Auditory processing difficulties is an area I have long been interested in. I have worked closely in assessing and supporting children with these difficulties. Estimates vary but often state that as many as 3 children in any classroom may have auditory processing difficulties. These may be linked to other difficulties (such as dyslexia, ADHD, Autism or learning needs) or may be a specific difficulty. It is relatively poorly understood, and teachers often have limited awareness of how to spot auditory processing needs and how to help.

What are auditory processing difficulties?
Auditory processing difficulties can present in similar ways to hearing impairment. However, the difficulty is not with the child's hearing, it is with the brain's ability to process, retain and make sense of what is heard. Children who experience recurrent glue ear in childhood are thought to be at higher risk of auditory processing difficulties. A child may appear to:

• Not listen or focus when spoken to.
• Respond in a way that suggests they have not heard properly.
• Struggle when there is more background noise (such as in the school playground or at parties)

What difficulties might be caused by auditory processing difficulties?:
Children with auditory processing difficulties may face challenges with the following areas:

• Understanding speech
• Distinguishing between similar sounds: e.g. 'cold' versus 'called'
• Concentrating in background noise
• Memory and organisation
• Focusing and attention
• Coping in group and busy social situations, where there is a need to listen to multiple people. This can sometimes lead to anxiety.
• Muddling up instructions or information.
• Finding it difficult to accurately repeat back what they have heard

How do we tell the difference between hearing loss, language difficulties and auditory processing difficulties?

• In the same way as we need appropriate assessment and identification of dyslexia, we need professionals with relevant knowledge and experience to identify auditory processing difficulties.
• Information should be pulled together from Audiologists, Speech and Language Therapists and other professionals in order to distinguish between conditions which present in overlapping ways.

​What should I do if I think my child has auditory processing difficulties?

• ​If your child has not yet had a hearing test then visit you GP and request a referral to Audiology. 
• If hearing is normal then the next step would be to access a Speech and Language Therapist with relevant experience (don't be afraid to ask!)

What can be done in the classroom to support children with auditory processing difficulties?
​Many of the same adaptive strategies that benefit deaf or hearing impaired children are also effective for children with auditory processing difficulties:

• ​Sitting front and centre so listening to the teacher minimises background noise. Children with auditory processing difficulties often lip read more than the average child.
• Minimise chair and pen pot scraping by using dampening materials on chair legs and pen pots. Tennis balls popped on each chair leg can really work.
• Use visual resources to support learning where possible.
• Pre and post teach key lesson vocabulary, ideally in a quiet environment.
• Encourage the child to repeat back instructions and provide opportunities for reinforcement if needed.

Auditory Processing Disorder
Currently in the UK a diagnosis of Auditory Processing Disorder can only be given in the presence of no other diagnoses. A diagnosis can only be given by a limited number of professionals following referral.

However, auditory processing difficulties can be identified and good support given without a formal diagnosis.

I get a lot of enquiries from parents of 2 and 3 year olds, whose have concerns about their child's speech clarity, the amount of words they can use, or their play and social skills. Sometimes it's all of these areas. Sometimes these parents have sought help and have been advised to 'wait and see' what happens with their child's language skills. Or sometimes they are put on the waiting list for therapy assessment and support.

Parents are often asking if they are worrying over nothing, and if the skills they are concerned about will develop on their own. The honest answer is: there's no way to know for sure.

I am passionate about early intervention, and often give advice to parents about ways to promote a great language environment at home and in nursery. I also often advise parents to keep a diary and note down any concerns they have and  language their child uses. This can prove very valuable if the child goes on to need Speech and Language Therapy input.

More than anything I always encourage parents to trust their judgement....if they feel something 'isn't right' or isn't progressing as they would like then it is always a good idea to seek advice and support.

I have been thinking this week about the questions I get asked the most during my working week. I can't answer all of them, but I always try to give honest feedback:

1. Does my child have Autism? This one comes up a lot. Especially with new assessments and enquiries I receive. Speech and Language Therapists can't diagnose Autism Spectrum Disorder, but the information we can provide can help other professionals to reach a decision about suitable diagnosis. We can provide information about social skills, play, language and imagination....all skills which children with ASD often struggle with.

2. Will my child's speech/language get better? A tricky one to answer, because it depends on the nature of the difficulties. I have often wished there was a magic wand to solve communication difficulties.....sadly there is not. Hard work, consistency and working together are the necessary approaches.

3. Is it my fault my child has communication difficulties? Overwhelmingly often the answer is.....No. Parents often turn to themselves when looking for a reason why their child is experiencing communication difficulties. We often cannot pinpoint a reason, which is frustrating.

4. Are my child's difficulties linked to other communication needs other members of our family have? It's possible. We know there can be patterns of difficulties within families, and that's why Speech and Language Therapists (and other medical professionals) often do a detailed case history. It helps to spot patterns and have an understanding of the wider picture.

5. Will my child be able to make friends? Understandably parents worry a lot about social and emotional wellbeing, but particularly when their child has communication needs. They worry about isolation and bullying. I always work really closely with parents and school staff to ensure that everyone has a good understanding of a child's needs, and I give advice around how to include and encourage social skills in children with communication difficulties. 

It's easy to think there are specialist games and resources that are best for developing children's language skills at all ages. In fact, there are lots of games (secret language weapons!) in almost every household that are excellent for developing understanding, expressive language and social skills. Some of them you don't even need to buy! The list below is more suited to primary aged children (4-11):

1. Guess who? Develops turn taking, eye contact, question formulation, category knowledge, theory of mind (thinking about what others know and are thinking)
2. Headbandz. Develops similar skills to Guess who?
3. I went to market.... Develops listening and attention, eye contact, auditory and working memory, sequencing, expressive language.
4. 20 questions (can also be achieved with Alexa, try saying, "Alexa, read my mind")...Develops understanding and vocabulary, categorisation and sub-categorisation, theory of mind.
5. Shopping list...Develops vocabulary and categorisation, turn taking, memory, social skills.

The best thing about all these games and activities is that children don't realise they've developing their language skills! 

As well as working as a Speech and Language Therapist I am also a mum of 2. My daughter, who's 7, is deaf and has cochlear implants. As a family this has been tough: she wasn't born deaf. We discovered her hearing loss when she was 3, and by the time she was 6 she had lost more hearing and had qualified for cochlear implant surgery.

To cut a long story short.......we're all ok, she's doing well and has the right support in school.

It's a lot of hard work getting the right support and raising awareness about a child with additional needs. I've known this professionally for years. But.....I never truly appreciated just how many hours of thinking, writing, planning, phoning, emailing and talking were involved. Not to mention the worrying....

It makes me wonder: how much does it help me that I play a professional role in the support provided to other children? Does it mean I cope better with the challenges my daughter faces? Certainly there have been times where I have thanked my lucky stars that I know how to develop language skills, as I am positive this has helped my daughter.

However, on the other hand my professional experience means I know only too well how hard it can be to fight for the support children need. I know how long it can take. I know how many brick walls parents can come up against. I know the impact of cuts to services.

A definite positive for me personally is that it has helped me to support and relate to the parents of the children I support. 

Here goes nothing......my first blog attempt!
I thought I'd start by telling you a little bit about what we Speech and Language Therapists do!  When I tell people that I'm a Speech and Language Therapist they usually say something like: 

"That must be rewarding!"
"How interesting!"
"Did you always know you wanted to do that?"

And my personal favourite: "Can you help me to talk proper?!"

The answer is that yes, it is rewarding and it is interesting. It's also busy, challenging, sometimes upsetting and frustrating but mostly a privilege to be in a position to help improve the lives of children and families. Some children I work with only briefly and some are stuck with me for years!

I work with children ranging in age from 2-12 at the moment, but have lots of experience of working with teenagers too. Some of the children I work with are a little late in starting to talk, or have some difficulties in speaking clearly. Some have Down's syndrome, some have diagnoses of Autism Spectrum Disorder and some have cerebral palsy. I visit them at home, nursery or school....wherever I am needed.

As part of my day-to-day working life I assess children's needs, deliver therapy sessions to help them make progress with their communication, attend meetings, write reports  and do lots of planning and making of resources.

My aim with this blog is to share little ideas, thoughts and information that may help parents and professionals to support their children.

​Watch this space!...............