I’m going to tell you a story.
It’s about a recent presentation I gave on Auditory Processing Disorder.
Afterwards one of the attendees had some specific questions,
and I had some ideas to offer. Here’s how it goes:
One of the things that I had mentioned that APD wasn’t really “curable”, but that one could improve some skills to cope with it. She was concerned because the school had released her son from therapy some years ago, and yet her son was demonstrating obvious difficulties again … she was concerned and puzzled.
As I’ve mentioned before, a person can “lose their label” by having achieved the proscribed psycho-educational goals. This means that the particular skills have been met so that the problem is no longer severe enough to warrant the diagnostic label. The therapists, the school district that may have employed them, the family, and the child have all succeeded in the neatly-documented IEP goals. Whoopee!
But in cases like this, although the child’s enunciation may be much improved, and his phonemic awareness sharpened (meaning he is better at discriminating between different spoken sounds), that does not mean the APD has necessarily gone away.
So why was the boy having so many of the familiar, discouraging, “Huh?” moments again?
Well, I asked, how old is the boy now? Thirteen, she explained. Ah, yes … well, things have changed in the school environment. Think about it: he was doing well in grade school, where one has relatively small classes with the same teacher all day long. It’s easier to know what’s going on because there is a lot of consistency.
But when you get to junior high / middle school, suddenly there are class changes all the time, with different teachers who have different speaking and teaching styles. There’s also a lot heavier cognitive demand going on academically as well, as the material is more abstract and is being assessed at higher taxonomic levels. Students have to start taking more notes as part of their instruction and learning processes. Things are much more complex and demanding now. Plus, the social world in junior high is a really rough place, which adds to the stresses. There are a lot of changes to get used to and learn to deal with.
She went on to explain that before the APD diagnosis, they were concerned because the boy was speech-delayed, and not very social; he just “sat in the corner and played with his Legos”. They’d even wondered if he was autistic or something.
I was nodding energetically again at this familiar tale (as are, I’m sure, a lot of you readers). It’s quite possible that the boy could have something else in addition to the APD, as a lot of these things are co-occurring (“comorbid”). A lot of the symptoms tend to overlap, especially with AD/HD, Asperger’s, or Non-Verbal Learning Disorder.
There seems to be this phenomenon of what I call “diagnostic stoppage” where if a person gets one diagnosis, it is usually deemed sufficient to describe most all issues they are having. It’s as though a person is only “allowed” one disability, possibly because that’s more one-dimensional and therefore much easier to deal with.
As tutors, such problems with our own children are particularly frustrating for both of us, because one of the problems is that no matter how much either of us knows about teaching or tutoring, our offspring are quick to tune out any advice or suggestions we may have, because at home, we’re just Mom (or Dad, as the case may be for some of the other tutors).
On the more immediate end of things, she asked, what about all those “Huh?” moments? Of course, the kid never seems to misunderstand when asked, “Do you want to get a new video game?” But if you ask, “Did you remember your materials to study for the history test?” then there’s that “Huh?” response again. She explained that years ago the therapist said he had a “15-second delay” in processing. Fifteen seconds is a l-o-n-g time. (Seriously, watch fifteen seconds on your clock.) What was going on, and what could be done? Did it really take him 15 seconds to process the test-studying question but not the game-purchasing question? Parental skepticism and frustration and confusion and obvious love for her child oozed from her questions.
Well … probably not, I suggested. Of course, I don’t really know what’s going on in someone else’s brain, but I could describe the sort of thing that might be going on.
Being asked if you want to get a new game is easy — you already know what new games you want.
But being asked about the test studying is more likely about all the accessory answer-processing, than it is about decoding of the sounds into words and the words into a meaningful sentence. Think about it — you’re a teenage kid, and you come home from school. Your mind is already miles away from scholastic subjects, thinking about snackage and relaxing from the work day, when suddenly your mom asks you, “Did you remember your materials to study for the history test?”
So when he says, “Huh?” it’s not so much about not understanding what was being said, as it’s really more of a conversational habit and a place-holder, while he’s thinking. Meanwhile, his mind is churning with thoughts about Test? What materials was I s’posed to bring home? History? What do I need for studying? Did I bring it home? How grumpy is Mom? Do I have to do this right now? Am I in trouble?
Well, that made more sense as a possibility. But how could it be handled?
Well, at our home I’ve a kid of my own with APD, and a hubby who’s hard of hearing. I have APD too, so you can imagine the potential for conversational confusion at times. When I’m being sufficiently self-aware I try to “headline” queries. (Parents aren’t perfect, especially those who are tired and/or pre-occupied, which is oh … 99.9% of us.)
You know how someone at work will stop you in the hallway and ask you a question, and it takes you a few seconds to figure out what they’re talking about? That’s the kind of thing that can be going on. Headlining is about alerting someone to the subject you’re introducing, and giving them time to pull up the necessary information. It could go something like this:
“Say, in your history class,”
(pause a couple seconds for auditory processing and recollection about history class)
“… you have a test coming up …”
“… did you bring home the stuff you need for studying?”
What this does is to not only alert the person to the upcoming subject of query and slows down the rate, but it also does something else that’s important. The normal question (in English) would actually have those three parts in reverse order: “Did you bring home the stuff you need for study for the test in history class?”
So someone with APD is not only decoding a long sentence, but also trying to put the parts into order (sequencing is a common issue in APD), and also trying to figure out what they need to know to answer the question plus recalling the necessary information.
The headlining puts things into the right processing order, and gives enough time to retrieve the necessary bits of information, review them, and assemble an answer.
Additionally, it might be time for someone (else) to review her son’s situation. New demands upon his abilities can mean new difficulties.