Auditory Processing

Auditory Processing Disorder (or Central Auditory Processing Disorder/ CAPD)

is the role the brain plays in the hearing process which ultimately enables us to develop learning skills.  Since the majority of early learning is auditory, a weakness in how language is processed can lead to delayed development in a number of other learning skills, including reading which requires language dexterity.

Symptoms of CAPD:

• Reading and/or spelling difficulties
• Had speech therapy or language delays when young
• Difficulty listening in the presence of background noise
• Difficulty with phonics and speech sound discrimination
• Poor auditory memory
• Often misunderstands what is said, requests information be repeated
• Poor expressive language skills
• Slow or delayed response to verbal requests and instructions
• Poor auditory attention

Efficient -- fast and accurate -- auditory processing skills help the clarity and breadth of phonological vocabulary, a skill required for reading.   Hearing "cat" as one sound is enough to participate in conversation but to recognize it in text form requires "phonemic awareness" (definition: phonemes are the smallest components of sound that make up words) or being able to hear the component sounds of cat, i.e., "c-a-t."  This opens the door to automaticity in reading and to more effective learning.

Enthusiasm for learning is inextricably tied to the daily educational experience.  An auditory processing weakness can make for a miserable school day.  For instance:

• If instruction is coming at a student faster then he or she can absorb it, the teacher is hard to follow, making time in class exhausting, difficult or downright impossible. Children will habitually miss huge chunks of information, misunderstand or simply tune out.
• It may be hard to gather directions for homework assignments.
• Nuances of peer conversation and jokes may be hard to pick up, creating social discomfort.
• Reading is almost always affected due to the lack of phonemic awareness required for fluent decoding, creating anxiety at reading time, reading math problems, etc.

Fast ForWord to Address Auditory Processing: A Viewpoint

by Theresa Brassard, Audiologist

In 1997 The Scientific Learning Corporation introduced the Fast ForWord Program.  Since its introduction there has been considerable interest and some controversy raised regarding the program.

Fast ForWord was designed to facilitate the development of a child's language skills.  It is based on the premise that the language delays and auditory perceptual disabilities of many children stem from a slower rate of processing.  When children process information at a slower rate they will miss certain acoustic cues and on a micro level, may mishear individual words and confuse/interchange sounds within words.  On a more global level these children may experience difficulty in many areas of receptive and/or expressive language i.e. reduced vocabulary, difficulty remembering and/or sequencing information as well as in reading and reading comprehension.  The Fast ForWord program attempts to increase the rate at which children process information resulting in improved/more accurate processing and subsequently improved language and reading skills.  This is accomplished through a series of computer based exercises which utilize the theories of neural plasticity of the neural pathways and structures of the brain.

There are 7 games in the program and each game targets various aspects of auditory processing and language. For example, the Circus Sequence game focuses on improving processing rate and discrimination between up and down tone sweeps.  Research has shown that to process language at a normal rate we ought to be able to hear the difference between tone sweeps, at the longest, of 40 msec. in duration. An inability to do so may result in language and/or processing difficulty. Another game, Language Comprehension Builder, aims to improve a child's ability to understand various grammatical constructs I.e. pronouns, plurals, negatives, passives, double negatives while Block Commander targets auditory memory skills.

Upon entering the program all children start at the same basic level.  The children must attain a predetermined level of proficiency at that level before they are allowed to progress to the next level.  The rate at which a child progresses through the program is therefore determined by the child.  On average, children well complete the program in 6 to 8 weeks.  Many children will take longer (i.e. 12 weeks).  The maximum time allowed by Scientific Learning Corporation to remain on the program is 6 months.

The Fast ForWord program is a good program which has benefited many children. However, it is not appropriate for all children.

When evaluating candidacy for the Fast ForWord program, several factors ought to be taken into consideration.

1) The age of the child. Technically the Fast ForWord program was designed for children 4 to 12 years of age. Many younger children however do not have certain concepts required and/or the attention span necessary to complete the program.  Just because a child has a language delay does not mean that this is the best program for the child at this time.  Each child must be evaluated individually to ascertain the appropriate time for entry.  Similarly, children beyond 12 years  of age can still benefit from the program. The gains, however, are often more subtle.

2)  Ability to wear earphones. The child must be comfortable wearing earphones for extended periods of time.

3) Behavior and Attention Span.   Children with reduced attention spans will require very close supervision, 1:1 in many cases.  A reduced ability to concentrate does not preclude a child from going throughout the program.  It does, however, influence the structure and environment in which the program is conducted.  Other behaviors must also be taken into consideration.  For some children, it is advisable to defer the program until the child has reached a certain level of maturity/self-control.

4) Same/Different Concept.  Many of the games in the Fast ForWord program require that the child understand this concept. Otherwise the program ought to be deferred until the concept is understood at least on a visual level.

5) Colors and Shapes.  Children ought to know basic colors and shapes to fully benefit from the program.

Other considerations:

6) Expectations. Every child is an individual.  Although many children have shown significant improvements in language skills over the course of the program, for others the gains have been more modest.  Even with careful selection there are no guarantees.

7) Location.  The program can be conducted either at home or at a clinic location.  Location choice ought to be based on the environment which will be best for the child.

8) Monitoring.  Monitoring of the program is a critical element for success.  It involves more than tracking a child's progress.  Monitoring includes interventions to help the child  acquire the concept of a game and strategies to assist the child in the event of a block.  This supplement to the program ought to be provided regardless of the location (home, school or clinic) in which the program is conducted.

The Fast ForWord program has been very effective in stimulating the development of language skills in many children.  It is worth considering for children who exhibit speech-language and/or auditory processing difficulties, particularly those whose progress is slow or whose development has reached a plateau.  It is however meant to complement the speech- language therapy and other programs the child may be attending. It should not be viewed as a replacement.

The views expressed in this article are personal and have not been reviewed nor solicited by Scientific Learning Corporation.

Theresa Brassard is an audiologist in private practice in Toronto, Ontario.  She holds a Fast ForWord certification by the Scientific Learning Corporation.