□ Have difficulty listening and paying attention?
□ Misunderstand spoken information?
□ Display poor sequencing of auditory information (e.g. next, before)?
□ Get easily distracted by background noise?
□ Find some sounds uncomfortable or painful?
□ Have trouble identifying similarities and/or differences in sounds?
□ Struggle to perceive high frequency sounds in speech (e.g. t, k, p, th, sh)?
□ Experience confusion with similar sounds (e.g. ‘da’ and ‘ba’)?
□ Misunderstand and not remember things they have been told?
□ Experience academic difficulties in language-based activities?
□ Need to have directions and information repeated?
□ Have poor phonic skills for reading?
□ Have behaviour problems?
WHAT IS AUDITORY TRAINING?
For most individuals, Auditory training is something that occurs naturally as part of our daily experience as we are exposed to sound from the world around us. However, for some individuals, the daily auditory experience is insufficient for the auditory system to develop and function efficiently and effectively, especially when the auditory system has been compromised by global developmental and speech and language delay, and pathology of the middle ear such as fluid, otitis media and other conditions.
The causes of auditory processing difficulties are varied and it can occur on its own or it can co-exist with a number of difficulties and disorders such as learning difficulties and dyslexia, autism spectrum, speech and language delay, attention deficit and attention deficit disorder, dyspraxia, global developmental delay and other difficulties.
Auditory training provides individual a series of increasingly more difficult auditory exercises in a systematic way dependent on the weaknesses of the individual, to address the auditory deficits. The aim of the training is to improve the individual's auditory processing ability over time (Weihing & Musiek, 2007). Through regular evaluations using normed assessments, improvement can be gauged and adjustments made to the protocol of intervention.
A little more about auditory processing….Auditory processing is what we do with what we hear. It is the efficiency and effectiveness by which the Central Nervous System utilizes auditory information.
Skills involved are:
To discriminate sounds
To localize and lateralize sounds
To recognise auditory patterns
To discriminate the timing of sounds
Auditory Processing Disorder is the inability to attend to, discriminate, recognize, or to comprehend auditory information even though the individual has normal intelligence and hearing acuity. (Keith, 1994).
Other key Indicators of AP difficulties:
· Chronic fluid,
· Repeated grommets
· academic underachievement
· weakness in receptive language skills when undertaking psychological and language tests
· Low Verbal IQ
· Difficulty following instructions
· Behaviour typical of peripheral hearing loss despite normal hearing
· Diagnosis of other disorders related to auditory processing impairment: ASD, ADHD, learning disorders, dyslexia, dyspraxia etc.
How we assess for Auditory processing difficulties?
We combine a battery of cognitive, auditory processing and memory assessments and preliminary questionnaires to determine if and where auditory processing difficulties exist.
During APD assessment the skills assessed include:
Auditory Closure: This is the ability to complete or fill in missing parts of auditory information when the auditory signal is degraded, such as when a speaker is speaking from another room.
Auditory Figure Ground Differentiation: This is the ability to listen to and understand specific auditory information in the presence of competing background noise.
Spatialized listening: Is ability to hear and understand spoken sentences both when background noise is coming from the same direction as the spoken sentences, as well as when background noise is coming from a different direction as the spoken sentences.
Dichotic listening is the ability to hear auditory information through both the left and right ears and to either integrate these bilateral auditory sources, synthesizing the two sources, or to differentiate them, ignoring one source while hearing and understanding the other source.
Temporal auditory processing skills is an individual’s ability to hear and understand speech which is time altered by various methods. For example: assessing if an individual is able to understand rapid speech.
What makes the Auditory Training Program unique?
Auditory Training is a non-invasive program uses electronically modified music and vocal sounds to stimulate the auditory pathways and enhance auditory neural plasticity. Auditory training enhances the ability of the auditory system to detect differences in frequencies and other auditory skills, which are a pre-requisite for language development, and for the processing of auditory information.
The Auditory Training program was developed from the work of Alfred Tomatis who pioneered the use of orchestral music, acoustic filtration and bone conduction for auditory training in the 1980’s. For more on the development and history of auditory training you can read Norman Doiges top selling book on neuroplasticity, The Brain’s Way of Healing. The Auditory Training Program utilises the world leading Besson-of-Switzerland technology to provide a unique and comprehensive auditory intervention which includes:
Auditory training through Orchestral music which incorporate Tomatis Techniques: Auditory training using orchestral music typically has the following characteristics:
a) The underlying media is full spectrum orchestral music thus providing the auditory system with the complex experience of the complete spectrum of sound, particularly the higher frequencies, that may be missing in daily life.
b) Acoustic filtering of the music using a variety of high, low and band pass filters, which are progressive or partially filtered to train pitch discrimination skills.
c) The random use of sound treatments that invoke auditory attention.
d) The use of bone conduction transducers to address differences in the perception of bone conducted sound versus air conducted sound. This technique aims at resembling true hearing / listening as we hear and process auditory information via the two domains.
e) Volume intensity to train left versus right ear perception to further assist with auditory discrimination and address ear weaknesses
Dichotic Listening training: Dichotic Interaural Intensity Difference (DIID) Training, was a procedure initially described by Musiek et al. (1979). The procedure is to present stimuli such as words and numbers with differing volume intensity differences between the left and right ears, to strengthen the auditory pathways under challenging conditions, aimed at strengthening the weaker ear's performance with specific exposure and training
Audio-vocal biofeedback: provide the individual more advanced opportunities to listen to a word or phrase, repeating it into a microphone which is fed back to the individual and in this process, creating a biofeedback loop by listening to his/her own voice, impacting his/her own voice perception aimed and improving auditory skills and articulation.
Auditory working memory exercises: Whilst the use of orchestral music has not been shown to improve verbal working memory, the program addresses this area by incorporating an auditory working memory component. This contains a range of exercises that automatically adapt to the working ability of the client providing a constant working memory and attention challenge.
By using information from the Auditory Processing Assessments, each plan is specialised to target the individual’s AP difficulties. The customised protocol is then delivered in intensive blocks, which usually consist of 20-30 hours of training.
Auditory training program objectives.
Stimulate the middle and inner ear, brainstem, auditory pathways, temporal lobes and language centre.
reduce latency in the brainstem (speed of processing)
To assist the development of receptive language (via improvement in auditory processing skills) and expressive language skills(via audio vocal feedback mechanisms).
Our Auditory Training Programs include:
Pre-training assessment for auditory processing difficulties and used to develop individual’s training protocol
Pre-training report and training protocol
30 hours of auditory training
Post-training assessment and report (1-3 months after training completion)
Additional training is delivered in either 20 or 30 hours blocks depending on the individual’s needs.
Loo, J. H. Y., Rosen, S., & Bamiou, D. E. (2016). Auditory Training Effects on the Listening Skills of Children With Auditory Processing Disorder. Ear and hearing, 37(1), 38-47.
Krishnan, A., & Gandour, J. T. (2014). Language experience shapes processing of pitch relevant information in the human brainstem and auditory cortex: electrophysiological evidence. Acoustics Australia/Australian Acoustical Society, 42(3), 166.
Tremblay, K., Kraus, N., McGee, T., Ponton, C., & Otis, B. (2001). Central auditory plasticity: changes in the N1-P2 complex after speech-sound training. Ear and hearing, 22(2), 79-90.