An auditory perception test gives clear insights into your sensory-motor, communication, creative and emotional performance as well as your energy levels and the capacity to learn. It shows the balance between your inner and outer perception. Your listening response usually shows significant distortions if you are under stress, have emotional issues, or have difficulty with movement, balance or coordination, speech or written language, maths, memory or motivation.

Your pattern of listening performance illuminates your present capacity to happily reach your potential as well as your capacity to learn, socialise and maintain dynamic personal growth. An assessment allows us to design an appropriate program to help normalise the way you process sound and unlock your hidden potential.

If you have three or more of the following issues, it would be sensible to book a listening assessment:

• Anxious or nervous (this can often be well hidden – even from parents and teachers
• Low attention – easily distracted, poor concentration and often low comprehension
  
• Behavioural or social problems – abusive, aggressive, attention-seeking, oppositional, violent
  
• Bored  easily lead – often says: “I don’t know what to do” or “I’m bored ”
  
• Daydreams,  too often “in their own world” or “away with the fairies”
  
• Disorganised – homework, task management and completion, punctuality,  low motivation
  
• Hard to sit still at school – including those who are hyperactive and or distractible
  
• Hearing problems – often have had ear infections or chronic congestion
  
• Performing below potential – this may not be show up as a Learning difficulty in intelligent clients
  
• Listening difficulty – needs repeated instructions, reinforced with visual cues, often says: “What, What?” or “Huh?”
  
• Maths is difficult or memory weak
  
• Low self confidence or self-esteem, negative attitudes, self-critical or even depression
  
• Overloads easily – particularly if there are many things to process; may look away when being spoken to.
  
• Poor posture, low muscle tone, clumsy, poor balance or coordination – inadequate gross motor development
  
• Poor handwriting – poor pencil grip, knitting or tying shoelaces hard – inadequate fine motor development
  
• Speech – unclear or delayed, stutter, poor vocabulary or language difficulty
  
• Reading or writing difficulty including spelling
  
• Slow to react or respond – this suggests processing speed may be undermining performance
  
• Very emotional – anger, tears, frustration, delayed emotional maturity, emotional regulation difficulties
  
• Fatigue, tired after school, low energy

Learning, attending or performing below potential … is Listening the issue?
Harry Armytage offers a comprehensive Listening assessment to identify the underlying causes of learning and performance deficits. This takes 90+ minutes (30m+ if under five) and is best done in the morning when clients are fresh.

What can a listening assessment reveal?
Our listening assessments comprise otoacoustic emissions (an important aspect of hearing), processing speed, memory and auditory perception tests. All these components give us a very good picture of the way in which you process sounds and integrate sounds with other sensory information. These are the foundational skills which support and enable effective learning.

Our listening assessment takes approximately 90 minutes and includes:

Information gathering:

• History  questionnaire to capture information about birth , medical history, school and social performance, developmental milestones as well as social & family history;
  
• Listening questionnaire to capture information relating to sensory-motor performance, auditory and emotional performance.
  
• Teacher questionnaire and Fisher’s Auditory checklist
  
• A careful discussion to surface your concerns and your goals.
• Identifying how we can deliver measurable and achievable outcomes to meet your goals.
  

Testing:

• Otoacoustic emissions test to measure what sounds your ears capture and identify “how” you hear.
  
• An Auditory Perception Test assesses how you listen, how you perceive sound, how well you can pitch discriminate. Your performance allows us to identify how well you use the sounds that you capture with your ears.
  
• Using the Brain-Boy Auditory and visual processing speed thresholds test, we measure how fast you process sounds & vision. Many process far too slowly to comprehend normal speech.
  
• Audit digit span test assesses if short-term memory is age-appropriate (Auditory digit span test). Short-term memory is an important pre-requisite for comprehension.
  
• Sensory-motor screen assesses posture, balance, motor, muscle tone and some primitive reflexes. These are all important foundations for learning  
• Drawing of a House, tree and person
• Zinc Tally test
• We refer all clients for a SCAN test to measure  speech comprehension under difficult conditions.

and for some clients

• LAC test to determine if reading and phonemic awareness is age-appropriate
• Osteopathic, nutrition or energetic medicine (NES) assessment.

Written report:

• Summary of results
• Program recommendation
• External referrals as required (ie behavioural optometry, audiology, nutrition, sensory-motor program)

What makes our assessments different?
A cochlear test measures the echo from the cochlea hair cells in response to a stimulus. The cochlea is the special nerve centre in the inner ear, which converts sounds into nerve signals for processing by the brain. In the cochlear test, a small probe is placed inside the ear canal and the child hears soft, short bursts of static sounds. These sounds vibrate the receiver hairs of the cochlea, which echo a signal to the computer for analysis. We gather 260 groups of echoes at 205 frequencies. There is no way to influence the test results, which help to measure hearing function as used in many neonatal hospitals to screen newborns.

There is more to hearing than the mechanics of the inner ear. The brain plays a critical role in the rapid processing and interpretation of sounds by identifying and prioritising useful sounds over background noises. This is why we prefer to conduct listening, processing speed and digit span tests to assess the processing of sound and its comprehension.

A standard screen of children's hearing often reviews only 4-6 points on the hearing scale. This is based on a norm originally developed to assess the range needed for an adult to hear a conversation on the then newly developed telephone.  Such tests may not identify whether a client is able to adequately assimilate their mother tongue in those early years when language is being laid down in the brain.  A more sensitive assessment tool such as a cochlear test may achieve this difficult assessment task.

What is Auditory Processing?
Auditory processing is what you do with what you hear. It involves the pathways from the ear to the brain as well as the efficient collection of sound by the ear itself. Auditory processing encompasses hearing and listening and can be undermined by a deficit in the outer, middle or inner ear, in the pathways to/from the brain or in the brain itself.

Why is the ear so special?
The input of sound to the cochlea energises the entire nervous system and the brain provides powerful stimulation for the brain to adapt to our daily needs.  Auditory processing allows us to achieve many tasks, including:

• Attend to those sounds that are meaningful and to tune out what is not,
  
• Comprehend language
  
• Communicate effectively
  
• Read and write
  
• Identify the source of sound

Good hearing is the most important sense for learning in children – it is even more important than good sight. On average, if you compare children who are born deaf with those who are born blind, by fourth grade, the deaf children will be two years behind the blind children!1  So avoidance and management of ear infections, chronic congestion and food intolerances are important.

Robert Keith and others have shown the importance of the right ear in childhood. Up to 18 months, the right hemisphere is leading. We hear babble and long repeated sounds: daa-daa, maa-maa and baa-baa and processing time is very slow.  From 18 months to 4 years, there is a left hemisphere growth spurt, and language develops, with two syllable phrases, e.g. "all done, want dwink", then short sentences and as processing speed improves, we hear more complex sentences. From 18 months to 11 years, the right ear is the prime listener and decoder for speech.

Recent research has confirmed Dr Tomatis’ conclusion that the right ear is designed to process speech and the left to process music.2 This has profound implications for speech and language development. So, children with right‑eared problems are at a distinct disadvantage.

Learning and auditory processing
Those with learning or performance deficits usually have inadequate auditory processing. They process too slowly, and can only manage to understand short blocks of words and only parts of a sentence. They overload quickly, cease to attend and their memory, comprehension and speech becomes scrambled.  They often have delayed or poor speech, poor language skills and are poor at phonics, decoding new words, reading, spelling and comprehension.

Those with learning or performance deficits often labelled attention deficit, they are often emotionally behind their peers. Learning difficulties are not always obvious and often cause behavioural issues. While the causes of learning and attention deficits are complex, about 70% of children diagnosed with a learning difficulty and 50% of those labelled ADD have an auditory processing problem. Such children are usually unable to listen effectively.

Poor listening and Auditory Processing Disorders can be triggered by and are often associated with hearing losses in childhood.  For this reason it is important to obtain a diagnosis and appropriate treatment if you suspect there is a hearing loss. Many conductive losses can be reduced or resolved by the removal of excessive wax and dietary changes involving the removal of dietary allergens like dairy and gluten.

• Conductive hearing loss erects a physical obstacle to the collection of sound by the nerves in the inner ear.  Most common causes in children include environmental (smoke) and food intolerances (dairy, wheat), chronic upper respiratory infections, depressed immune system, inadequate Eustachian tube drainage,
• Blockage or closure of the external ear canal – commonly by wax or objects
• Outer ear infection (otitis externa) – can be caused by swimming;
• glue ear (otitis media) – often seen in younger children causes a fluid build-up in the middle ear
• Scarred, damaged or perforated eardrum
• Poorly formed or damaged ossicles in the middle ear,
• Sensorineural hearing loss is also called nerve deafness and involves damage to the hair cells in the inner ear or the acoustic nerve. Causes include the process of ageing, loud noise exposure, head trauma, mumps, measles, meningitis or Meniéres disease, some medications (high-dose aspirin, strong diuretics) and immune disorders.
• Loss of the hair cells in the cochlea or inner ear  (sensory hearing loss)
• Loss of signal between these cells and the brain (neural hearing loss)
• Mixed hearing loss involve a combination of a conductive and a sensorineural hearing loss.

Can Listening therapy help?
For most clients, Listening Therapy appears unable to deliver significant measurable improvements to client hearing as measured by otoacoustic emissions testing. This suggests that Tomatis was incorrect when he claimed that one could deliver significant auditory gains by retraining the muscles in the middle ear.

However, Listening therapy can deliver substantial improvements to the perception of sound for those with measurable hearing loss.  For instance, these perceptual gains can restore much of the ability to attend to and comprehend speech in noisy environments like classrooms and social situations.

What is an Auditory Processing Disorder (APD) and why is listening so hard for some?

APD is a dysfunction of the auditory system, which significantly undermines the ability to make sense of the sounds which you hear. It undermines auditory attention and comprehension and can make communication difficult. An APD can undermine your ability to disentangle meaningful sounds like speech from background noises, particularly in noisier environments like the average classroom. Because this disorder undermines the efficient processing and comprehension of auditory information, it also undermines your capacity to keep up with peers at school (or work) or reach your potential.

An APD can delay speech and cause significant fatigue particularly if you are really trying to listen to those around you. This receptive sensory disorder involves the ear and the pathways between the ear and the brain. While APD does not describe or deafness or a hearing loss it can be caused by and is often associated with hearing losses in childhood.  An APD may be caused by a failure anywhere in the auditory system. Those with APD may appear to be less intelligent, lazy or inattentive. We see the following patterns in our practice:

• A Central Auditory Processing disorder (CAPD) involves a problem in the central nervous system within the brain. This undermines the comprehension of speech and other sounds. Some can hear perfectly but struggle to interpret or understand speech, particularly if is indistinct or under noisy conditions. Causes of an CAPD include:
• Physical trauma such as a difficult birth or an accident involving a mild traumatic brain injury.
• Suffering or emotional trauma such as the loss of one’s natural mother for those adopted.
• Significant or chronic anxiety.
• Identifying an APD
• It is not easy to indentify because the majority of children with an APD, have “normal” audiological hearing sensitivity.
• Always trust your mother’s intuition that something is not right – even when the experts think you are worrying unnecessarily
• We assess auditory processing with the Fisher’s Auditory Checklist, the SCAN test, an Otoacoustic emissions test (OAE) and an Auditory Perception test.

What are some of the patterns we see in those with APD? 1

• Children
• Reliance on other senses (ie visual-spatial learners)
• Delayed speech, acoustic confusion b, d, g, p, t & k
• Speech – too loud or soft, monotony
• Delayed written language or maths
• Poor attention or distractibility
• Overloads easily, non-compliant, emotional
• Teenagers
• Tend to be loners
• More extreme behaviour (males) ie class clown
• Increased promiscuity (females)
• Higher incidence of delinquency
• Adults
• Actively avoid noisy social situations
• Tendency to become increasingly isolated
• All ages
• “He never listens”
• Low self esteem

How can Listening therapy help?
The main aim of Integrated Listening Therapy is to improve the efficiency and effectiveness of auditory processing by gently retraining the way in which the brain processes sound. Therefore Integrated Listening Therapy should be the first choice of therapy for anyone with an APD. See the Research for the demonstrated capacity for Dynamic and Integrated Listening Therapy to help those with APD.

This section of our website is currently under construction, please check back soon.

We may then recommend some of the following gentle drug-free interventions to re-build the foundations of learning:

# PICTURES

• Listening therapy in the clinic or at home to normalise the way you process sound;
• Sensory-motor assessment to identify if there is a physical issue undermining learning (Extra Lesson assessment);
• Osteopathic treatment for those with birth strain or over-sensitive hearing;
• Nutritional assessment to identify any failure in the gut which can significantly undermine behaviour/ performance, and 
• Professional referrals for other deficits: behavioural optometry, tympanometry, audiology, psychology or play therapy.

This section of our website is currently under construction, please check back soon.