Sensorineural Hearing Loss and APD

[jonnyghost]

I'm starting to sound like a broken record here but i'll point out again that there are other issues with apd other than speech in noise. I'm not a profesional but it seems to me that if they suspect a processing problem that they should try for an assesment if possible so that they can make sure all the issues are being addressed.

 

[Lau2046]

I just wonder if the APD is an unnessary additional label, since it goes without saying that even late deafened people still may have issues with processing speech in noise.

Labels are "hearie," "deafie," "us" and "them."

"Hearing impaired," APD, VPD, LD are medical terms to define types of disabilities....which aren't meant as personal insults or to discriminate against a group of people. Categorizing people (based on this forum anyway and my own personal experience) tends to be a favorite activity among the deaf community, not those in the medical field.

 

[CSign]

I concur. It is extremely rare that anyone with an at least a moderate or higher loss will function well in noise, even with HAs. That's why HA manufacturers are working on programming that help to eliminate background noise in speech in reception. The newer Naida's, if I understand correctly, are going a long ways towards that. There have been some other threads here about that. Anyway, I think it's the level of loss/noise in speech issue that is the concern here.

Right. Anyone with a significant hearing loss has difficulty hearing in noise.

However, there are individuals with a hearing loss and an Auditory Processing Disorder as evidenced by some of the posts in this thread.

 

[CSign]

Two things......first of all, the audi, someone who actually has a lot of interaction with dhh children stated that he has very good speech and hearing.....I think that should make you feel a lot better.....it's one less thing to worry about.
Second of all, I wonder if the audi actually KNOWS what she is even talking about. It's possible to be HOH AND APD at the same time, but even unilateral dhh people can and do have significent difficulty in noise...that's all part and parcel of being HOH!

Point of clarification: The Audiologist said he had good speech- not that he had good hearing. His speech has not been an area of concern for me. He does have great speech and language. It's the receptive end that concerns me.

 

[deafdyke]

Point of clarification: The Audiologist said he had good speech- not that he had good hearing. His speech has not been an area of concern for me. He does have great speech and language. It's the receptive end that concerns me.

So why were you so worried about his articualtion then? I'm just asking.....An AUDI says he has good speech.....that should reassure you.
And yes, no dhh person has perfect hearing. Virtually ALL of them are still functionally HOH.

 

[deafdyke]

Right. Anyone with a significant hearing loss has difficulty hearing in noise.

However, there are individuals with a hearing loss and an Auditory Processing Disorder as evidenced by some of the posts in this thread.

True, but overall you really can't seperate one from the other you know?
It also seems like the people who have both seem to have an unusual manifesation of hearing loss...........like a unilateral loss plus APD...

 

[Bottesini]

True, but overall you really can't seperate one from the other you know?
It also seems like the people who have both seem to have an unusual manifesation of hearing loss...........like a unilateral loss plus APD...

What? My older daughter has a moderate bilateral loss and CAPD. People who have both often do have families with a history of deafness.

 

[deafdyke]

What? My older daughter has a moderate bilateral loss and CAPD. People who have both often do have families with a history of deafness.

Sorry, meant in this thread. Maybe the CAPD is basicly a result of the way that Deaf people's brains are wired......I mean it makes sense that someone who was born dhh would process sound completely differently from a hearing person. Guess it's just more proof that hearing aids/CIs do not make a dhh kid hearing.

 

[jonnyghost]

True, but overall you really can't seperate one from the other you know?
It also seems like the people who have both seem to have an unusual manifesation of hearing loss...........like a unilateral loss plus APD...

Sure you can. When the problems experienced cannot be explained by periferal hearing issues.

 

[Anij]

True, but overall you really can't seperate one from the other you know?
It also seems like the people who have both seem to have an unusual manifesation of hearing loss...........like a unilateral loss plus APD...

Actually, yes you can separate HL and APD.
They aren't the same thing.

Hearing Loss impacts one's ability to hear and understand sounds, while APD (and CAPD) impact the ability of the brain to store, access and process sounds and sound memory.

That might seem similar, but it's not.

In a typical Hoh person (without APD) IF the sounds can reach the brain, the brain then stores and processes them as language etc in a fairly typical and predictable way... this isn't how it works for those of us with APD.


The "trouble" is that if someone has HL, then the current diagnostic tests for APD don't work properly. That is why in older children and adults APD is almost always diagnosed not by "machines", but by an in depth interview and audiological assessment with an Audiologist who specializes in communication disorders (which includes APD & CAPD).

 

[Anij]

I know this has been mentioned before, but it's worth restating here:

APD and CAPD are not interchangable terms.

APD is "Auditory Processing Disorder"
CAPD is "Central Auditory Processing Disorder"

CAPD is a very very specific type of APD, and true CAPD is actually fairly uncommon in terms of APDs

APD tends to have a wider impact on sound processing, comprehension, and auditory memory etc. whereas CAPD is more specific.

unfortunately people tend to toss around the two terms interchangeably, even professionals.

 

[deafdyke]

So APD is basicly the hearing version of cortical visual impairment?
I know there's cortical hearing loss

 

[Anij]

So APD is basicly the hearing version of cortical visual impairment?
I know there's cortical hearing loss

Sort of - at least in a "broad strokes" sense.

APD and CAPD like CVI is often caused by "trauma" - a difficult birth, "near SIDS" occurrences, near drowning, head/brain trauma or from part of the brain that are formed or function atypically. Sometimes the trauma happened but it was subtle enough, or their weren't witnesses, so the trauma isn't even a "known" to the individual or their family.

APD is the brain not understanding auditory information (or making a mess of decoding it), versus the ears not functioning/being able to give information to the brain.

Like with CVI, there is a percentage of people who have both hearing loss and APD - sometimes it's a coincidence, sometimes they are connected because the event etc that caused one also caused the other (including physical brain formation/development or trauma etc issues).

Also similar to CVI, with APD or CAPD any hearing loss greatly compounds the issues one faces with the APD and vise versa.

In my specific case, a good example is that if I get too much indecipherable auditory input, after a few minutes my brain "shuts down" auditory processing entirely. I become totally deaf. If it happens is a loud room, it goes completely silent except for a very specific type of tinnitus (and I become even more hyper-aware of vibrations when this happens). That reaction is my APD, not my hearing loss.

 

[KristinaB]

Well - this is confusing me a little. I was told my daughter had CAPD, but after reading about CAPD and APD, I'm not sure what she has.

She was listed with SNHL, but she hear all sounds; low, high, soft, hard; as long as it is a sound. What she doesn't get is the speech recognition. All speech to her is muffled. She used to say it was "fuzzy", then after she got older, she said it sounded like talking under water. Also, she cannot follow multiple spoken commands. She only gets the last 1 or 2 steps. There's a bunch of other issues she has, but this is what we were told as far as her hearing.

I guess I need to look everything all over again.

 

[dogmom]

I have issues with multiple instructions and sequences; sometimes hear but it doesn't process - it's like what I hear doesn't actually get anywhere useful.
That is, of course, if I hear it, or hear all of it. Sometimes what I hear is also "fuzzy". Used to be that many "everyday" things was too loud, then I started losing my hearing and things range from either "heard it ok", "what?" and/or "fuzzy".

 

[Anij]

Well - this is confusing me a little. I was told my daughter had CAPD, but after reading about CAPD and APD, I'm not sure what she has.

She was listed with SNHL, but she hear all sounds; low, high, soft, hard; as long as it is a sound. What she doesn't get is the speech recognition. All speech to her is muffled. She used to say it was "fuzzy", then after she got older, she said it sounded like talking under water. Also, she cannot follow multiple spoken commands. She only gets the last 1 or 2 steps. There's a bunch of other issues she has, but this is what we were told as far as her hearing.

I guess I need to look everything all over again.

What does her audiogram look like?

Typically (meaning for most people) SNHL does make things "fuzzy" - especially once you get into the moderately-severe or more range.

The not being able to follow (meaning retain and process) multiple verbal commands is fairly typical of APD - however it's also common to a lot of other conditions as well. (I also have massive issues doing "word problems" because I tend to read with an "internal voice" which for me engages the auditory processing part of my brain (which is effected by APD).

 

[KristinaB]

What does her audiogram look like?

Typically (meaning for most people) SNHL does make things "fuzzy" - especially once you get into the moderately-severe or more range.

The not being able to follow (meaning retain and process) multiple verbal commands is fairly typical of APD - however it's also common to a lot of other conditions as well. (I also have massive issues doing "word problems" because I tend to read with an "internal voice" which for me engages the auditory processing part of my brain (which is effected by APD).

Her audiogram is cookie bite shaped, but in the mild range. (It's packed right now)

She never learned to read until age 9 since she never understood the sounds the letters made and she still hates to read now and she's 19.

She also had borderline Autism, Dyscalculia, poor memory retention, fine and gross motor skill problems, and a quirk where she walks on tippy toes and has done so since she was a baby.

 

[Anij]

Her audiogram is cookie bite shaped, but in the mild range. (It's packed right now)

She never learned to read until age 9 since she never understood the sounds the letters made and she still hates to read now and she's 19.

She also had borderline Autism, Dyscalculia, poor memory retention, fine and gross motor skill problems, and a quirk where she walks on tippy toes and has done so since she was a baby.

Based on this (especially with the borderline Autism and tippy-toe walking etc), I'd say it's more likely that she has a more global sensory integration/processing disorder that has auditory components (versus APD/CAPD).