AUDIO PROCESSING DISORDER: ADULTS
"If only the hearing of sound was determined by the size of one's ear."
(please excuse spelling errors - author is visually challanged)
WHAT IS CENTRAL AUDITORY PROCESSING?
Difficulties with auditory processing is referred to as a CENTRAL AUDITORY PROCESSING DISORDER (CAPD or by others, APD).
The word "central" in this title, indicates that APD originates in the brainstem which is found at the top of the spinal cord. At this brainstem site a malfunction on this central structure leaves one without a clear interruption of what was received.
In many adults, hearing loss is often said to be attributed to a conductive and/or neurosensory hearing dysfunction of the 8th nerve or assigned as a symptom due to the aging process. Those who excuse a hearing loss to be conductive and/or neurosensory, in nature, may well be describing a coexisting hearing malfunction of auditory processing. Auditory processing gone wrong invites difficulties in all aspects of communication including the understanding of expressions of speech and sound.
HOW DID I (author) DISCOVER I LIVE WITH CAPD (APD)?
Before I condinue to describe how I discovered CAPD, I urge you to be accountable and seek a consultation by an Otologist.
I found CAPD to be present while in the space of extreme and intense frustration. In absolute desperation, I found myself asking why and how do my peers consistently, "get it" and I am left only to scratch my head. I was totally baffled as to what commonality I was missing. My hearing instruments provided me with amplification and despite hearing clear, crisp sound, I remained on another page........one that peers were not having difficulty with in understanding/interpreting what I was not hearing.
When I was able to calm down from my frustration crises, I had a brain wave and went to my computer to see what I could find on hearing loss types. I was with great hope that the Internet would provide information that would help me find this missing commonality - a link. I first asked Google for information on "hearing loss types" and it was with neurosensory deficits and conductive hearing issues however the third category, titled "audiology processing", compelled me to continue my search and match my hearing issues to audiology processing disorder testimonies.
In the material viewed I felt I was reading my own hearing history.....there was such hope and a sense of relief gleaned from what I read. All this was what I call a life ah, ah moment !!
WHAT QUESTIONS SHOULD YOU ASK YOURSELF IN AN EFFORT TO RULE IN OR RULE OUT THIS DISORDER?
I so wish I could tell you what question(s) to ask yourself if you feel a CAPD is present -- I am unable to provide a cue as we are so unique in our own private history and life events.
Despite finding an answer through awareness of your past history and events, it is imperative you make a visit to an Otologist so that he can accurately determine what and how to manage with this disorder. Don't find yourself stuck or make assumptions! There is no cure for APD however coping strategies can provide you with peace, self-confidence, with less anxiety, and comforts by many descriptions
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THE AWARENESS OF NOISE VERSES SOUND.
Going back to that moment of awareness of APD, which Google
provided when I matched my personal experiences with testimonies of others. With each match I was propelled from one
event to another and as far back as age 6. These flashes were detailed memories of past personal experiences and went back far as being six years of age. The discovery of the presence of an Audiology Processing Disorder left me spellbound as I continued to acknowledge my past history. The puzzle is now complete and
the expectations I have of myself have greatly shifted -- in essence, this awareness clearly identifies that I frequently receive
sound as "noise" and unable to sort out background sounds. All sounds become contaminated by other sounds present -- I feel bombarded and scramble to focus on that which I an intended to hear. Perhaps my having a conductive hearing loss and a coexisting inherited neurosensory loss adds to my awareness and period of denial of the processing factor gone wrong.
In keeping with the past, I felt reason to excuse my inability to receive sound in the same manner as peers as lack of intelligence. I then also realized that I had to work significantly harder to achieve that which my peers so comfortably privileged to hear.
Prior to my awareness of CAPD (APD), I felt the need to understand peers....I continue to struggle to keep up and on occasion I have felt a need to exceed the capabilities of peers to prove my intelligence. Now, with the knowledge of the factors of APD I can sit back and give myself permission to understand that the remark by a young family member to the effect that I was the "Village Idiot" need no longer haunt me.
Several years ago, my self-confidence greatly dwindled and I began to isolate or participate in activities that I was in full control of .
Looking back t my late 30's my self-confidence greatly dwindled and I began to isolate or participate in activities that I was in full control - skiing, equestrian sports, gliding, painting, etc..
These activities did not call upon my constant need to hear and did give me a sense of accomplishment after a day of pushing my limits....a "personal best" was the carrot.
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| Artist - Melanie Elliott - "Lotus Light" |
Career Selection - Cost of Taking the High Road:
When reflecting back to my choice of careers, I choose a profession in a healthcare profession that would require little contact with other professionals. The medical library, medical research opportunities and information management defined just what I thought to be of comfort and as well as being a source of increased knowledge and personal growth. As the years past however, my desire to embrace a more progressive level in my career out-weighted my wish to withdraw thus I continually found myself out of my box!!
Initially, finding and creating coping strategies to communication became an every hour, every day application. Eventually that well went dry.
Virtually, I did not know what direction to follow. I questioned the fact that I must give up my social and cultural freedoms and employment options in order to remove myself from expected communication requirements. When examining frustration levels, I quickly realized that the frequency and levels of frustration were unhealthy and likely the foundation of near intolerable
HIGH ANXIETY !! I was a displaced person and the only resource I could come up with was to reach out to was that of education with respect to body language which I understood as being 45% accurate.
I instinctively knew that major changes were before me and consulted a deaf individual who was disappointed with my questions regarding social participation and hearing of the extent I have gone to find coping strategies. My questions were considered to be insulting as they carried with them a perception that living the deaf culture was not attractive or adequate for me. Weeks later I returned to the deaf community and sat with a few in a group setting....a location in which they gather each morning and spend the entire day socializing with their peers. My questions were again taken as offensive to their sensibilities. In hindsight, I was judging them as "Children of a lesser God'.
MOVING FORWARD
Coping Strategies
Introduction:
In the process of a progressive hearing loss from Meniere's Disease, I was well aware that communication was beginning to take on a picture of hardship. This was most noticeable in my years of university studies. I was loosing grasp of being in the world of others. Not only was I struggling with the hearing loss associated with "Meniere's Disease" but that of a coexisting conductive hearing loss and a neurosensory loss secondary to the resection of the 8th nerve (a treatment option of "Meniere's Disease" when the affected ear was near total dysfunction). It is my guess that the APD was present from birth. I suspect intuition and necessity became the foundation to the creation of coping skills.
In retrospect, my identical twin, Melodie Elliott-Clark was also unknowing struggling however the coping strategies were abundant and was inheritant to her personality. She being the "class clown" (humor) was her greatest tool to coping and in applying this art was a much more effective and less exhaustive strategy. Personally, I was intense, impatient, frustrated and at times felt helpless.
Coping strategies and samples:
1.
In desperation, in the 1970's, I visited the Western Institute
of the Deaf (Vancouver. British Columbia) and it was there
that I was privileged to an introduction to
speechreading by a
hearing specialist. I left that encounter with great hope and
excitement as it was obvious that combining speechreading with an awareness to body language I would have the tools required to remain in the hearing world.
Speechreading is a skill that requires a very high level of concentration and attention. Should you take this upon yourselves, remember it will take time. I have often asked how long does it take and my response is - "with regular daily practice an individual can reach a level in which he/she can converse after a one year span in time. There are no hard fast guidelines to time as every individual learns in a different manner.
2.
The coping strategy I see most often used is described by a hard-of-hearing individual
informing a receiver of a telephone conversation that he/she (the HOH caller) has an auditory processing deficit. He/She explains that words being misunderstood or not interpreted (processed) correctly lead to chaos for both parties.. The HOH individual continues to form the receiver that this can be averted by the receiver providing wording and sentences in a slow manner.
There is a glitch to this strategy -- All "sounds" rosy until the receiver realizes that providing language in a slow space causes her an unexpected delay in her working timeline. Initially, the telephone communication from receiver is a pleasant experience however this is not a comfort that extends beyond three minutes
(personal experience). Disappointment and a sense of lagging behind accomplishes little.
I continually ask myself what it would be like to be on the receiving end of a telephone conversation. My daily experience is that of strained communication for both parties.
3.
Applying
humor is a tremendous tool to both the speaker and the receiver. Communications loose the intensity....both participants gain a sense of trust and an appreciation of how a hard-of-hearing individual can cope and when the HOH person reaches out in this manner his/hers efforts are embraced and received with kindness.
A matter of one week ago, I had a lengthy discussion with a psychologist who has an interest in the coping techniques for HOH clients. He informed me that humor was likely one of the most powerful coping methods. I have since had a few opportunities to test this out and oh my gosh ---
SUCCESS. Friends continue to this day mention my calmness and the fact that my energy was so much more soft and present.
I am rather surprised that this coping method has come so late in life as my twin has used it since her teen years, whereas I continued in my questionably merry way of being intense and had a need for absolute and exacting perfection.
4.
Take time out periodically when you find yourself becoming overwhelmed by "noise"
.....do not denying your fatigue as such is counterproductive....a short timeline in a noisy setting can put you out of commission.. The author has known of individuals becoming so overwhelmed with noise that they begin to vomit and such is followed by an intense migraine.
If you are concerned that people will be curious of your leaving the room, I suggest you simply say that you are in need of the washroom....end of story! If there is no where to go but the restroom -- use that as your re-energizing location.
5.
"Give Yourself Permission": This is a new topic to the author of this blog and she is very, very thankful for the recommendation and guidance of a psychologist for this solution
. IT WORKS
Giving yourself permission suggests that you have the right, thus permission to ask for adaptions and translations. It is time to put aside "shyness, pride and "perceived good manners' along with Independence and jeopardize your receiving an incomplete picture which can be dangerous when misinterpreting directions or instructions. It is paramount that you remain aware of your brain beginning to slow down and take time out to clear that fog !.... take time out and remain in the social boundaries as you wish to be involved.
6.
Take a matter of second each day and remind yourself of your positive attributes, namely "I am Kind, I am Wise, I am intelligent etc. if you say it enough -- believe me, you will wear it and unconditionally so.
Samples of Past APD Events - recent discoveries:
Hopefully, my provision of personal APD events will give you a cue or a match to your experiences thus "ruling in or ruling out" the presence of APD.
Perhaps the following will help you open a window of your past that would be in keeping with an APD-related matter. I promise that once you have found one example, others will quickly come to the forefront if indeed they fall within the criteria of APD. I urge you to pick up the challenge as should you find the same or similar picture, your findings will be monumental and and food for a hug in recognition of a personal period of growth. The realization of APD will open flood gates to memories that will comfortably and appropriately fit under this heading if in case they do.
a) My first memory of possibly experiencing APD goes back to age 6. Our Grade 1 teacher was preparing a pageant for Christmas and in her efforts to put together a sensitive and colorful presentation, we were asked to skip in a circle with several other students. My twin and I achieved this after a lot of work with our Grandmother who had the patience to teach us to skip. She would instruct us to put a particular foot forward - right or left. The quickness to self identify which foot she was referring to was not easily applied.....it had a sense of mental "delay" to it. That "delay" to which I refer was likely APD related.
....., namely we lacked the speed required of this maneuver however after getting the feel of it all came naturally and we were off and back in the circle.
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b) One of the most profound events of an APD episode takes me back to about the age of 14 years. While camping with the family in Prince Edward Island, I did not sleep well despite games and pillow fights that were strenuous - enough to make anyone tired. I asked my parents if I could sleep in the van so as not to disturb the rest of the family in my restlessness.
After much discussion, parents give me the permission to sleep wherever I could sleep best. They reassured me that they would be just yards away and that the can alarm would be set.
Why did I prefer this? In hindsight I was feeling overwhelmed by the sound of the surf pounding along the shore. It took me 35 years to come to this conclusion !!!
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c) While leaving a theatre with friends after a musical presentation, I remarked to a friend how good the performance was......she stopped and curiously looking at me stated "I thought you did not like Western Music"). That perplexes me to this day.
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d) As a student I studied best in an environment with little stimuli.....even the Library was not a choice for and supporting environment. I had gone as far as retreating to the bathroom in an effort to remain focused.
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e) Mother had agreed to teach me how to drive a car however there was one element I was not pleased with.....there was always a few giggles when she would ask me to turn right and I would do the opposite. In retrospect - I was not able to process the words right and left in a timeline that was required for me to make a safe turn. The teaching was passed over to a driving instructor. (in hindsight, this was the same issue as learning to skip as described in "a)" under this same heading..
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f) I watched a young family members open their gifts beside the Christmas tree and the actions of one dear child were rather disturbing. She waited until there was a lull in the opening of gift activity and then attended to her gifts. She lit up the room with joy in receiving a make-up kit. Moments later she picked up the gifts and retreated to the next room where she would be alone. In retrospect, the level of auditory stimuli (crackle of paper, etc.) was obviously sensory painful and causing this family member great distress. Her leaving the room was a dilemma to all present. { It should be mentioned that she also struggled with other signs within the Autistic Spectrum. It is not uncommon for APD to coexisting with the Autism Spectrum signs and symptoms.}
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g) At age 32 years, before the days of the resources of Google
, I enjoyed the music and dancing in the production of "Jesus Christ Superstar". I had a desire to know what the lyrics were after the performance. I could hear each and every note however hardly a word was interpreted. In the privacy and controlled noise environment of my own home, a friend spoke the words as the recording progressed on a video taping - a wonderful experience and a copying strategy that became frequently applied.
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What causes an Auditory Processing Disorder?
Introduction:
(note that the following details are shared with an identical twin)
There is little information available on this topic as it has only
been explored in detail after 1990. I trust the following will shed
some light to this question.
a) Genetic Disorder:
As an identical twin and with both of us with APD would likely support that it is, in part, genetic.
Unfortunately we cnnot provide an absolute as both of us have were subjects of brain trauma and such gives probably reason to assign the problem to trauma.
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b) Trauma to the brain at birth:
There is a possibility that we (twin and self) acquired APD during a difficult birth. Additionally, I sustained a significant brain injury when falling from a retaining wall at age 6 and a second event when exposed to a toxic pesticide in my late 30's. My twin received severe neurological injuries when in a motor vehicle accident in her mid 20's. These post-birth traumatic events may have increased the intensity of an alrea
dy existing APD.
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c) Exposure to toxic chemicals -( this is described in b).
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d) Bacterial or viral infection. An episode of a bacterial meningitis have been the experience of my twin and self. I (author) have experienced a toxic encephalopathy....once again these events may have topped up the APD characteristics.
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e) Auditory Processing Disorder coexisting with a neurological disease is not uncommon. Autism, Tourette's Disease, multiple Sclerosis and others are samplings of this
experience. A little famly member currently struggles with issues of the Autistic Spectrum. This comes not as a total surprise in my world (author) as inherited neurological diseases are in abundance.
What does Brain Function have to do with Hearing?
Answer: In order for one to undersatnd what is being said demands a series of complex audiology processes. Precision of sequences within the brainstem (thus, processing) must be flawless. When one of many finely tasks and sequences fail in the processing and presentation to the brain , we are left with an inaccurate message and often confused by what we have heard.
This subject appers in several Internet searches - to search apply the keywords "Auditory Processing Disroder and Hearing".
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{Notation: CAPD / APD can present as inadequate messages in the workplace and the nuances of social convention. It would appear that the adult may well be inaccurately and unfairly deemed as one who struggles with an Attention Deficit Disorder.}
*Meniere's Disease: A personal experience.
In 1970, a radical surgical proceure of an 8th nerve resection and a labyrinthectomy was a success. (The disease was in one ear only at that time, hearing level in that ear was of little benefit). The procedure eliminated severe episodes of vertigo and balance was enhanced through compensaiton. The procdure was life-changing and the outcome enabled me to return to the coastal mountains of British Columbia to ski, to return to competitive ballroom dance, skating and the list continues. The procedure, in its infancy, was performed at the House Clinic, Los Angeles, California.
After the surgery I was able to return to physical challenges that were my passion - skiing down the coastal mountains of British Columbia. Pushing my limits beyond ability became an addiction. It was a source of instant gratification and the sense of being judged was not present. I again felt so alive and fulfilled. It was a way of taking control of my space, challenging the limits and freedoms. This carried on to equestrian acrtivities and opportunities to fly a glider.
After a recent consultation with a psychologist whose interest is coping with hearing loss, I have come away with wisdom and the realization that I no longer need to strive, compete and exceed successes of others in the need to provde intelligence. As for "the Village Idiot"....that too no longer deserves my energy and in fact I see it now as the individual who gave me that nickname was speaking from a mirror.
I can now give myself permission to be "just me" and take to heart the words I hear of validation and participate in self-affirmation.
CONCLUSION:
BELIEVE IN YOURSELF
SET PERSONAL VALUES (keep to that path)
GET A SENSE OF WHO YOU ARE
Reference 1: http://judithpatton.com
Reference 2: http"//www.idonline.org/article/visual and Auditory Processing Disorders
Reference 3: Devon Barnes, Clinical Director, Learn Fast Education
Reference 4: http://www.ncld.org/types-learning-disabilities
Reference 5: http://www.daitinstitute.org/what is capd.htm
Reference 6: http"//voices-yahoo.com/auditory-brainstem-complications-confused...
Keep Posted: Visual Processing Disorder to follow ( - article in progress)
