Treatment of children with (Central) Auditory Processing Disorder (APD) fall into the scope of practice of speech-language pathologists. A speech-language pathologist working in the public school system may have students diagnosed with APD on their caseload and will have to assist in evaluation of APD and provide services. Thus, all speech-language pathologists must be aware of intervention approaches for APD. Similar to other communication disorders, there is no one cure-all method of treating APD. Instead, intervention should include a combination of multiple approaches and should be based on the needs of the child. Intervention approaches for APD include environmental modifications, compensatory strategies and central resources training, and direct skills remediation (ASHA, 2005a). This paper will provide information for the school-based speech-language pathologist regarding each therapy approach and provide suggestions for how they can be used
Environmental modifications serve as one type of intervention for APD (Bellis, 2003). These modifications are “intended to improve the individual’s access to auditory information by enhancing the clarity of the acoustic signal and facilitating listening and learning in the academic, home, work, or social environment” (ASHA, 2005a). Examples of environmental modifications include preferential seating, use of visual aids, use of assistive listening systems, architectural intervention to “reduce reverberation and improve the signal-to-noise ratio” (ASHA, 2005a).
When serving clients in the school system, the speech language pathologist should ensure that all students with APD have a personal FM system to “amplify and transmit the teacher’s voice at intensity levels well above the environmental noise, creating a favorable signal-to-noise listening condition” (Schow & Nerbonne, 2007). The therapist should work with a student’s teacher to locate the place in the classroom that is most beneficial to the student’s learning. Typically, modifications placing the student up in front of the classroom with a direct visual line to the teacher aid the child’s processing ability. Additionally, the speech language pathologist should encourage teachers to minimize background noise and reverberation. While it is unrealistic in most schools for the SLP to change the “acoustic architecture” of the classroom, positive changes can be made by working with the teacher to create a good listening environment and minimize the negative effects of noise by “eliminating unnecessary noise sources (replacing buzzing fluorescent light bulbs or placing carpet on the floor to absorb chair and feet noise)” (Schow & Nerbonne, 2007). The therapist also must play a role in educating and counseling parents regarding environmental adjustments that should be made at home. Parents should be encouraged to minimize background noise and provide visual support like a list when providing important information (Chermak, 1998).