James and Karen Hood Foundation

By Tara Parker-Pope

Source: The New York Times

Parents and teachers often tell children to pay attention — to be a “good listener.” But what if your child’s brain doesn’t know how to listen?

That’s the challenge for children with auditory processing disorder, a poorly understood syndrome that interferes with the brain’s ability to recognize and interpret sounds. It’s been estimated that 2 to 5 percent of children have the disorder, said Gail D. Chermak, an expert on speech and hearing sciences at Washington State University, and it’s likely that many cases have gone undiagnosed or misdiagnosed.

The symptoms of A.P.D. — trouble paying attention and following directions, low academic performance, behavior problems and poor reading and vocabulary — are often mistaken for attention problems or even autism.

But now the disorder is getting some overdue attention, thanks in part to the talk-show host Rosie O’Donnell and her 10-year-old son, Blake, who has A.P.D.

In the foreword to a new book, “The Sound of Hope” (Ballantine) — by Lois Kam Heymann, the speech pathologist and auditory therapist who helped Blake — Ms. O’Donnell recounts how she learned something was amiss.

It began with a haircut before her son started first grade. Blake had already been working with a speech therapist on his vague responses and other difficulties, so when he asked for a “little haircut” and she pressed him on his meaning, she told the barber he wanted short hair like his brother’s. But in the car later, Blake erupted in tears, and Ms. O’Donnell realized her mistake. By “little haircut,” Blake meant little hair should be cut. He wanted a trim.

“I pulled off on the freeway and hugged him,” Ms. O’Donnell said. “I said: ‘Blakey, I’m really sorry. I didn’t understand you. I’ll do better.’ ”

That was a turning point. Ms. O’Donnell’s quest to do better led her to Ms. Heymann, who determined that while Blake could hear perfectly well, he had trouble distinguishing between sounds. To him, words like “tangerine” and “tambourine,” “bed” and “dead,” may sound the same.

“The child hears ‘And the girl went to dead,’ and they know it doesn’t make sense,” Ms. Heymann told me. “But while they try to figure it out, the teacher continues talking and now they’re behind. Those sounds are being distorted or misinterpreted, and it affects how the child is going to learn speech and language.”

Blake’s brain struggled to retain the words he heard, resulting in a limited vocabulary and trouble with reading and spelling. Abstract language, metaphors like “cover third base,” even “knock-knock” jokes, were confusing and frustrating.

Children with auditory processing problems often can’t filter out other sounds. The teacher’s voice, a chair scraping the floor and crinkling paper are all heard at the same level. “The normal reaction by the parent is ‘Why don’t you listen?’ ” Ms. Heymann said. “They were listening, but they weren’t hearing the right thing.”

The solution is often a comprehensive approach, at school and at home. To dampen unwanted noise, strips of felt or tennis balls may be placed on the legs of chairs and desks. Parents work to simplify language and avoid metaphors and abstract references.

The O’Donnell household cut back on large, noisy gatherings that were upsetting to Blake. Twice-weekly sessions focusing on sounds and words, using rhyme and body gestures, helped him catch up on the learning he had missed.

Help inside the classroom is essential. One family in Westchester County, who asked not to be named to protect their son’s privacy, met with his teachers and agreed on an array of adaptations — including having his teacher wear a small microphone that directed her voice more clearly to a speaker on the student’s desk so he could better distinguish her voice from competing sounds.

Nobody knows exactly why auditory processing skills don’t fully develop in every child, according to the National Institute on Deafness and Other Communication Disorders. Scientists are conducting brain-imaging studies to better understand the neural basis of the condition and find out if there are different forms.

Reassuringly, the disorder seems to have little or nothing to do with intelligence. Blake has an encyclopedic knowledge of animals — he once corrected his mother for referring to a puma as a mountain lion. The Westchester child is now a 17-year-old high school student being recruited by top colleges.

“He’s in accelerated Latin, honors science classes,” said his mother. “I remember I used to dream of the day he would be able to wake up in the morning and just say, ‘Mommy.’ ”

Not every child does so well, and some children with A.P.D. have other developmental and social problems. But Ms. O’Donnell says that treatment is not just about better grades.

“It definitely affected his whole world,” she said of her son. “Not just learning. It cuts them off from society, from interactions. To see the difference in who he is today versus who he was two years ago, and then to contemplate what would have happened had we not been able to catch it — I think he would have been lost.”