Auditory Processing Disorder (APD) or Central Auditory Processing Disorder (CAPD) is a language and information processing disorder that makes it difficult to understand differences in sound or speech. APD often begins in childhood but can also be acquired through disease, head injury, or aging (1). Children with CAPD might have difficulty processing, tolerating, filtering, and listening to sounds when background noise is present (2). APD is not a learning disability, is not related to hearing loss, and is not a cognitive or psychological disorder but a “perceptual disorder” (3) in how information is processed. It is believed that 2-3% of children worldwide have APD (4), although there is no standard test or diagnosis, and affects individuals differently.
There are four identified areas of weakness that may occur with an APD diagnosis and affect music learning. The first is auditory discrimination (5) or hearing the difference between two things that may sound similar or words that begin similarly (ex. floor and flower). This may affect students who cannot hear the difference between a note that is “out of tune” and one that is “in tune.” The second is auditory figure-ground discrimination (6), meaning there is trouble focusing on words when background noise is present. Some scenarios where auditory figure-ground discrimination might be difficult are in a music classroom where one section is receiving instruction while another is rehearsing, noisy fans or air conditioning, or music playing in the background while giving instructions. A third area of weakness is auditory memory (7). Auditory memory is how we perform auditory recall, an aspect that is essential for music students who learn by rote. Auditory memory also affects the ability to recall instructions. Lastly, people with APD may struggle with auditory sequencing (8) or the ability to recall the order of sounds and words. Auditory sequencing affects rote learning, singing, sequencing lyrics, and rhythm recall. A few other areas that may be affected are sound localization, identifying where a sound is coming from, and auditory pattern recognition or identifying degrading acoustic signals (8), such as noticing a decrescendo.
Because APD affects how the brain processes information, when a student has an APD diagnosis, we must adapt our approach to music learning. The following are some identified working solutions for creating a sensory-friendly space for students with APD (9).
1. Reduce reverb within your studio or classroom. Be sure your studio contains sound-absorbent materials such as soft rugs, heavy curtains, and seating with plush cushions which all help to absorb the sound and eliminate too much reverberation.
2. Reduce the background noise. Try to eliminate the use of noisy fans, air conditioning, or space heaters. If your studio space cannot function without these items, consider turning to a lower setting to reduce the noise. If you are giving instructions, aim to eliminate background music so students can more easily focus on your voice.
3. Speak slowly, pause, and section instructions. You may need to repeat your instructions more than once and at a slower pace. Try to give instructions one at a time, in a step-by-step manner, and not all at once. Students with APD may need more time to process the information.
4. Pair verbal and visual prompts together. The use of PECS boards, whiteboards with images, and demonstrations to accompany your instructions will go a long way in helping your student process and retain the information. Recording sections of your lessons, rote learning examples, or instructions will provide a good reference for your students to return to when practicing throughout the week. Detailed instructions written in a step-by-step manner will provide a reference point for future practice.
5. Distinguish similarities with differences in sound patterns. When working with students who may struggle to notice auditory differences, start small with obvious differences such as loud & soft, fast & slow, high & low and work your way to differentiating more nuanced differences. Pair contrasting auditory examples with visual examples, such as representing major or minor sounds with emojis.
As you work with different students with APD, you may find some strategies that work for all students and some that work for only one student. It is important to remember that APD can manifest differently with each person and that it is common for APD to co-exist with attention disorders (10), reading impairments, and language disorders (11). Because APD is a processing and perception disorder, many children with an APD diagnosis will struggle with exhaustion due to the constant, daily intake of information at school. Researchers identify that there is a need for deficit-based intervention. This can be done through remedial activities that help to reinforce the four areas of auditory weakness identified earlier. As always, regardless of diagnosis, we must always “Teach the student first, the music second, and the piano [or any other instrument] third” (11).
Happy Teaching!
References:
1. Cleveland Clinic. (2023). Auditory Processing Disorder. https://my.clevelandclinic.org/health/diseases/24938-auditory-processing-disorder.
2. ASHA American Speech-Language-Hearing Association. (2005). (Central) Auditory Processing Disorders Technical Report. Available from www.asha.org/policy.
3. Koravand, A., Parkes, E., Duquette-Laplante, F., Bursch, C. and Tomaszewski, S. (2019). The Effects of Singing Lessons on Speech Evoked Brainstem Responses in Children with Central Auditory Processing Disorders. Canadian Acoustics, 47(2), 31-39.
4. Chermak, G. and Musiek, F. (1997). Central Auditory Processing Disorders: New Perspectives. San Diego, CA: Singular Publishing Group.
5-8. Cleveland Clinic. (2023). Auditory Processing Disorder. https://my.clevelandclinic.org/health/diseases/24938-auditory-processing-disorder.
9. American Speech-Language-Hearing Association. (n.d.). Central auditory processing disorder [Practice portal]. https://www.asha.org/Practice-
Portal/Clinical-Topics/Central-Auditory-Processing-Disorder/
10. Cacace, A and McFarland, D. (2005). The importance of modality specificity in diagnosing central auditory processing disorder. AM J Audiol, 14(2), 112-123.
11. Chermak, G. and Musiek, F. (1997). Central Auditory Processing Disorders: New Perspectives. San Diego, CA: Singular Publishing Group.
12. Quote from Frances Elliot Clark, Author of Music Tree publications
