In my last article, “How a Hidden Disorder Can Affect Your Life,” I wrote about a client named “Linda” whose boss referred her to us because of her difficulties with written and oral communications. In this article, I’ll finish telling Linda’s story about how she learned that she had a condition known as Auditory Processing Disorder (APD).
Note: Auditory Processing Disorder is sometimes referred to as Central Auditory Processing Disorder (CAPD).
Summary of Linda’s Story Prior to APD Testing
Linda was a 49-year-old chemical engineer who had worked for a major manufacturing company for almost 30 years. Her job was in jeopardy because of poor written and oral communications. Her supervisor referred her to us for 360 Feedback and possibly for coaching. However, he was almost positive that he would have to let her go.
After an initial interview, we determined that Linda’s performance issues were not due to a lack of effort but, in all probability, to a “hidden disorder.” We provided coaching support services that helped Linda get neuropsychological testing. However, her test results didn’t point to a specific disorder. Since the neuropsychologist recommended that Linda work with a speech therapist to improve her communication skills, we also consulted with a university-affiliated Speech & Learning Center.
Specific Testing for Auditory Processing Disorder
After reviewing Linda’s neuropsychological evaluation results, the Speech & Learning Center recommended that she be evaluated for Auditory Processing Disorder (APD). The Center explained that neuropsychological testing does not assess for APD. In fact, they told us that neuropsychologists are trained to test for areas of cognitive-linguistic difficulty, but not for APD.
The first step in assessing for APD is for an audiologist to administer a full audiological evaluation to rule out hearing loss. The audiologist determined that Linda’s hearing was within normal limits.
Next, the audiologist and a speech therapist administered tests for receptive and expressive language, including the Test of Auditory Processing Skills (TAPS). They determined that Linda met the criteria for a “Moderate delay in Expressive/Pragmatic Language” and a “Mild-Moderate delay in Receptive Language.” The primary reason for these delays was that Linda also met the criteria for Auditory Processing Disorder.
Linda was actually relieved – at last, there was a diagnosis! Now, perhaps, someone could help her with her communication challenges!
But What Is Auditory Processing Disorder?
A diagnosis of APD is given when a person has difficulties in one or more of four different categories:
|Tolerance Fading Memory (TFM)||Difficulty with short-term memory skills. May also have difficulty with blocking out background noise.||Difficulty with reading comprehension, following multi-step commands, and verbal directions.|
|Decoding||Inability to quickly and accurately process speech.||Difficulty with phonic skills, spelling, and receptive language ability. Generally have delayed responses to verbal stimuli. May appear as if have hearing problem.|
|Integration||Inability to bring together auditory and visual information.||Severe reading and spelling problems. Can be associated with dyslexia.|
|Organization||Difficulty with organization and sequencing.||Usually seen with other areas of APD. Unable to follow sequential directions or follow through on assignments without assistance.|
Linda’s test results showed that she met the criteria for APD in three categories:
- Tolerance Fading Memory (mild)
- Decoding (moderate)
- Organization (severe)
APD and ADHD Are Often Co-Existing Conditions
We’re telling Linda’s story because we coach college students and adults with ADHD. Like Linda, some of our ADHD clients have been unaware when they also have APD. Similar to several other “hidden disorders,” APD is more prevalent in people with ADHD than in the general population. Linda did not meet the full criteria for ADHD, but she did have mild attention challenges.
Sometimes our ADHD clients “self-diagnose” for ADHD or receive an ADHD diagnosis from their primary doctor, but never have comprehensive testing. When a person has attention issues, it’s important to start with a comprehensive psychological evaluation, followed by specific ADHD, auditory processing, and other testing, if indicated.
APD and ADHD can present very similarly, as some of the most common signs for APD are also prevalent in people with ADHD:
- Difficulty carrying out multi-step commands
- Difficulty understanding directions
- Easily distracted by background noises
- Poor short-term memory
- Poor listening skills
- Delayed responses to sounds
- Highly dependent on visual information
- Academic challenges in reading, comprehension, spelling and writing
Is There Treatment for Auditory Processing Disorder?
Yes! In fact, Linda’s prognosis was “good to improve language skills and pragmatic skills, given skilled intervention.” Over the course of several months, she received speech therapy services two times per week for 30-minute sessions. In these sessions, Linda learned strategies to compensate for her difficulties in speaking and writing, with a special focus on how to speak and write more clearly in her profession. As a result, her communication skills improved significantly. And, in fact, she got a promotion to a more suitable job at another one of the company’s nearby facilities.
Because our coaching model includes not only coaching, but coaching support services, I continued coaching Linda for a short while after her APD diagnosis. I helped her with workplace disability accommodations, workspace organization, and time management. With the combination of coaching and speech therapy, she became aware of how APD was affecting her job performance. She also developed strategies for improving communications and gained self-confidence in her ability to sound professional in her communications.
When It’s More Than ADHD
These days, it seems like almost everyone either has ADHD or knows someone who has ADHD! It’s a very common diagnosis. This concerns us because a diagnosis of ADHD may miss the mark! Sometimes attention issues are primarily due to undiagnosed Auditory Processing Disorder, Autism Spectrum Disorder, a learning disability, depression, anxiety, or another condition. It’s important to get an accurate professional diagnosis so you know how to treat the symptoms.
Please contact us for a 30-minute pro-bono consultation if you want to know more about our customized coaching services for adults with ADHD, APD, and other co-existing disorders. We would love to hear from you! We also welcome your comments on this article!