Do you know one of the best tips to help your child with APD at school?
To briefly read/discuss with him any topic that will be taught in class before the teacher. This will make the information more redundant so the child won't have to rely on every speech signal to understand the message; instead, he will be able to use his previous knowledge to fill in the gaps of any degraded or masked speech in the classroom. This is basically a good example of a top-down strategy helping the bottom-up sensory system to process what is heard. Top-down strategy? Bottom-up sensory system? What is this?
As explained in the blog “Hearing and Listening in Children”, listening skills involve not only the sense of hearing but several other “non-auditory” skills that directly affect the way we listen to a message. Brain activation studies have demonstrated that even to perform a simple auditory task, cortical areas beyond the auditory system are also activated, indicating that they are also involved in sound perception (Patel et al., 2007; Holland et al., 2007; Sharp et al., 2010). Those areas are functionally related to vision, memory, attention and emotion. If the auditory message is verbal, as in the situation described in the classroom, language areas will also play a significant role in speech perception.
If your child has APD, he will probably have difficulties involving specific listening skills, such as spatial processing, speech in noise perception or competing sounds. As explained above, those skills will encompass both sensory and cognitive mechanisms. The sensory or “bottom-up” mechanisms are related to the ascending part of the auditory system, which is the part that is almost mature at birth. The cognitive or “top-down” mechanisms consist of all those “non-auditory” functions that develop until adulthood (Moore, 2012). The integration of both aspects will guarantee that the message will be accurately processed. Thus, both aspects have to be considered when dealing with APD management (in fact, they must be considered since the beginning of the Auditory Processing Assessment).
Now, let's consider that specific situation in the classroom again. Suppose your child had an auditory processing assessment that detected a deficit in understanding speech in the background noise. In that case, he will likely struggle to understand his teacher or friends in the classroom. This is because children with this deficit need a very good signal-to-noise ratio to understand the message, which basically means that the signal, which is the message to be heard (such as the teacher) must be significantly louder than the background noise (such as friends talking) to be accurately understood. Strategies to improve this signal-to-noise ratio will probably be considered, such as changing the seat in the class or improving the signal with remote microphone system. The training of the specific skill will also be considered through auditory training sessions. All those strategies will improve the bottom-up aspect of the listening skill. Top-down strategies such as the one mentioned above must also be considered. Reading or discussing the topic beforehand will significantly increase the message redundancy as it will boost his previous knowledge about the topic. This previous knowledge and all the semantic cues involved will be used to fill in any degraded or masked speech gaps in the classroom and improve his listening skills in those situations.
To read more about the influence of top-down and bottom-up mechanisms on listening:
Moore DR. Listening difficulties in children: bottom-up and top-down contributions. J Commun Disord 2012; 45(6): 411-8.
References:
Holland, S. K., Vannest, J., Mecoli, M., Jacola, L. M., & Tillema, J.-M. (2007). Functional MRI of language lateralization during development in children. International Journal of Audiology, 46, 533–551.
Moore, DR. Listening difficulties in children: bottom-up and top-down contributions. J Commun Disord 2012; 45(6):411-18.
Patel, A. M., Cahill, L. D., Ret, J., Schmithorst, V., & Choo, D. (2007). Functional magnetic resonance imaging of hearing-impaired children under sedation before cochlear implantation. Archives of Otolaryngology-Head & Neck Surgery, 133(7), 677–683.
Sharp, D. J., Awad, M., Warren, J. E., Wise, R. J., & Vigliocco, G. (2010). The neural response to changing semantic and perceptual complexity during language processing. Human Brain Mapping, 31(3), 365–377.
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