PLEASE NOTE THAT BEFORE CARRYING OUT AN APD DIAGNOSTIC ASSESSMENT YOU WILL NEED TO FIRST ATTEND FOR A FULL DIAGNOSTIC HEARING ASSESSMENT TO RULE OUT HEARING LOSS AND OTHER CAUSES OF LISTENING DIFFICULTIES.
AUDITORY PROCESSING DISORDER (APD)
Even when a person has normal hearing, they may still face challenges with listening and processing information. This is referred to as auditory processing difficulties/disorder (APD). APD can affect a person’s ability to learn, follow directions, read, engage in conversation, and reach their full potential socially and in the work place. Adult onset APD may be due to concussion, head injury or aging.
Common signs include:
- Struggles to hear in background noise
- Mishears or misunderstands what is being said
- Cannot remember longer instructions
- Difficulty concentrating unless it is very quiet in the room
- Difficulty understanding accents and cannot follow fast speech
- Dislikes speaking on the phone
Before your first appointment…..
Before attending your appointments with us, we will ask you to complete up to 6 questionnaires online beforehand to give us more insight into your listening difficulties.
The questionnaires collectively are designed to ascertain how much listening difficulty you are currently experiencing, the impact of this on your quality of life at home, work and socially, and measuring communication problems relating to memory and attention.
We will review your questionnaire results as part of the assessment prior to you coming in so that we are prepared for your visit. You can complete the questionnaires in your own time. This way you will be relaxed and have enough time to consider your situation before replying. This will also reduce the amount of listening and explaining you will need to do in clinic.
Handedness Inventory –
Adult Auditory Performance Scale (AAPS) – This assesses your listening difficulty (5 sub-categories of listening: Noise, Quiet, Ideal, Multiple Inputs, Auditory Memory/Sequencing).
Hearing Handicap Inventory For Adults (HHIA) – The helps us see how your difficulties correlate to someone with a hearing loss – a useful counselling tool.
LSEQ (Self-Efficacy)- This looks at your self-perception of your ability to perform skills necessary to attain a desired outcome. It looks at one-on-one dialogue in quiet settings, direct listening, complex listening, and overall listening self-efficacy.
Cognitive Difficulties Scale – This assesses your self-perceived cognitive dysfunction, a tool to measure communication problems related to memory, attention, etc.
La Trobe Communication Questionnaire (LCQ) – This looks at your perceived communicative ability before and after head injury (if applicable).
Meeting your Audiologist
Person Centered Care.
We follow the principles of person centered care within your appointment. We work together to:
- Establish what you wish to achieve from the visit with us.
- Clarifying and expanding on results from the questionnaires.
- Summarising your main difficulties.
- Exploring your individual needs and preferences.
- Discussing impact of listening difficulties on your family and loved ones.
- Introduce you to the concept of shared goal setting and decision making.
- Talk about your medical history and hearing health.
This is what one of our patients has to say about our APD assessment and management:
“Hi Trisha and The Hearing Clinic Team,
I just wanted to thank you for all your help and support over the past 10 months, after receiving a very late diagnosis of adult autism I went through most of my life not knowing what was wrong. My diagnosis introduced me to the existence of the comorbid condition of auditory processing disorder. After reading about the general difficulties associated with APD I immediately suspected that I was suffering with this on top of my autism struggles and contacted the clinic for an assessment.
Trisha was really amazing at my appointment, I was very apprehensive as I am sensitive to light, sound and struggle in social situations. I was treated with such kindness and was allowed to take breaks throughout the session. I found the assessment itself to be incredibly difficult and it became starkly apparent that my brain was not able to process the tasks I was being asked to do. Trisha went above and beyond to get the audiology report to me quickly which was amazingly detailed. It was recommended that I would benefit from Oticon REAL hearing aids, this was a surprise to me as having been assessed for hearing difficulties by the NHS I was informed that hearing aids would not help me due to my hyperacusis and that hearing aids would make this condition worse. This advice turned out to be completely inaccurate and I am so pleased that I contacted The Hearing Clinic for a second opinion.
Having worn the hearing aids now for over 2 months my quality of life has improved beyond words, I do not suffer with as many headaches, the tinnitus I was experiencing has completely gone and my mental clarity in being able to deal with day to day tasks has changed my life. I have spare energy left over in the evening to be able to communicate with family and I have tolerated going into a supermarket for more than 10 minutes. It took me a while to realise how the hearing aids were helping as I couldn’t tell an immediate difference in what I was hearing, the processor is now handling the brunt of the sound instead of my brain getting in a tangle over multiple sounds at the same volume. You do not know what you are missing in conversations until you can hear every word. Without the hearing aids my brain would only process a handful of words correctly in a sentence and I was guessing words which were missing as my brain simply wouldn’t hear the entire sentence. Doing this every single day is exhausting and lead to feeling very unwell on a daily basis not to mention frustrating family members due to not hearing them properly which lead to a lot of miscommunication! I can now pick out individual sounds and this technology has allowed me to listen to Youtube videos as the hearing aids allow you to stream directly from your PC and phone. I am finally able to use the phone without experiencing motion sickness and fatigue after every interaction and I no longer have to put subtitles on the TV. My problems were particularly noticeable when I was at school over 2 decades ago when teachers used to inform my parents that I simply didn’t listen in class or I was daydreaming and not paying attention. For anyone not sure whether APD is worth the assessment and support or if you are a parent of a child struggling to hear I cannot stress how much you need to talk to the Hearing Clinic, I wholeheartedly recommend their services; they don’t just treat the condition, they transform lives, thank you for everything!”
Peripheral Audiological Testing.
- Video Otoscopy – a small camera is inserted into the entrance of the ear canals. This enables us to assess the health of the ear canal and eardrum and determine if there is occluding wax
- Tympanometry – to determine how sound travels through the ear drum and middle ear and to check for glue ear
- Ipsi and contra otoacoustic reflex testing – This is to check the early neural function within the auditory system.
- Pure Tone Audiometry (audiogram) – This is the “beep test”. The patient needs to listen to soft tones presented under headphones and they are required to press a buzzer for the duration of the tone
- Speech in quiet testing – The patient will listen to short words like “shoe” or “fan” and will be asked to repeat back what is heard
- Sentences in noise testing – This is done to get an idea of general auditory processing of sentences when presented in background noise.
- Otoacoustic emissions testing – A small soft tip is placed inside the ear. Soft tones are played into the ear canal. This is similar to the hearing check carried out on newborn babies. It looks for abnormal inner ear functioning.
Central Audiological Testing.
- Words in noise test – You will hear words presented in background noise. As the test progresses the background noise increases.
- Pitch Pattern Test – You will be required to listen to, identify and name the pattern of three tones/notes played to each ear.
- Duration Pattern Test – You will be required to listen to, identify and name the pattern of three tones of varying duration played to each ear.
- Dichotic Digits – You will hear sets of numbers presented to both ears simultaneously. You will be asked to repeat back as many of the numbers that you have heard.
- Masking Level Difference – You will be required to listen for some tones played within a white noise and report when you have heard the tones.
- Random Gap Detection testing -you will hear 2 short tones played in very quick succession. Sometimes the sounds are so close together that they sound like one tone. You will need to listen closely to see if you can one tone or two tones.
- LiSN S or LiSN U Test – Test for spatial processing problems.