Auditory Processing Disorder (APD) in Children: Guide

Multi- or interdisciplinary team

A multi- or interdisciplinary team is needed given the overlap between APD and other developmental disorders/delays.

There are different multi- and interdisciplinary models that can be considered.  For example, it is possible for the audiologist to request that a speech and language assessment and educational psychology assessment be done prior to referral for an APD assessment and that any other professional reports, alongside a school report, be sent ahead of an APD assessment.  Another approach is to have an interdisciplinary team all working together under one roof.  This has the advantage that an integrated report can be written (identifying primary versus secondary concerns) with a cohesive management plan.  Again professional reports from outside and a school report are reviewed ahead of the appointment.

While an interdisciplinary model holds distinct advantages, practicalities and funding dictate that this may not always be possible.

Audiological assessment for APD should however not be done in isolation given that aspects such as language, attention and memory can affect test results.

The immediate team would typically be comprised of:

• The Audiologist who is responsible for the assessment of hearing using the most sensitive tests available. In cases of suspected APD it is important to rule out peripheral hearing loss, middle ear dysfunction and Auditory Neuropathy Spectrum Disorder. S/he is responsible for the audiological assessment of auditory processing and recommendations for intervention, including the fitting of assistive listening technology and further onward referral.
• The Speech-Language Therapist who is responsible for evaluating and diagnosing problems in speech and language (comprehension, language use and pragmatics (social aspects of language)), phonological awareness, working memory and executive function.  S/he plays an important role in supporting children with APD given the overlap between language delay/disorder and APD.
• The Educational Psychologist who assesses cognitive abilities, processing speed as well as verbal and non-verbal cognitive ability, attention memory, reading, spelling and writing.  S/he assesses overall development, including social and emotional well-being. S/he can make recommendations for further onward referral as well as support at school, including special exam arrangements and educational placement.
• The Teacher of the Deaf who has traditionally supported children with hearing impairment but many of these skills are equally beneficial and transferable to those with APD, i.e. recommendations for improving the listening environment and technology such as assistive devices.
• The Teacher, together with the Learning Support Teacher/SENCO who support  the child at school to ensure that each child is able to realise their potential.

The wider team comprises of the general practitioner (GP) and other professionals, again depending on the needs of the child.  Professionals often involved include ear-, nose- and throat consultants, paediatricians, occupational therapists, sensory integration specialists, opticians but others may also be involved.