preventative breaks

It never ceases my to see how small insignificant activities can make such a difference to a child's sensory experience. While thinking about a discussion on how a child can communicate their sensory needs. At the same time I have been reading an article by Sue Larkey on a similar concept called a preventative break, all combining with information I learnt yesterday about the value of sensory input to ease transition to a new activity.

The holy grail for us as parents is the idea that our child can have a form of self regulation this is "is the ability to maintain a level of alertness appropriate to a given activity. Adequate self-regulation is essential to the development of attention, regulation of sleep/wake cycles, and the control of emotions, as well as the daily transitions that make up a child's routine."  Honestly I notice this issue in regards to being able to understand their bodies, what their senses are trying to communicate with them and thereby being able to handle the challenges of the senses and problem solving skills. This skill is something that has to be taught to any child who has sensory processing issues. 

Sue Larkey introduces the idea of preventative breaks, using activities and skills to enable a child to ask for help and defuse the sensory overload that is building. In her explanation of teaching these skills she introduces the concept of a break card, which a child can ask for an activity that would assist them in their self regulation such as a movement break, wall push ups and breathing. 

Social Stories

Carol Gray originally introduced the concept of a social story. If you are considering using social stories often I do recommend you buy her book which gives you hints on how to write a great social story.

In teaching these skills Sue mentions the importance of social stories in this process. My thoughts on the subject are also in this process teaching a child how their sensory system works. An example could include:

When I hear sometimes the noise can be:

• too loud
• too soft
• too much

If my ears are having trouble sometimes I might:

• cover my ears
• make more noise
• find it hard to think

When my ears tell me something's wrong I can

• find a quiet place
• ask for the noise to be turned up (TV) or ask Mum for headphones
• ask for the noise to be turned off

Augmentative communication

This type of communication can be a powerful tool in helping our children learn self regulation. We can use a simple break card as Sue Larkey describes which would look like this:

I can

• ask for a movement break
• do wall pushups
• have a drink

Ipads can give us some useful tools to easily create social stories and and others to help our children communicate needs to us.

In the case of choices and feeling we can use:

My choice board

I forgot this app existed, it is a choice board app that has different boards that are easy to create show a child what they can and can't have. This can be easily utilised and divided into senses to show children how they can help themselves feel better.

Choice works

This app has a great section called a feeling board. It has simple instruction and visual cues to show When I feel (insert emotion) I can .... and ..... to feel better. 

Also included in this app is a visual schedule I think this is a great app for our younger kids as visually it is simple and I have been able to use it for the feelings board and learnt a lot about my second boy's feelings.

It would be great to in the process of teaching these skills add a sense each week and learn all about it, what could work is to have a visual cue on the fridge with pictures of each sense and then use that in communication about their self regulation skills. 

Social story apps

Keeping in mind, I haven't needed to use social stories often but we do use a calming book sometimes. There are quite a few apps that are spoken of, but it is really hard to recommend the social stories apps as they are so varied, these apps include, icommunicate, speech journal (another fantastic mobile education store app) and I think you can even use imovie to make a social story video if you like as well. 

Using preventative breaks to aid transition

Particularly in the school environment, sensory tasks can really help a child to transition and provide a valuable opportunity to build the sensory diet into the daily routine. For example when finishing an activity you can punctuate the routine with activities such as bouncing on a small tramp, doing a lap on the bicycle, wall pushups, respiration activities. This can help I think also when getting ready for school and transitioning from play to getting ready for school. I also find using routines and even better an ipad with a routine will really help a child be empowered to follow a schedule and complete tasks with minimal involvement. I have mentioned it before I have bought large cooking timers to help at home and this can help (there are apps such as time the timer that can work too) finishing a task or helping a child do a task, I generally use the time to remind myself to shut up and give the child the time including processing time, to complete the task. 

This has all been processing lately and I have some new ideas of how to tackle the sensory needs of my son. At one point I think I believe that my son's issues with sensory processing were not so bad. Since watching "traffic jam in my brain" and attending the "autism-the whole person conference" raised some valid issues. Interestingly enough I can see how easy it would be for someone to dismiss a child like mine's concerns in the classroom setting. Please share your ideas of how you teach self regulation and what apps you use. I would be happy to share more on what social story apps are available if you need me to!

the why of what they do

Every parent that deals with sensory issues knows what a meltdown is. Now this is something that most parents may think they have experienced, often it is only a milder version a tantrum. Let's not misunderstand normal behavioural issues as a meltdown as believe me some kids have insane behavioural issues but a meltdown has some different components things to look out for:

Pre meltdown

• small fractious moments usually occur before a meltdown, a child may seem unreasonable about small things. Something that doesn't normally set them off will become a major issue.
• look at their body language take notice of (physical movements, [are they clumsy, falling over, jerky] emotional temperature [responses to situations and interactions are disproportionate to the expected norm for them], vocal temperature [their voice may change they may get louder often more whiny and bossy, or may start making noises] 

During the meltdown

From my experience I have noticed the following:

• physical reactions (hitting, kicking, running, pushing, throwing)
• emotional component (usually appearing angry, extreme versions of emotions, lack of ability to be able to engage in a discussion about their behaviour)
• vocal component (usually crying, yelling, demanding, screaming)
• normal coping techniques have no effect (breathing, counting, space, talking to them)
• discipline will have no effect
• if you leave the situation often it may not change their behaviour

Post meltdown

This is often a fragile time

• it is good to offer a cool/hot drink and some food, meltdowns can be exhausting
• some quiet space or activity to allow them to regroup
• this is the time once they have recovered to discuss what happened

Another concept which is as fluid as anything is the idea of a neurological threshold:

"Neurological thresholds refer to the amount of stimuli required for a neuron or neuron system to respond. When the nervous system responds really quickly to a sensory stimulus, we say there is a low threshold and when the nervous system responds more slowly than expected, we say there is a high threshold for responding. All of us need a balance between low and high thresholds so that we notice just enough things to keep aware and attentive, but not so many things that we become overloaded with information and feel distracted.

At the extreme ends of the neurological threshold are habituation (related to high thresholds) and sensitization (related to low thresholds). Habituation refers to the process of recognizing familiar stimuli that do not require additional attention (Dunn, 2000). For young children, habituation is essential so they might focus their attention on the activity at hand. Without this process, children would be constantly distracted by the variety of stimuli that are present in the environment.

Sensitization is the process that enhances the awareness of important stimuli. It is significant to development because it allows the child to remain attentive to the environment while engaged in play or other learning. The ability to modulate (organize/ balance information from all sources) responses of the nervous system (i.e., balance between habituation and sensitization) permits the young child to generate appropriate responses to stimuli in the environment.

References: (Baranek & Berkson, 1994; Dunn, 1997a) (Dunn, 1994, 2000; McIntosh, Miller, Shyu, & Hagerman, 1999; Wilbarger, 1995)

In the context of a child's life and emotional regulation, at times the amount of stimuli required for optimal arousal (the place where we are ready to learn and engage) can change from day to day. Meaning that a behaviour or stimuli one day will not cause a meltdown can cause a meltdown tomorrow. Simply because their threshold is much lower or higher as the case may be. So for example after a trying day at school a child may have a low threshold or high threshold and will be primed for a meltdown.

The goal for any child would be to allow a child to be able to receive and interpret their world is such a way that they can stay in the state of optimal arousal. This means that us as parents needs to pay particular attention to allowing our child to experience many things and use tools to facilitate this process, particularly important for each child to be able to learn in the school environment or to feel comfortable at home.

Often (honestly) we can not quite figure it out why they have a meltdown, partly because sometime the lead up was at school. However prevention is an amazing tool. Providing extra sensory tools during trying times can help such as after school and getting ready for school some suggestions that I heard recently in a conference include the following (and some from my own experience)

• An electric toothbrush can be calming
• Routines and schedules (doesn't matter what form)
• providing sensory diet activities that are needed
• removing any sensory things that overload your child such as noise, smell and sight
• keeping them well fed, plenty of water and enough sleep works wonders

Getting down to the latest revelations:

The primary goal for sensory processing is to enable your child to achieve an optimal level of how they are feeling not too much, not too little. It is an insane process and one that unfortunately is worked out through trial and error, this information I have found helpful. There are two types of nervous systems discussed: 

Parasympathetic nervous system: This is where our nervous remains most of the time and when we are at “ready state” for learning, social interaction, and alert and awake.  

Sympathetic nervous system: The state of “fight or flight”.  This part of our nervous system is intended for safety and the ability to react to a perceived dangerous situation.

The issues with these two states is that in children especially (without any sensory processing issues) are prone to fluctations in moods and behaviour. Part of their development is learning to regulate their emotions. Often they feel out of control of their world, then add in any other stresses we can see why they don't cope so well. 

What can occur is the child feeling particularly out of control, not understanding their environment or their body. This is a scary experience for anyone. Let alone if you add in any communication issues and other mental health issues. Secondly once they are in the place that their senses are overwhelmed they will feel on the edge and it takes not much at all to send them into a full scale melt down.

So how do we know what type of state our children are in? Another blog article suggests these are signs of the fight or flight state.

"There are many different manifestations of “fight or flight” but some common responses may be:

• Hitting, kicking, biting, spitting, pushing (especially while standing in line or in new challenging/overwhelming situations or activities)
• Trying to run or escape from the situation
• Trying to hide under something like a desk, table, or chair 
• Burying themselves in a teacher’s arms, avoiding all eye contact, or trying to curl up in a ball on the floor or at their desk
• Covering ears or eyes
• Crying or screaming
• Hiding in the closet, under couch cushions, or under covers in bed
• Shutting down completely and not speaking or responding
• Even falling asleep unexpectedly"

Consider these as signs that your child is trying to avoid stimulas and struggling to cope with their environment. Taking cues from their behaviour, it is important to remove stimulas in an attempt to avert a full scale meltdowns. If you consider the list above, if they are covering their eyes or ears it could be an auditory or visual issue, if they are psychically reacting it could be a tactile issue.  As I was told yesterday "there is always a reason for their behaviour".  

Sometimes and this is not that uncommon we are clueless as to why and what our child is experiencing. Aside from sensory activities and a sensory diet, yesterday I discovered this tool called a Motivation Assessment Scale that can help in the classroom or at home to assess why things are happening. It is worth investigating to see if you can identify the cause and redirect the behaviour or eliminate it all together (wouldn't that be nice). Another topic that has raised my interest is the idea of preventative breaks which has been discussed in an article by Sue Larkey. I also plan to include some of the resources I got from the latest conference I attended.

coming soon

Upcoming reviews 

Please forgive the presentation of the graphics, couldn't get them to align properly!

Raising a Sensory Smart Child: 

The definitive handbook for helping 

your child with Sensory Processing Issues

        

Traffic Jam in my Brain:
Sensory Processing Approach
to Challenges Associated with Autism, ADHD,
Learning and Behavioural Differences
by Gen Jereb

the finer details: sitting in a w position

In the past I have seen it noticed that my son sits in a w position, even therapy assistants bug my son to sit in a different position. At the time I thought it was just plain annoying, I honestly thought would you leave the kid alone! So whilst reading one of my new books Raising a Sensory Smart Child by Lindsey Biel, I come across this topic and this time I thought I should actually take an interest. 

In case you are wondering what on earth I am going on about, this is what W sitting looks like. Lindsey discusses this in her book "When sitting, a child with low tone may always sit on the floor in a position that resembles a W, bearing weight equally through his bottom, legs, knees, ankles, and feet. This widens his base of support and frees up his arms for play. In this position, this trunk is inactive and he often slumps. While this is a very stable, secure position, it does not encourage the development of postural control." pg 200

The question is what to do about it. The issue with W sitting it can reveal other issues that can be at play such as low muscle tone, stiffness in the hips, instability in sitting which can all be linked to childhood disorders such as sensory processing disorder, also associated with children with autism, and in our case the issue of hyper-mobility of their joints.

From here I think it is important not be become a sitting sheriff and pester our children to sit properly or correctly. More importantly it is to teach them what to do and strengthen them to be able to do it. One issue that can arise is the fact that your child might not be ready developmentally (such as a baby or toddler) or your child's individual delays might slow, this is something that you as a parent and your OT if you have one should be deciding.

If you are thinking of doing something then this is where to start. I found a great article that gives some practical tips from Learning Links. What will assist your child to sit better are firstly building up their core strength through activities such as using a scooter board, swimming, standing on a balance board or sitting on a fit ball and as a parent modeling other ways to sit is helpful, encouraging different ways to sit in a non threatening manner will also help. What will be the challenge for some time is it is easier for your child to sit in the w position, so they will naturally resort  to sitting this way. I would even bet that they don't even know why they sit this way. But as they get older it is even more important that they learn to sit in a different way. So here's to change. 

Using idevices for Auditory Processing and Speech Therapy

As a Mum to two boys with speech and hearing issues I am passionate about speech therapy and how to encourage my boys speech development. So with a great tool such as the ipad I am always keen to use this tool to help my boys to develop and practicing any speech skills. Secondly with a son who has possible auditory processing issues, I know he needs to work on apps that deal with instructions and listening. These are the apps that I have found helpful:

   

Sock Puppets

Play School Art Maker

Toca Boca Tea Party

           

These particular apps are quite affordable and can be used for a variety of uses, for speech therapy, social skills, emotional regulation. They can be also used for encouraging imaginary play which is also part of speech development. 

iMovie

Speech Journal

iModeling

Media apps can be used for a variety of purposes, iMovie can be used to edit movies and to create movies. Speech Journal can be used to take photos that can create a story with an attached audio file. iModeling is a social stories app, this app is great for created video social stories.

Bugs and Buttons

Bugs and Bubbles

Preschool Pencil Pal

Bugs and Buttons and Bugs and Bubbles are delightful little apps that develop many speech therapy skills, including directions, sequences, letters, numbers and coordination. Preschool Pencil Pal is a app from the School Zone collection of apps they are educational and work on many skills including listening to directions, and understanding complex phrases. There are many more apps in the school zone range.

iPads are invaluable tools for developing speech. As a mum to two boys who need help in this area it is such a relief to know that they can play an app that will teach them the skills they are learning in speech therapy. It also helps me by taking away the stress of being supermum and coming up with fantastic ideas to work on speech development.

Understanding a sensory diet and how to create one for your child

Sensory processing in itself is a puzzle, previously I have spoken about how it can be like a cake, if you get the ingredients right it can be great, but if you don't it can be a total disaster, this can be just the same with our children. What is discussed when you have a child with sensory issues is a sensory diet. It sounds like food but it is about our senses, every child has a individual recipe. First of all you need to know what your child's sensory profile is, you can find this out by doing the sensory processing disorder checklist that I have discussed in other posts. From this information you will know in what areas you need to focus and strengthen on. Also I would be observant of the things that your child does that indicate what their sensory needs are examples could include: chewing on everything, fiddling, running, crashing into things, climbing all over the couch, jumping on the bed.

In the next post I will post some photos of what we have been doing at home to work on sensory issues. We are waiting for a parcel in the post with some goodies.  What we already found useful for us 

- giving breaks after school before homework, especially including physical activity

- listening therapy, helps in many ways

- structured activities such as art, colouring in

- audio when going to bed such as music or an audio book

- fidget tools when anxious

- giving opportunities for your child to broach activities that they find difficult in a safe atmosphere can de-sensatize them and help them cope in the future

Ideally it is best to work with your Occupational therapist on this but you can incorporate some simple activities into your day that potentially can make a difference please check out Sensory Smart and their article Sensory Diet Activities for children which lists activities for each sensory area a lot are very simple tasks that we naturally do with kids, that also has a sensory value. If you have any ideas that really work for you, please comment and let us know what makes a difference in your home!

But wait there's more

It feels like a black hole of questions sometimes. Is what we have been given as a diagnosis it, or is there something more. Struggling with what I saw and what he struggled with and also hoping for something to answer the struggles. Wanting more for my son, wanting answers so that we can relieve part of his burden. Living in a constant state of instability not knowing how school feels, how he is really doing, does he feel safe, can he speak. Does he need help, can he ask for help. Living with the after effects of anxiety and stress on his body. Coming home exhausted, tired, emotionally spent. Knowing that a day when he is able to do everything he doesn't cope, he comes home and falls apart. It feels like grasping, trying to see in pitch blank darkness. Not knowing when to relax or when to be alert. 

Then comes answers or something. We travelled to Perth for another appointment. We get one diagnosis at least that explains some of his struggles. The pediatrician explained that my son is just like a perfect storm his anxiety affecting his speech stops him from asking for help from learning, then his speech limits him understanding and processing, then a new word his hyper-mobility issues then add to the list exhaustion, tiredness and sore muscles. Answers to the questions you forgot to ask about about the odd comments of his legs are sore. His struggles to write and expression and how long it takes him. Next step is more testing and assessment appointments with a Rheumatologist, a fresh assessment of his Selective Mutism by a psychologist and a speech therapist as well a MRI and EEG to rule out a certain type of epilepsy (Landau-Kleffner syndrome). 

Back to the new diagnosis of hyper-mobility this presents are over flexibility. A test is done on their movements to determine if they have typical flexibility this is measured by the Beighton Hypermobility Score. If a child scores above a certain level this indicates hypermobility as a diagnosis. How does it present in a child. 

A physiotherapy clinic in Perth describes these symptoms on their website:

"What the parent may notice a myriad of symptoms, of which the child may have some or all:

• Tiredness, fatigue more than peers or other siblings of the same age
• Toddler - wants to be in the pram a lot
• School age - too tired to walk home or walk to car from classroom
• Exhausted more than peers/siblings at end of the day
• Pain
• Night pain
• More frequent growing pains
• Frequent strains/pains
• Recurrent subluxations,  dislocations or fractures (commonly knee cap, elbow, shoulder)
• “Pulled elbows” in toddlers and babies
• Coordination issues
• Awkward running, difficulty putting clothes on in morning
• Difficulty keeping up with handwriting in early school years (either slow to finish or messy writing)
• Some are very coordinated and some poorly coordinated

Some of these symptoms could easily describe my son, at the moment he is struggling a lot after school with tiredness, we now understand why. At school he struggles with the time allocated to do tasks. He has complained of sore legs and we never understood why and often didn't take it seriously. However he doesn't tick all of these boxes, but enough to confirm this is what he is experiencing. 

At this point we are waiting for more information on how bad this really is. I know I have had a lot of his symptoms mainly in the area of flexibility and it hasn't been a dramatic issue for me. However I can see that for Josiah it is quite different. We have a few appointments booked in a few weeks hopefully all will become crystal clear then. 

A exciting new Sensory Processing Tool on your iDevice

                                                                                                                                      For those of you who remember me talking about listening therapy, let me fill you in on some exciting news. Audioforge Labatories and Ease Music have worked together and have  produced an app there are three versions:

                    

                    EAse Lite Version                                    EAse Personal Version                                       EAse Pro Version

What Listening therapy can do, is assist those who are on the spectrum those with Auditory Processing Issues and those with Sensory Processing Issues. The initial idea is that you desensitise the person to the sounds that bother them. A simple illustration would be a child who struggles with the hand dryer in the toilets, to gradually introduce the sound of the hand dryer from different positions until they are able to use the hand dryer without distress. This music works on a similar principle.

Desensitisation is not the only benefit of this listening therapy. As with any other symptoms of Sensory Processing Disorder I am sure it also assisted with other issues. This included things like emotion regulation, planning and organisation. Also we had a breakthrough in one area that our son who had been struggling to put his socks on, suddenly learnt how to put his socks on. Keep in mind some of the music will have different effects on your child which is why it is so beneficial and I believe essential to have an OT work with you as they have the experience to share with you and make adjustments as you go. 

This year with our money we are considering purchasing this app.. and using it to add to our son's current therapy as we have found it extremely beneficial. 

Further Information:

Audio Forge

EAse Listening Therapy
Vital Links

Vital Sounds (music and accessories)

EAse Listening Therapy APP information

EAse available apps

EAse app user guide

Therapeutic Listening Information

Please check out my other posts on Sensory Therapy as well :) 

Making sense of it all

I must admit when I think about Sensory Processing Disorder sometimes I have an idea of what it means but there are so many components to it, that I do get lost. So in order for me to attempt to get my head around this I need to take a deeper look at the way it all works.

As I mentioned before (in other blog entries) there are seven senses that we use everyday:

Tactile or the Somatosensory System - sense of touch

Visual System - sense of sight

Auditory System - sense of hearing

Gustatory System - sense of taste

Olfactory System - sense of smell

Vestibular System - sense of balance

Proprioception System - sense of body position

Each sense works to provide us with our perception of the world, not all people have the same experience of the world as we do as a person. This is why there can be so many misconceptions and misunderstands when dealing with an undiagnosed person with sensory processing issues. Another person will see a child who has sensory processing issues can see their responses and behaviour as unreasonable, illogical and naughty. This is precisely the reason why some children get punished at school for their behaviour or ostracized socially because of how they act. Without understanding through a diagnosis, these people are not able to make sense of their world and be at peace with it.

The first image most people see when we are told about Sensory Processing Disorder or even more commonly Autism (it is common for SPD to be diagnosed with Autism) is about children who struggle with tags, their socks, touch or sound. With my son it was a little different we noticed small things like as a baby my son hated the beach and the sand it took years for him to be able to tolerate it, to this day we are not able to use the hand dryers in the toilets, sound for us is the biggest issue. However tantrums and meltdowns also come hand in hand with these situations. Then strange situations when our son was overspun on the wizzy dizzy and vomited afterwards it took six hours plus the possibility of a CT Scan and suddenly he was able to work straight again. 

Over the next few posts I am going to look at each different sense, how it works and what activities you can do to assist in that area. Bare with me I will attempt to provide a comprehensive idea of how it works, from my point of view as well. 

Listening (Auditory Processing Issues)

It sounds easy enough doesn't it. Listening. For some time we have been frustrated about how hard it has been for Josiah with his speech. He has been able to have speech therapy since he was a baby yet even now he has a speech delay, expressive and receptive to the point it is severely disordered. Because Josiah has struggled with his hearing for most of his life, he has had glue ear and seen an ENT Specialist from 18 months old.

For some time we have been noticing that it is more and more difficult for Josiah to understand what we are saying, he is struggling with understanding instructions we have to repeat what we say over and over again. Even though we know he is trying to understand us, he really struggles even though we do our best to help him to understand what we says.

After consulting with WAIDE (WA Institute for Deaf Education) who we helpful in answering my questions, I had always been sure that he had bad hearing as his first normal hearing test was only recently. Having two children with hearing issues I had gotten mixed up with whose hearing was worse.

The path of diagnosis always seems rocky. So we spoke to the audiologist and asked for a repeat hearing test. Now to our delight or dismay his hearing is completely normal which was quite a shock. The answer which seemed easier was not for us. What frustrates me is when I have questions about my children I don't often get suggestions as to why things are happening, what they could be.

So after speaking to my son's psychologist suggested as we have in the past wondering about CAPD or APD Auditory Processing Disorder. What has confused me in the past is that he doesn't fit all of the criteria but quite a lot of it. Because our son has had problems with his speech we have naturally included visual cues for instructions. When Josiah started to read we stumbled upon some interesting things. For some time we had attempted to teach him one phrase it took six months for him to learn one sentence. At school he started learning sight words for something different we used these sight words to create sentences and he understand what we were talking about instantly and understood it completely, 10 minutes compared to 6 months is a dramatic difference.

Since he has started Year One with the different teaching style and relying on instructions and the children being able to understand and complete what is asked for us. Our son is willing and able but really struggles with instructions, in his report as expected when it said following instructions they ticked not developed. Common complaints in our house, I can't hear you, what, he's distracting me, stop talking etc..

What is Auditory Processing Disorder

On the Australian Auditory Processing Disorder website it lists these as indicators of APD

"Children with APD will display some or all of the following signs:

• Delayed language development
• Inability to listen effectively
• Trouble in sequencing the sounds of words
• Difficulty perceiving high frequency sounds: 't', 'f' 's', 'k', 'p', 'th', 'sh'
• Confusion when faced with similar sounds: eg. 'da' and 'ba'
• Extremely poor comprehension in a noisy environment
• High distractibility, with short attention span
• Poor speech comprehension, often asking 'What?'
• Misunderstanding and poor memory for oral messages
• Inconsistent responses to the same auditory stimuli
• Inability to follow directions
• Difficulty in expressing desires, often blaming the other person for not understanding
• Academic problems, particularly in spelling, reading or comprehension
• Behaviour problems
• Social difficulties."

Reading this we can tick most of these boxes except the reading, spelling or comprehension. So at this point I am still processing what this actually means, do I want this to be a part of my son's life, is it what he has. Fortunately we have a paedatrician's appointment soon which may be able to give us some answers.

What I found most helpful was the sub types of Auditory Processing Disorder

"Children may experience:

• Associative deficit - difficulty associating sounds with written language
• Auditory decoding deficit - problems recognising sounds and therefore decoding words or messages
• Auditory integration deficit - trouble combining auditory cues with other sensory cues that contribute to a message (eg. seeing a written word and knowing what it would sound like when spoken)
• Organisational deficit - difficulty in organising auditory information to effectively decode the meaning of a given message, often as a result of one of the above three problems
• Prosodic deficit - speaking in a monotone, without rhythm or intonation, and not perceiving these subtleties in other speakers
• Auditory hypersensitivity - background sounds cannot be ignored"

The path of diagnosis

The difficulty in getting a diagnosis of APD is that apparently the brain does not mature enough until it is 7 to be able to successfully diagnose Auditory Processing Issues. Some of the tests to diagnose APD are:

From what I have read the first step of this process is a routine hearing test to rule out hearing impairment.

Adhd.com.au write a good article on CAPD and it's diagnosis

"The auditory test we use to assess auditory function fall into two major categories: Behavioural tests and Electrophysiological tests." Electrophysiological tests measure "the brain's response to sounds, a special cap with built in sensors is placed on the head of the child for the purpose of measuring the electrical activity that arise from the central nervous system in response to an auditory stimulus."

The other methods of testing is behavioural, of most benefit would be the screening test SCAN this test is used "to identify children who have auditory processing disorders and who may benefit from intervention." There are two tests that can be performed from for the age group 5-11 and another for individuals from 11 to adulthood. Other audiological tests that follow are monaural Low-Redundancy Speech Test and Dichotic Speech Tests.

What to do next

As I wrote before the path of diagnosis is rocky. We began investigating the possibility of auditory processing issues more than a year ago. I enquired about what to do next however because our son is too young, he can't be tested to see if he has it. This is problematic because in the meantime we don't have the specialised help to understand what to do, he can't get help from funding for this at school and we are left waiting up to 2 years wondering if he has it at all. The only thing we can do, is what we have done before which is Josiah participating in a listening program which is an 1/2 music twice a day, which did make a difference unfortunately we are waiting for him to be able to participate in it again as they don't have enough resources at this point.