Simulation of Auditory Processing Problems

It is often difficult to understand what it may be like for people with auditory processing disorders (APD) to deal with information they receive through their auditory systems. Regardless of how you approach auditory processing, regardless of what is your beliefs and understanding of APD, there are certain basic common factors on which most specialists in the field of auditory processing agree. These factors often relate to processing problems such as deficits related to understanding speech in the presence of competing auditory signals (also referred to as auditory figure-ground, speech-in-noise, competing listening conditions), auditory decoding problems, auditory temporal (related to time) processing deficits, auditory memory difficulties, and auditory integration problems. Therefore, this simulation will focus on these areas.

The purpose of this simulation is to compare processing of altered visual stimuli (words, letters, commas and spaces in the typing) as comparisons to processing of auditory messages. The letters represent the sounds of speech also called phonemes. In some cases, the letters that make the sounds of speech will be used rather than the letters used to spell the words. For example, in the word "thing," the letter "i," the vowel, actually makes the sound of /ee/. Thus, to spell the word thing to represent the phonemes, for this simulation, the word would be spelled using slashes "/" and the letters would represent the sounds such as /theeng/. Although students of phonetics will realize this is not correct phonetic transcription, it will be used to help the reader understand that the word is to represent the sounds and not the letters.

In order to better understand what is each component of auditory processing discussed in this simulation, the specific factors, such as integration, will be briefly described at the start of the section related to that factor. Therefore, read each section entirely in order to understand what is meant by that factor as it relates to auditory processing.

In general, auditory processing is viewed as what a person does when his/her ear receives an auditory message and the central nervous system extracts the meaningful information from that message, eventually, comprehending or putting meaning to the message. Auditory processing, then, can be viewed as the various steps or "processes" involved once an auditory message leaves the inner ear and travels from the inner ear (known as the cochlea) through the central nervous system to the brain and then is acted upon by various components of the brain. As such, auditory processing is a very complex thing involving many different processes. What this simulation provides is visual information (letters, words, spaces) that must be processed by the reader via the visual processing system in order for the reader to gain some understanding and insight into the complexity of processing in general.

Different aspects of auditory processing are presented as "factors." You can go to any specific factor and go through the simulations presented related to that factor. For example, the factor of decoding is divided into decoding at the speech sound or phoneme

(letter) level, decoding at the temporal or time (spacing) level, and decoding at the whole word level. Therefore, you can go to the section on "decoding," and then go through the simulations for each of these levels or just focus on the simulations for one of these levels.

For each of the simulations, an explanation is provided of the specific process being simulated and how the visual information is being used to represent auditory messages. Additionally, at the bottom of each simulation is a link to the "answer" or the message unaltered and unchanged. Additionally, some examples are discussed related to strategies that may be useful in helping a person with that type of processing problem maximize his/her abilities to process more efficiently and effectively.

It is hoped that these simulations will provide a greater insight for you into the complexity and difficulties for people with auditory processing disorders. Additionally, the sample strategies may be helpful when converted to listening, communication, and learning strategies in the auditory area.

Decoding relates to the extraction of meaningful elements for the stimuli we receive. We decode through all of our senses, but we first have to learn the meaning of the code in order to extract or decode the information. For example, we touch things when we are infants and toddlers and realize that some things are pleasant and enjoyable to feel while others hurt us when we touch them. We may only know, initially, that one thing is fun to touch while another hurts us. Depending on the reactions of the adults in our environment, depending upon how many times we touch something and are hurt by what we feel, and depending upon what things we have available to touch relates to how rapidly we learn to associate the cues (the code) of the items that are enjoyable or positive to touch vs. those that are unpleasant or noxious or even harmful. Some children may have difficulties distinguishing the pleasant from the unpleasant, some adults react in ways that are incomprehensible for some children so the children never learn to make the positive vs. negative associations between the things to be touched. In some cases, the child does not have sufficient experiences to learn the cues to distinguish the things to be touched from the things to be avoided. There are many reasons a child may not learn what to touch and what is not to be touched.

This same type of learning occurs with sounds and listening. Children do not immediately know the relationship between the sounds they hear and the meanings for these sounds. They have to learn these relationships. As such, children have to learn the features of auditory messages that relate to specific factors within the code. Additionally, the code is the sounds of speech that exist within the child’s environmental language. For example, there are sounds in English that do not exist in other languages, and there are sounds from other languages that do not exist in English. Just ask a native English speaking person to distinguish and produce the so-called French "r" or the German "ch" or the Spanish "b." In contrast, ask a native speaker of Japanese to produce an English "l" and "r" and distinguish between these two sounds. Here the problem is one of environment and experience. Imagine a child who is not exposed to the phonemes or speech sounds of "l" and "r" but hears the same auditory message whether the person speaking is saying an "l" or "r?" This child may not learn to distinguish or discriminate "l" from "r" without being taught how to distinguish the specific auditory features that differentiate these two sounds in English, if English is the language of use in the child’s environment, especially at school.

So, let’s take a look at the first simulation. This simulation is called Knowing the Code. It is an analogy to a child who has not learned to distinguish the features that represent the specific factors of the code that are represented in the message.

In this simulation only one word will be presented. This word will look funny to many readers since it does not seem to make sense. Additionally, the word does not always follow the rules of an English word represented visually in letters. That is, when reading the letters of this word, you will notice that the first two letters are Gh. From your knowledge of reading, you should realize that in English, the Letter G does not have the letter h following it at the beginning of a word. Thus, your first impression may be that this is a word from a foreign language, or this is not a real word, or the word is misspelled with the h added in error.

Your task is to read this word and make sense of it. The rules are that the letters or letter groups represent sounds of speech and not real letters as in a written word. Additionally, the word is a simple word often seen in a child’s vocabulary, and often seen in books for early readers. The meaning of the word is very simple and you probably know this word if it were written in the usual, or normally spelled manner. Again, the only clue is that the letters or letter groups represent the sounds of speech as presented in spelling in many English words.  The word is:

Ghoti

Give up yet? Can’t figure out what common English word this is? Maybe it’s because you haven’t learned the code. Some of you may know this "trick" word, and you have prior experience seeing it and are able to "translate" what it really says with ease.

Consider a child who lacks experiences in hearing the sounds of speech (phonemes) spoken the way the speaker says them. Imagine a child who has only heard speech spoken with one specific accent? Imagine a child who has limited exposure to different people speaking so that the child expects all speech sounds to sound as spoken by these people in his/her environment? What about a child with a hearing loss who hears sounds differently and, suddenly, is given a hearing aid or other type of system and is expected to understand all of the sounds of speech spoken to him/her? Or consider a child with a history of chronic middle ear infections and fluid (called otitis media) who has a fluctuating hearing loss and then has the middle ear problem resolved and is unable to make sense of the words spoken by people since the auditory code has not been clearly learned?

Well, let’s not keep you in suspense. Let’s teach you the code. The first two letters go together. These letters are "Gh." They represent the sound made by these letters in words such as laugh. Thus, the first sound of this word would be the sound of /f/ since the "gh" in laugh make the sound of /f/. The next letter is "o." It represents the sound made by the letter "o" in the word women. In that word, the letter "o" has the sound of /i/ as in the word "it." So, we now have the first and second sounds for this word: /f/ /i/.

The last two letters, "ti," represent the sound these letters make in words such as nation. In that word, the "ti" makes the sound of /sh/. Now, let’s look at the code and see if you can figure out the real word.

Gh as in laugh is the sound /f/

O as in women is the sound /i/

Ti as in nation is the sound /sh/

Thus, the word is "fish."

Once you realize the word, you may start to see the difficulty a person with an auditory decoding problem at this phoneme level has when the underlying factor accounting for the problem is not knowing the code. Additionally, imagine a child who mishears what is said. This child may also see the word Ghoti and not know that it is really the word "fish." However, in this case, the child would actually see the word fish and not be able to figure out it is the word "fish." Thus, there is a difference between a child who has not learned the code (for whatever reason) vs. the child who mishears the code and confuses or mixes up the sounds he/she hears. Let’s look at the next simulation to better understand the child with an auditory decoding problem at the speech sound discrimination level.

Many people with APD have deficits due to distortions in how they process and perceive the speech sounds or phonemes they hear. For example, imagine not being able to distinguish whether you hear a /p/ or a /t/ or a /k/ and you hear a person say, "Do you have the car keys?" You may hear that sounding like "Do you have the tar teys?" or "Do you have the par peas?" You may even ask yourself, "What are par peas and why should I have them?"

People who can not readily or easily distinguish or discriminate the differences between sounds of speech, especially similar sounds like the /p/, /t/, and /k/ can become easily confused, frustrated, and overworked. Imagine the constant need to figure out what is being said. Additionally, for people with APD at the phonemic or auditory discrimination level, they are processing word-by-word. This can easily lead to an overload, falling behind when the speaker talks quickly, even if quick is the normal rate of speaking. Imagine how difficult it would be to keep such a high level of concentration working to decode every word. This often leads to the child "shutting down" and appearing inattentive or "spaced out."

What is it like for these people? Let’s try the following simulation. In this simulation, a simple child’s poem will be altered so that what you are reading is changed at the letter (speech sound) discrimination level. That is, some of the letters are incorrect, but have been confused based on a specific rule chosen for the simulation. See if you can decode and figure out what this simple message is.

Twhnkke, tvinjle kitsle rtaq.

Hov I wnnddr wgat wou zre.

Hov I wnnddr wgat wou zre.

Perhaps you can figure out what are the real words in this poem. Make a note of what cued you into figuring it out? You will then realize one of the important strategies we can use or teach to people with auditory decoding/phoneme discrimination problems. Some strategies may be figuring the probability of a word based on the cues that seem to be correct. For example, in the first word in the poem above, we have Twhnkke. If the "Tw" is correct, there are not too many words in the English language that begin with those two letters. Additionally, this word is repeated in line five, so, we can try to see what children’s poem has the same first word in line one and line five and starts with "tw." Additionally, we can narrow down our possible choices of words by the number of letters in the word. For example, one English word starting with "tw" is twin. But, twin is only four letters, maybe five letters if it is plural (twins), and the first words in lines one and five have seven letters. Thus, by elimination and decision-making, twin or twins is not the word if the "tw" is the start of the word and the word has more than four or five letters.

In line two and six, the second word is only one letter. In English, there is a limit to the number of one-letter words, and I is such a word. Thus, the word I in lines one and six appears to be correct. Thus, I have the probability of the second word being I in these lines.

As you go through more and more decoding in this manner, you realize what you are doing involves figuring out or problem solving and decision-making and calling upon memory and experience and knowledge of the words in the English language. Thus, what we need to decode goes beyond mere decoding of the words. (In this simulation, visually, but for people with APD, auditorily.) We apply cognitive processing as well as memory and experiences to help in the decoding process. Therefore, improving decision- making and providing experiences and building a strong foundation for language is critical in helping children with auditory decoding problems.

So, what is the real poem? Let’s learn how to detect the features of the code and you can figure it out yourself. The underlying rule is to pick every third letter and substitute the letter in the alphabet coming before the actual letter in the word. For example, in the word "word," the third letter is "r" and the letter in the alphabet coming before "r" is "q." Therefore, the word would be presented in this simulation as woqd where "q" is misdiscriminated and, thus, substituted for "r."

To help, let’s do the first two words together. If you did not realize it, the first two words, Twhnkke, tvinjle, are actually a repetition of the same word. In the first word, the third letter is "h" and it was substituted for the letter following it in the alphabet, "i," thus the first substitution is "Twh" becoming "Twi." The third letter after the "h" is the second "k." It stands for its preceding letter, "l." Thus, the first word presented as Twhnkke, is really Twinkle. The second word is also twinkle, and the poem is about that little star that a child wonders "what you are."   

View lyrics used for simulation.

One area of auditory processing discussed that is often misunderstood by non-professionals is called auditory temporal processing deficits. The word temporal refers to the time aspect of auditory messages. There are numerous timing factors related to what we hear such as:

• Long sound like /s/ or /h/ vs. short sounds like /t/ or /g/
• Amount of time for one sound blending into the next blending into the next such as "c" "a" "t" in which the first consonant has a quick (short) change to the vowel, and the vowel has a long change to the final consonant
• The length of time between sounds indicating whether the sounds are part of the same word or part of different words. Compare the two utterances: "The cat sat" vs. "The cats at" (Notice that in both phrases, there is the same sequence of speech sounds or phonemes, but it is the longer pause between the "s" and the "a" in the second phrase that indicates, auditorily, that the "s" is part of the preceding word, cats in that phrase and part of the word sat in the first phrase.
• The length of time between sounds that can change the meaning of the utterance. Consider the sentence "Look out the door." If the pauses between words are the same, the meaning is for you to visually look out of the door. But, if the pause between "out" and "the" is longer (in writing, indicated as "Look out! The door!"), the meaning would be to watch out, the door may hit you.

In order to simulate temporal processing problems, two simulations are presented. In the first, the timing deficit will be at the speech sound (or letter) level. To present this first simulation the material will be typed with errors representing problems a child with APD may have because some speech sounds are so quick, they are missed. An example of this would be hearing a word with a consonant blend, but not being able to process the rapid speed of changes in speech sounds so that some of the consonants are not processed. For example, imagine the word "star" being spoken, but the rapid changes from the "s" to the "t" to the "a" cause the listener with APD to miss the "t" and only process "sar" wondering what does that mean? In the second simulation, the timing error is between words and sentences to such a degree that long words will be broken up into multiple words, and some words will be blended together to form new, longer words. Additionally, errors in processing will cause sentences to be processed where there are no sentences, and sentences to be blended together when there should have been multiple sentences.

(View lyrics used for simulation.)

This third simulation of auditory temporal processing problems presents what may happen when pauses are not appropriately interpreted and meaning is changes as in the example presented above, "Look out the door." For this simulation, the grouping of words has been changed in an attempt to throw off the meaning of the message. The actual message may be easy for you to understand as it is well known. However, see how sentence spacing, commas, and periods being placed incorrectly change the meaning.

                   Oh!

Auditory Attention Problems

One of the controversies in the area of APD is differentiating a child with a general attention problem or a specific attention deficit (such as ADHD) from a child with an auditory processing problem related to attention issues. It is not the purpose here to discuss the issue of differing between APD and ADHD. Instead, this section of the simulation will look at some of the common problems in auditory processing with which people having auditory attention difficulties my present.

One of the most common complaints people with auditory attention problems state is how they are distracted by background, irrelevant sound (called noise) when they are trying to focus and attend during listening tasks. Background noise can come from a variety of sources such as fans, air conditioners, heating, chit-chat of neighbors, people walking, street noises, movement of furniture, etc. Just imagine you have the task of disarming a bomb and you’re at the point of cutting the final wire when someone sneezes. We often see this scene in movies and realize the tension of the person involved, and sometimes for "comic relief" there will be a noise such as some accidentally knocking over an object onto the floor. Just imagine the level of focal energy for the person working with the bomb. This may be similar to the level of energy a person with an auditory distractibility problem faces with difficult listening tasks.

To simulate the effects of distractibility in this simulation, irrelevant letters will be typed at random. Your task will be to figure out the actual words that make up the message while filtering out the irrelevant letters just as a child focusing on a speaker is trying to figure out the words being said while filtering out the background, interfering, competing noises.

                    Hicqkorwy, edicrkorty, ydocuk,

Before looking at the answer, did you figure out the message? Well, here’s a clue. The irrelevant letters follow the standard "qwerty" keyboard. Therefore, go through the message crossing off each of the letters in the qwerty sequence and you will find the correct words of the message. In doing this, think of how many words you needed to get before you knew the message? One word? Two words? If you only needed a few words, then familiarity with the language and information as well as experience with the information is certainly helpful. Therefore, one strategy we need to consider in working with a child who has decoding problems and speech-in-noise distractibility difficulties is to familiarize the person with the information and vocabulary used in messages in order to increase the likelihood of successful comprehension and recognition of the message and information presented.

View lyrics used for simulation.

Another common auditory attention problem relates to selective attention. Selective attention is viewed as the ability to know to what one must attend. In essence, the problem is in selecting the relevant information and filtering out the irrelevant. For example, if a teacher said, "There will be a test in two days," and some children next to the child with auditory selective attention difficulties said, "Let’s get together tomorrow and study," the child with the APD attention problem may process the message as "There will be a test tomorrow, so study."

To simulate auditory selective attention difficulties, the next message will include a combination of relevant and irrelevant information. Your task is to filter out the irrelevant and figure out the correct message.

                    Little Jack and Jill Horner sat went up in the corner

If you figured out the message (or read the answer) you would know that it contains the complete versions of both Little Jack Horner and Jack and Jill. But, how would you know which is the relevant message? What if we increased the font of the words in the relevant message and decreased the font of the irrelevant message? This is what happens if a child with auditory attention problems, especially involving selective attention, uses an accommodation known as an FM system. This device amplifies (increases in loudness) the teacher’s voice (to a comfortable level) while decreasing the loudness of background noises. Now, here is the same message as above, modified as if through an FM system.

                    Little Jack and Jill Horner sat went up in the corner

crown and said "What Jill came a tumbling good boy am after I."

Is it easier to see the two nursery rhymes now? It should be much simpler to read the relevant one, Jack and Jill. Therefore, increasing the volume (font) of relevant speech can certainly make it easier to understand. 

View lyrics used for simulation.

Auditory Attention and Focusing: Effects of Linguistic Knowledge and Familiarity

One factor often overlooked with some children who have auditory attention problems relates to loss of focus because of the difficulties in decoding and comprehending messages. This factor is the difficulty level of the language used. That is, the child may have a language based processing problem and the child does not understand the vocabulary or concepts presented in the message. The information may be unfamiliar because of lack of experiences or difficulties with auditory processing in early life that led to the child not having a sufficient language base for understanding the material.

To simulate this type of problem in attention and focusing due to lack of knowledge and familiarity with the words, concepts, and information in a message, the following text was chosen because the poem presented contains very unfamiliar language and may not be well known to some readers. Furthermore, to make it even more difficult, irrelevant words have been added to simulate background noise and there is no spacing between words to add a time or temporal processing deficit to the simulation. See if you can figure out the poem.

Well, you did figure out the poem? How about we improve your temporal processing and add the spaces between words. Here, try again.

                    One twas has brillig and the slithy cows toves

                    Did look gyre and gimble water in the wabe street

                    All mimsy lights were the borogroves house

                    And the mome dogs raths cats outgrabe.

Have you figured out the poem yet? Is it about the cow jumping over the moon? Or is it about water in the street? Well, let’s try an FM system. In this simulation, the relevant words are made larger, and the irrelevant words smaller.

                    One twas has brillig and the slithy cows toves

                    Did look gyre and gimble water in the wabe street

                    All mimsy lights were the borowgroves house

                    And the mome dogs raths cats outgrabe.

Still can’t figure it out? The words are in English; olde English. It is a poem written by Lewis Carroll, the author of Alice in Wonderland and related works. The title of this poem is Jabberwocky.  

View lyrics of Jabberwocky.

So, it is difficult to know to what you should attend when the vocabulary is unfamiliar and strange. Helping a child with an auditory attention problem become familiar with the vocabulary and concepts the teachers may use in presenting information in class can be a great help for improving focusing, attending and maintaining attention.

Many children with auditory processing problems have difficulties at the level of short-term memory, often called working memory. Problems with short-term memory are mostly noted on long verbal messages. That is, children can remember part of the long message or short messages, but get lost trying to remember longer messages it total. For example, a child may have no problems remembering to "Take out a pencil," or "Open your book." But, given the directions to "Open your book to page 37 and complete items one to ten in section B" may present too much information for the child to remember.

For this next simulation, you will see parts of a message presented one sentence at a time. However, the sentences will flash on the screen at the click of your mouse and will remain on the screen for only a brief period of time. You will be able to catch some of the words, but can you figure out the entire message?

                    Sentence 1:  Click here

                    Sentence 2:  Click here

                    Sentence 3:  Click here

                    Sentence 4:  Click here

Well, did it flash too fast for you? Did you get a couple of words, enough to figure out the entire message (again, demonstrating the importance of familiarity helping with processing)? Well, what about another strategy? Do you think you’d do better if you knew something about the topic of the message? Let’s try the following simulation. The sentences will flash, again, as before, but you will have a clue, the topic of the message.

Topic = A sheep is asked if it has a sufficient amount of it’s "sheered" product to give to its male owner, its female owner, and for a child who lives down the street.

                    Sentence 1:  Click here

                    Sentence 2:  Click here

                    Sentence 3:  Click here

                    Sentence 4:  Click here

Easier to figure this one out, isn’t it? You may even have figure out the nursery rhyme before clicking to get the first sentence. Thus, another helpful strategy for children with APD is setting the topic and being sure the child has some familiarity with the topic.  

View lyrics used for simulation.

The last area covered in this simulation relates to what is often called auditory integration. Some people refer to this as auditory closure, binaural integration, or auditory synthesis. In essence, integration relates to how a person takes pieces of messages and puts them together to form the whole.

In order to simulate auditory integration difficulties, only pieces of the message will be presented and it will be your task to figure out the entire message. Again, strategies such as familiarity, knowing the topic, and linguistic knowledge will help you as they can help a child with auditory integration deficits.

                    Hey the cat cow

Have you figured it out yet? Perhaps it was too easy, but that may be because of your familiarity with the nursery rhyme. But, what if the message were made even more difficult by removing parts of words and you have to synthesize the words as well as the sentences to figure out the message. Try this example.

Did you get that one? For this example, you had to do a great deal of decoding, figuring out, problem solving, decision-making, and hoping that you’d get enough to provide cues to the message. Well, this one was difficult! Would it have helped to know that the topic is about a old, jolly royal majesty ordering something to smoke while he would listen to a trio of string instruments? I thought it might help!   

View lyrics used for simulation.

It is hoped that these simulations provided you with a better and deeper understanding of the frustrations and decision-making that goes on inside the minds of children with auditory processing disorders (APD). You must remember that as an adult, you have a greater language base, broader experiences and familiarity, and more practice in problem solving than many of the children who have APD. However, with a better understanding, you may be more patient and more acceptable of the problems and errors these children present. Hopefully, you have learned some strategies you can try to help these children.

For more information on Auditory Processing Disorders visit the NCAPD homepage.

This simulation was created through the joint efforts of Dr. Jay R. Lucker and Debbie Wood. Dr. Lucker  is an audiologist in private practice in the Washington, DC area specializing in auditory processing problems in children and adults. Debbie Wood is a parent of a child with APD and President of the NCAPD.  Debbie Wood is also founder of the website CAPD: From the Heart of a Mother and the CAPD Online Support Group.

Copyright © December 2000 (Lucker and Wood)
All Rights Reserved