Lois Kam Heymann was very excited when I spoke to her Last. I could hear her say it and I could hear it in her voice. The Center for Hearing and Communication has just opened a center for ADP, Auditory Processing Disorder, in New York City where Lois will be using her expertise to head the new division. There, they will see typical hearing children who have listening challenges.
Lois hopes to reach out to parents that are seeking answers to difficult to diagnose problems. The years of experience, a great book, The Sound of Hope, and her many speaking engagements has brought her to a place where she can do the interventions children need to learn and live to their potential.
The goals for Lois are many, the potential to succeed is almost a guarantee, time and patience will get her there. One of these goals is to train other Speech Language Pathologist, SPL, in auditory therapy that targets the deficits seen in APD. She will use the clinic and on-line training tools, or attend one of her speaking engagements. She is offering free in-services to schools as her schedule allows, bringing the background and the tools directly into the classroom for teachers and students to benefit from.
Most of Lois’ clients get to her from parents recommendations.
“Parents are saying something isn’t right and they are of course the first people to know that something isn’t right”
All children affected by APD won’t be able to get to NYC to see Lois that is why she is reaching out to other professionals so that they too can offer this specialized intervention in their communities. An audiologist is part of the team at the new center. Audiologist are the diagnosing partner, distinguishing between different parts of hearing and listening, to then be part of the treatment plan. It is up to SLP like Lois to organize a personalized plan for each client for individual success.
“I am getting so many children that are diagnosed with ADD or ADHD and on medication and the medications have not really led to better listening skills”
While those medications led to better auditory attention, the physiological problem is not addressed and academic improvement is not seen. There are links between language and auditory processing, and they overlap. What is thought as a child whose behavior suggests they are not listening can really be a child who is having difficulty with processing the auditory information and/or the language. It is important to think of a child not as choosing the behavior, but as the behavior as a symptom of an underlying problem, this is true for APD, and many other disorders.
The seven areas that Lois works with in APD and language processing are:
- Auditory Attention: how well the child can attend to the information, being aware and/ or focusing on sounds as in listening to a teacher at the head of the class. Children with APD’s often show a consistent inability to keep their attention on a single specific sound or voice (1).
- Auditory Discrimination: can the child hear the difference between sounds, “F sound and an S, “bat and bad” [Children] with auditory discrimination issues tend to withdraw from potentially fun, challenging, or educational social encounters altogether (1)
- Auditory Figure Ground: does the child have difficulty in noisy environments, and does noise disrupt the signals of the person speaking, background noise. This child will gravitate toward the source of each now sound, no matter where it comes from, confusion the essential with the nonessential (1).
- Auditory Memory: how much can a child hold in his or her memory, assigning meaning to words. Without the basic skills auditory memory, communicating specifically and clearly is nearly impossible (1).
- Auditory Sequential Memory: can a child hold auditory information in order, as in follow multiple step verbal directions. A child who cannot keep auditory information cannot follow instructions, and is denied a vital skill for making math and reading possible (1).
- Auditory Cohesion: puts all the areas together, part of higher level listening and learning, abstract language. A child who doesn’t develop auditory cohesion skills on schedule is confused by figurative language and intentional absurdities (1).
A child can have problems with any of these, or all of these. Some even have deficits in some areas while they are stronger in other areas. The Audiologist finds out, “where is the processing problem occurring in the brain” and Lois uses intervention to help bridge the gaps by therapy and education. Teaching kids skills to deal with daily living will help them be and feel successful.
There are three things that she shared with me that can help all children, and those with auditory problems will benefit even more:
We can all be distracted by auditory information, the saying goes, “turn down the radio so I can hear myself think”, so is true for children. When auditory information is important, so is the lack to noise so the focus can be on the speaker. Eye contact and close range conversation will get a child attention and let you know if they understand the information without distraction.
Lois is a huge advocate for reading to your children. In her book there are book suggestions for ages along with some activities. The activity and routine of reading to a child should last long into their teens. Early reading is helping them develop vocabulary and build a solid foundation for visual imagery and memory. I know that I loved James and the Giant Peach as a child. When thinking back on my memory of this story I always envisioned the peach fur to the point I thought I too lived in the peach, I even get a memory of what it smelled like. I had, for years, thought I watched it as a movie until my older sister informed me I had been read this book as a child. Many of my earliest memories are actually stories from books.
Reading a book to independent readers will build on their strengths. Treasure Island is a good example of a book that could be read out loud to an older child. Words and phrases in these level books can sometimes be confusing because they are presented in a new context. Looking for clues and allowing your child to ask questions improves his or her understanding of the story while letting them continue the visual story in their head. When a child struggles with their reading comprehension, they disrupt the story in their head and the experience becomes less memorable, and can lead to a dislike of reading.
The Twilight series has been popular among teenagers, and children get to the age where they enjoy reading similar books as a parent would enjoy. This is a great opportunity to read the same books your older child is reading and have open discussions about them. Lois suggests stating things you liked or disliked about the book and beginning a conversation over dinner with your child about the book. You can get an idea of their comprehension and just have some good table talk without quizzing or testing their knowledge about it. You might both learn some terminology and slag by sharing your experiences. Book clubs are nice amongst adults. Consider one with teens and parents, and then if it turns into a move it will make a great activity to look forward to seeing together.
Aside from book, music is another thing to work on sharing with your pre-teens and teens. It becomes a social problem when a teen is trying to participate in conversation about the lyrics of a song. There is a great show called, Singing Bee. The premise is to fill in the blanks of the lyrics and get them right. Famous songs have left their listeners singing the wrong words all the time, and it can be endearing, but not to a teen. Music is good for balancing out the brain.
Many OT’s will suggest that children listen to classical music while they sleep. The right side of the brain is processing the rhythms and the left side is processing the language and harmonies. Many clients of Lois have learned the right words to popular songs and felt confident to participate in sleepovers and hang out with their friends. Singing and dancing to music is just one fun part of being in therapy with Lois.
Her therapy and intervention extends into classrooms as well. She has observed kids in classrooms and given advice to teachers about helping students with APD get the most out of class time. When a child sits in the front of the class, they are getting more of the teacher’s spoken information but missing the information behind them. When sitting in a horseshoe or U shape, the auditory attention goes up. Students are able to get the teacher’s information and associate names with faces when other students are called on. A child is more likely to pay attention to what another student is saying thus giving greater understanding to the discussion going on around them while adding visual attention and read facial expression.
Checking in with kids who are known to have auditory problems is a skill. Lois suggest avoiding questions requiring a yes or no answer like, “did you hear me?” A child may have heard a teacher’s voice, they may not have heard the words He or She said. Even if they have missed one vital word it will change the directions from “do every other problem” to “do every problem”. If in a timed setting, solving every problem may leave a child’s work incomplete when the directions and time allotted were for every other problem.
What I hear from Lois is not just all the great therapy she can give the children she sees in her clinic. It is the skills for life, the self confidence and the strength that she has given kids to live life to the fullest that I hear from her. Listen to her speak , you too will hear her enthusiasm for the job she is doing. I commend her for striving to make fun out of therapy and wanting to share her skills with others so more children with APD can sing and dance and listen with pleasure.
(1). From The Sound of Hope chpt.3, pages 32-40