I write this as I sit here with my 7-year-old son, Holden, in the waiting room to have his hearing tested. This isn’t just any hearing test; Holden is about to be tested for Auditory Processing Disorder (APD).
You see, when Holden was a baby, around 10 weeks old, it was like a switch was flipped and he couldn’t handle his own environment. He became agitated anytime someone new entered the picture, and he was his happiest when it was just the two of us in our quiet home while my husband was at work.
As the months went by, a simple outing, like grocery shopping was too much for him. The ambient noise and curious strangers peeking into the stroller to see the cute baby was just too much. As Holden got older, birthday parties, (in particular people singing happy birthday), was torture for him.
Photo: Joanna Venditti
Holden never held back from letting me know he was unhappy. He wailed, and became almost animalistic, frantic with anxiety. This behavior wouldn’t stop until he was removed from the situation. We eventually learned that our best approach was to avoid potentially disastrous situations and ask to be given a heads-up when happy birthday was about to be sung.
As you can imagine, the amount of worry and constant isolation was hard on both me and my husband.
As Holden approached the age of 2, we decided it was time to explore what was causing Holden so much distress. One assessment turned into another, and another and another. We often got the same feedback: Holden has some really great qualities, but also displays some worrisome behavior.
As the months rolled by, and each assessment passed us onto the next, we decided to work with private speech therapists and occupational therapists. Holden was eventually diagnosed with Sensory Processing Disorder (SPD).
Sensory processing (sometimes called “sensory integration” or SI) is a term that refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses. spdfoundation.net
Holden was officially diagnosed with some sensory issues and a universal language delay by a developmental paediatrician. He was not on the autism spectrum which was once suspected.
As Holden eventually learned to speak and he overcame his childhood apraxia he was able to articulate what situations were too overwhelming for him and what he needed and when. He was self-regulating. This, for my husband and me, was huge. As we watched our son begin to learn how to enjoy life, make friends and excel in school, we felt like we had won the lottery.
Which brings me to today.
Photo: Joanna Venditti
Holden just finished first grade. He’s been enjoying his summer vacation at day camp and spending his weekends swimming and playing. Although Holden is an advanced reader, the sweetest peace-keeper and an (almost) straight- A student, something still plagues him: his hearing.
It’s not that Holden can’t hear, its that when there is competing noise, he can’t always understand what you are saying. When there is competing noise, he can’t always get out a full sentence. When Holden is given two or three step instructions, he forgets what he is supposed to do next half way through. When Holden hears a dog bark, or tries to enjoy watching fireworks, something in his brain is telling him “you aren’t safe! Danger! Danger!” Which sends him into a panic attack.
Holden is at an age now where he can articulate to me how he is feeling and what he thinks could be wrong.
I am now the mother sitting alone in the waiting room, wondering if I’m about to hear what I have been suspecting for a while. That Holden has auditory processing disorder. The last piece of the puzzle.
Auditory Processing can be understood as the link between the ears and the brain. Both children and adults can be affected by difficulties understanding what is heard, despite normal hearing and normal intelligence. This difficulty impacts the ability of the child or adult to function in everyday life. Our ears detect sound; the brain gives these sounds meaning. An auditory processing disorder (APD) is a disruption of sound along the pathway from the ear to the brain, which interferes with understanding. The ears do not work alone to decipher incoming information- the brain has its own part to play. For example, the ability of the child or adult to understand the language, the information (cognitive ability), to pay attention, and to remember what was said are all aspects of the brain’s ability, and are very important when considering auditory processing deficits. – OSLA
We are ushered into a small room and sit down at a table with the therapist. Sure enough, Holden has APD. I learn about the areas of the test that Holden didn’t struggle with and the areas that he scored lower than one percent.
Holden’s biggest area of difficulty is when more than one person is talking, or talking to him at the same volume level. For example if he’s watching T.V. and I ask him a question, there’s a good chance he won’t process it properly. Or if Holden and his sisters are all asking for a snack at the same time, he has a hard time getting a sentence out.
This can cause Holden a lot of stress, anxiety, him to have difficulty making a decision and forgetfulness.
Also, Holden’s right ear can hear better than his left, most likely because Holden is so left-brained.
So, what can we do for him?
First, purchase noise cancelling headphones and let him tune the world out occasionally while using his iPad. This will be especially useful after school to unwind, when his sisters are being loud or are upset, or in crowded and loud situations when he’s starting to feel overwhelmed.
We’ll talk into Holden’s right ear when we’re in a loud environment, and have him repeat what we said back to us.
We’ll also request that Holden’s school provide a small microphone for his teacher to wear, with speakers in the classroom. This will make her voice louder than the noise from the classroom.
These tips are just the start, and Holden might grow out of his APD by the time he’s a teenager. But, at this point, the emotion Holden and I are mostly feeling is relief. He’s feeling relieved that we’ve identified why he struggles with his hearing and I feel relieved to know the last piece of the puzzle.
Update: It’s been a few days since Holden’s appointment. We purchased noise cancelling headphones the next day and have been communicating with him in an entirely different way. Holden has been happier than I have seen him in a long time. Anytime he is about to spiral into anxiety, he has been able to regulate himself and we each know exactly what could be triggering his anxiety.