Accommodations for Students with Auditory Processing Disorder

Most often APD symptoms are first noticed in school.

Making changes in the classroom can have a huge positive effect on a child with APD. The competing noise and echoing environment of a classroom can make the easiest of instructions a huge struggle for a child who cannot comprehend what is being said. Not every child will benefit from every accommodation. You should take the list to the teacher and discuss and try out the strategies to see what helps most.

Note: These accommodations are not listed in any specific order. Every one of them is a valuable way to assist a child with APD.

The following accommodations are ways to help children who have APD:

1. Preferential seating
Seating your child in the front of the class is where he will have good visual reception of the area where most teaching is done. Avoid seating by open doors or windows. Make sure he can see the teacher’s face. Avoid strong shadows which hide the face. Standing in front of windows on a sunny day will hide the face.2. Reduce Background Noise
Make every effort to eliminate extraneous noise. A noisy background does not need to be loud to create a problem. Even mild noises such as the hum of a fan or the sounds of a quiet crowd may be enough to create a poor listening and learning environment for the child. In the presence of background noise, his behavior might look like: failure to respond when spoken to, incorrect responses when spoken to, distracted, overactive, confused or anxious.

3. Consider your distance
When and APD child is spoken to from a great distance (more than 5 feet), he will definitely be challenged to comprehend what is said. Consider moving closer to him when speaking to him. Sound intensity drops quickly over a short distance. Moving closer is a great, easy help.

4. Consider the acoustics
If the room has tiled floor and unfinished walls, there is a high probability a lot of echo occurs in the room. This can exacerbate competing sound situations for the APD. If possible, rug or carpet on the floor can reduce this effect. Decorating the walls with student art or other items that absorb sound will also help a lot. The Classroom Acoustics Coalition provides important information on problems caused by bad acoustics in classrooms. They also offer practical strategies and methods to correct bad acoustics.

5. Obtain visual attention
Get eye contact from a APD child before talking to him. This can be done by touching him on the shoulder or using an auditory prompt (ie. Saying his name). This is very important when introducing a new idea, changing subjects, or giving directions. APD child needs additional prompting in order to have attention focused properly.

6. Slow down speech
Too much information too quickly is challenging for a APD child to comprehend. Speak one idea at a time, and pause so he can take it in and assimilate it, then move onto the next idea. It does not have to be super slow, just pace your words, with a few seconds between ideas to help him take it in better.

7. Make the child responsible for understanding
Encourage him to repeat back what he has heard to make certain he understands. Don’t embarrass him by having him prove it in front of the class, do it in a sidebar one-on-one. In addition, remind him to always raise his hand and ask if he doesn’t understand. This is an area where the aide can assist to make certain he understands the directions he is meant to follow.

8. Think before criticizing
If the child does not respond, or his response is inappropriate, consider that he has not understood what you have said. The APD child is often not aware that he has misinterpreted what has been said. Ask him to repeat back what he thought he heard before assuming he is doing something “wrong”.

9. Simplify directions
Break multi-step directions into one or two parts before continuing on to the next piece. Children with APD need time to take in and process what is said, and often exhibit short-term memory issues. A child with APD will struggle to process was you said 10 seconds ago and isn’t always able to continue listening and taken in more information. Space out directions for better understanding and comprehension.

10. Provide additional written or visual material.
Simple words and visual cues that give him an idea of directions will help him keep up. Even just writing out 1,2,3,etc. for steps will remind him how many steps he has to go through. Many kids with APD have impaired short-term memory, so 10 or 20 minutes after hearing instructions, he may need them repeated.

11. Seat him next to helpful students
Children with APD generally enjoy independence, but often they are more open to help from peers than the teacher. In my son’s classes, being sat next to a helpful student improved his performance greatly. When he was sat next to students who talked out of turn a lot, or themselves had attention issues, John’s performance was definitely affected.

12. Consider an FM system
And FM system is a broadcast-type device that assists in filtering out background noise and delivering clearer spoken speech to the student. Read the What is an FM System information below.

13. Consider sensory issues
Many children with APD have additional sensory issues that complicate their ability to focus in class. Be aware of these sensory issues so you can accommodate for them as well. For example, my son has trouble with sudden loud noises. At lunch he had issues hitting other students, then the aide realized the aluminum roof/concrete floor eating area amplified noises which aggravated the problem for my son. Moving his eating place to an uncovered picnic table resolved the problem.

14. Say things in a different way
Sometimes the combination of sounds in a sentence are difficult to process for an APD child. If they cannot understand what you are saying, try using different words. For Example, if the child does not understand when you say, “Take out your math workbook and turn to page 22.” then try rephrasing it. Instead maybe say, “Get your math book out of your desk. Look at page 22.” Simple rephrasing may eliminate specific phonic sounds the child has greater difficult with.

A frequency modulation (FM) system can be used in a classroom to help filter out background noise and bring the teachers’ more clearly to a student. The benefits of an FM system for auditory processing disorder have brought mixed reviews. There are some studies that show benefits, but not enough to convince experts that the systems are of benefit [see Frequency modulation (FM) system in auditory processing disorder: an evidence-based practice? paper on PubMed].

Our son tried an FM system in class, and the unit the school district got was so old and horrible that it caused more problems than helped. There was a lot of static, and it often stopped functioning, and in the end we decided it was causing additional distractions rather than helping him hear better. We did not have the $5,000 to buy our own system, so we were at the mercy of what the district would provide.

There are two types of FM systems:

1. Teacher-to-Student system: There is generally a wireless microphone device that the teacher wears that transmits a signal to a box on the student’s desk. Sometimes the child could have a wireless earpiece similar to a cell phone hands-free earpiece. These are called personal FM systems.
2. Teacher-to-Class system: With these systems to teacher still wears a wireless mic, but it transmits to a set of speakers in the walls. The speakers are specifically placed to optimize sound transmission in the room. These are called sound-field amplification systems. They have been shown to help all children, even if they don’t have APD.

How would an FM system help my child?Many children do benefit from the systems, but you will not know if your child will be helped unless you try. The benefits these kids see include:

• Better perception of speech from the teacher
• Longer attention span
• Better auditory focus
• Fewer disruptive behaviors
• Improved academic performance

There are studies that have been done that show that an FM system helps all students (if it is the sound field type that runs through loud speakers).Does an FM system help APD?

After prolonged use, some children showed better speech perception even without the unit, which indicates use of an FM system may actually improve the symptoms of APD. I could not find any research studies that substantiate this, but there are anecdotal case studies that show measurable improvement.

Accommodations at home are similar to school

1. Reduce Background Noise
If you are trying to have a conversation with your child, quiet is the best way to do this. If you are unable to have quiet environment, then understand that the child may not be able to hear what you have said. Being patient, and even using sign language, will assist in communication. This is particular true in situations like parties, shopping malls or places where there are multiple noises occurring at once. Also, turning off the TV while talking is a must for kids with APD.

2. Consider your distance
How far away you are makes a huge difference in the ability to hear. Being within 3 feet helps defer extraneous noise. Don’t shout information or request across the room, and definitely don’t shout them from another room. Again, if your child doesn’t do what you ask, remember there is a good change he did not understand what you said.

3. Obtain visual attention
This one helps my son so much. I get eye contact from him by tapping him on the shoulder and asking him to look at me. This really improves our communication. I believe he may have learned to read lips a bit, and so he uses that when looking at my face. Note that looking at lips instead of the face is a symptom of autism, which is probably why my son was sometimes considered to be autistic.

4. Slow down speech
This doesn’t mean super slow. It just means to talk at a consistent pace and pause between ideas.

5. Make the child responsible for understanding
Ask your child to repeat back what you said so you can confirm he understood you correctly. So often we just assume the child got it, and you would be surprised how often he mishears things.

6. Create a homework space
Auditory distractions are so huge for kids with APD. Homework is very difficult if there are even small noises like a fan or lawnmower outside. Consider this when creating your child’s homework space. If there are noisy siblings, keep them in other areas of the house, or arrange for them to participate in activities outside the house. Most importantly, your child may need to do homework in several small 5-10 minutes sessions because the energy required to focus is intense. Give your child leeway and don’t expect them to sit for 30-60 minutes if they are really struggling with it.

7. Think before criticizing
When your child does not respond, or the response is not what you wanted, please remember that it’s highly likely your child did not hear you correctly. Before getting angry and punishing, remember this, and try to clarify instructions before jumping to conclusions.

8. Simplify requests
Break multi-step directions into one or two parts before continuing on to the next piece. Children with APD need time to take in and process what is said, and often exhibit short-term memory issues. A child with APD will struggle to process was you said 10 seconds ago and isn’t always able to continue listening and taken in more information. Space out directions for better understanding and comprehension.

9. Consider sensory issues
Many children with APD have additional sensory issues that complicate that cause them to get overstimulated. In this state their APD is aggravating and listening and focusing are even harder. Be aware of this at home. Our son cannot deal with a lot of loud noise. If his brother is being too rambunctious, he will seek out the quiet of his room. While we live in a small house, we made a point of making a space that was his so he could retreat to it whenever he felt overwhelmed.

10. The end of the day will be the hardest
After a full day of focused processing your child is going to be very tired. Take this into consideration when planning evening activities. Don’t expect your child to be able to do homework late, and be accommodating if he would rather just spend some time alone or doing quiet activities.

11. Create a signal for important information
All children have some degree of challenges when it comes to paying attention and listening. The child with APD has this even more so. An effective tool is to have some sort of signal that indicates to the child that you have to talk to him about something important. For example, perhaps you have to go over the morning schedule because something about it has changed. Consider the following signals that can indicate to your child that they should listen, then repeat back what you said so you know they have understood:

• The sign for “stop”.
• Laying a hand on his shoulder
• Count 1, 2, 3 with your fingers.
• Ask your child what signal he/she would like to use

12. Rephrase what you are saying
Sometimes the combination of sounds in a sentence are difficult to process for an APD child. If they cannot understand what you are saying, try using different words. For Example, if the child does not understand when you say, “Please brush your teeth and wash up so you can get ready for bed.” then try rephrasing it. Instead maybe say, “It’s time for bed. Use your toothbrush and clean your hands and face.” Simple rephrasing may eliminate specific phonic sounds the child has greater difficult with.

These accommodations are similar to what you might do to help a hearing impaired child.

1. Teach the child clarification techniques
A child with APD never knows when he hasn’t heard something right. Teach your child to verify information in a non-interfering way. For example, say “I just want to make sure I understand the rules. We do this…, right?”. In this way the child will make certain he has understood correctly. Role play various clarification techniques, especially after your child has had a bumpy social experience.

2. Teach your child to be okay when he mishears
Children can be very unkind. It’s important to talk to your child and explain to him the reason he seems to not get what his friends are saying. With my son children at his old school were very unkind about his mishearing things, and they called him stupid and excluded him from games. It’s important to help your child understand that they are their choices, and they clearly don’t know how to be unkind when somebody is a bit different. Encourage your child to talk about these events so he can express the emotions and learn new ways to handle these challenges.

3. Role play social situations before and after they happen
Role playing is an excellent way to help your child learn appropriate social behavior but in a quiet environment. Busy school yards bring a lot of auditory input and can be overwhelming and confusing for the child. It’s hard enough to learn social skills, but with an overwhelmed auditory system it’s nearly impossible for an APD child to learn even the basics. Social Stories (see next module) are an excellent way to teach this information. Choose stories that reflect the same experiences where your child struggles.

4. Teach your child other ways to perceive what is going on
This is going to be more beneficial for older children, but we began using this techniques when our son was 5. Teach your child to look for facial expressions, body posture or body movements. Also, tone of voice, loudness of voice can also be good indicators of how the person is feeling. While this may not give the specifics of a conversation, it will help with sensing the general mood of the conversation. Our son used to jump into play with kids who were fighting because he thought they were wrestling and having fun. Thankfully he was never hurt, but we knew we needed to teach him ways to figure out what was going on.

5. Praise your child when you see him getting it right
Always take the opportunity to reinforce positive behavior. Whenever you see your child with appropriate social interactions, point it out and offer positive words to reinforce the accomplishment.

6. Prompt your child when social opportunity arises
Find ways to help your child through social situations that your child may usually avoid. Maybe you go to the park and there is another child to play with. Encourage your child to initiate contact, and give him prompts as to what he should say. Stay close and provide additional prompts throughout the interaction. This helps the child move through the social situation with you as a coach to encourage appropriate behavior.

7. Point out positive examples of good social skills
There are many times you will see great examples that can help your child learn. This might be in the real world, in a book or on TV. Take the time to point out to your child what you see and how it is an example of good social skills.