that modality-specific approaches are too narrow and miss children with genuine perceptual problems that affect both auditory and visual processing. It is impractical for audiologists to lack access to proper and standardized tests, which are inclusive of visual analogs for different auditory tests (Parthasarathy, 2014). The discussion on this issue is quite unresolved. However, the modality-specific approaches diagnose fewer APD children than modality-general techniques. The latter approach operates at a risk of seeking the inclusiveness of children failing auditory tests due to reasons away from poor auditory processing. Even though the concept of modality-specific testing is advocated more decades, no tests to date are published to allow audiologists perform evaluations on a modality-specific basis. No clinical provisions of visual analogs through auditory processing tests are in existence (Holland, 2011).

The direct causes remain unknown for most developmental APD cases. The major exceptions include Landau-Kleffner syndrome or acquired epileptic aphasia. The conditions illustrate development regression in a child where language comprehension faces severe infection. The children are normally perceived to be deaf even though normal peripheral hearing is present. In subsequent cases, known or suspected APD causes among children include delay of myelin maturation, genetic predisposition, and auditory cortical ectopic cells in the areas. Families with autosomal dominant epilepsy, aspects of seizures affecting the left temporal lobe appear to induce problems in auditory processing (Musiek & Chermak, 2007). From other members of the extended family with high APD rates, genetic analysis shows haplotypes of chromosome 12 that fully co-segregates language impairment.

Hearing starts in the utero while central auditory systems continue developing in the following years. Considerable interests show that the disruption against hearing is based on sensitive periods that have prolonged auditory development consequences. Studies show thalamocortically connectivity to vitro is linked to a developmental window that is time sensitive and requires lcam5, a particular cell adhesion molecule, for occurrence of proper brain plasticity (Roeser & Downs, 2011). The concept points for purposes of connectivity in the cortex and thalamus after affecting the ability to hear at least one auditory processing period. Other studies show that rats living in one tone environment across certain critical development periods have auditory processing abilities that are permanently impaired. Compromised sensory experiences of temporary deafness from cochlear removal among rats led to the observation of the neuron shrinkage (Long & Eifert, 2012). Studies focusing on APD patients show that children having a blocked ear developed high right-ear abilities although not in a position of modulating such advantage across directed-attention tasks.

Individuals with Auditory Processing Disorder have difficulties in paying attention to as well as remembering information under oral presentation and continue coping with information acquired visually. Patients also have hardships in undertaking multi-step directions presented orally and hence the need for hearing sounds from a single direction at a given time (Madell & Flexer, 2011). Such people also have poor listening competencies and skills requiring more time in processing necessary information. APD patients face low academic performance and have behavior problems. Studies show that the individuals have difficulties in language as they keep confusing syllable sequences due to problems of understanding language and developing vocabulary. Lastly, APD patients have difficulties with reading, spelling, comprehension, and vocabulary (Parthasarathy, 2014).

Specific developmental dyslexia and language impairment are related in various ways. Specific language impairment is observed when children have difficulties in producing or comprehending spoken language without an apparent cause (Geffner & Ross-Swain, 2013). The issues are not explained based on peripheral hearing loss. Children with typical issues of talking and having problems in the production of speech sounds clearly also have difficulties in understanding and producing complex sentences. Various theoretical specific developmental dyslexia accounts regard it as an outcome of auditory processing problems. However, the view is not universally supported as critics consider the major specific language impairment difficulties as problems stemming from higher-level language processing aspects. In areas that children have both language and auditory problems, it is hard to differentiate the aspects of cause-and-effect. The standard practice is that APD is evaluated based on tests involving the identification, repetition and discrimination of speech (Madell & Flexer, 2011). Further, children perform poorly due to primary language problems. The studies that compare children with dyslexia diagnosis are involved in APD diagnosis. The observations raise worrying possibilities that diagnosis of a child may largely be a specialist function leading to a misdiagnosis, as other caregivers are not adequately consulted.

Treatment Methods

Lack of extensive and well-conducted APD evaluations leads to randomized trial methodologies in control. Evidence for efficiency and effectiveness are based on weaker standards of support including illustrating those elements of performance lead to improvement after therapy sessions. The approach does not have control towards viable influences for maturation, placebo, or practice effects (Long & Eifert, 2012). Research shows that the implementation of basic auditory processing elements such as auditory training improves on auditory processing performance measures as well as phonemic awareness measures. Changes made through auditory training also record high physiological outcomes. Most of the tasks can be incorporated within computer-based programs for auditory training like Fast ForWord and Earobics (Parthasarathy, 2014). The adaptive software is availed in clinics and at home worldwide.

However, evidence for outcome effectiveness of the computerized interventions involves the need to improve literacy and language through impressive concepts. The small-scale uncontrolled studies report success in APD outcomes… [END OF PREVIEW]

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