Auditory Processing

What is it?

Auditory processing is how sounds are transmitted after they leave the inner ear and travel along the nerve pathway to the brain. Sometimes there is a breakdown in the transmission of sound and it can cause learning difficulties, usually with reading and spelling but it can affect other subjects as well. Auditory Processing Disorder (APD) has many subcategories and it must be determined through proper testing where the individual is having problems. The most common areas are auditory memory, auditory figure/ground (problems hearing in noise), phonemic decoding, temporal aspects of speech understanding, and auditory closure..


What are the signs/characteristics?

 • Asking for repetition

 • Inability to attend to auditory stimuli for more than a few seconds

 • Easily distracted by background noise

 • Problems with sound discrimination

 • Difficulty following directions

 • Often saying "huh?" or "what?"

 • Inability to always relate what is heard with what is seen

 • Forget what is said in a few minutes

 • Frustration or distractibility in the classroom (children)



How is it evaluated?

A qualified audiologist is the only professional that can do comprehensive diagnostic APD testing. Dr. Schwalbach is the leading expert in APD in the Shenandoah Valley. It is very important that a diagnosis is NOT made based solely on screening tests but rather with a comprehensive test battery coupled with a thorough case history.


How long does it take?

It takes approximately 2 hours to complete the evaluation. A comprehensive hearing evaluation must be done first to rule out hearing loss. Once normal hearing is confirmed, the APD portion of the exam will be administered. A follow-up conference will be scheduled within a week to discuss the results.


What ages can be tested?

Children as young as 5 years old can be screened but 7 years old and up is recommended for a complete diagnostic evaluation.  Adults can and are frequently tested as well.


What can be done about it?

Once all of the data has been collected, Dr. Schwalbach will make recommendations designed to target each individual's problem areas. It may include any or all of the following, but will not be limited to:  Employing compensation strategies using an FM system in the classroom.

Auditory training therapy: Auditory training therapy is based on the scientific principle of neural plasticity, which simply stated means the brain’s neural pathways can reorganize in response to experiences.  Long lasting functional changes in the brain occur when we learn new skills.  When therapy is recommended, Dr. Schwalbach develops an individual program that targets the deficient domains identified during the APD test battery.  Each plan is unique to the child and the time it takes to reach success varies based on the severity of the problem and consistent attendance.

Custom hearing protection: Custom fit earmolds are essentially ear pieces desigined specifically for your ear(s), providing superior comfort and performance.  After a trained audiologist takes an impression of a person's ear, it can be used to make any of the following types of custom fit earmolds, among others, Tin essentially any color or combinations of colors that you could want.

Aural Rehabilitation


Aural rehabilitation (AR) is a multi-faceted approach, taking care of all aspects of an individual's hearing loss. Dr. Schwalbach and Dr. Murray firmly believe that people will be more successful in remediating their hearing loss if they have the right tools and information. AR involves appropriate amplification (such as hearing aids or assistive listening devices), and counseling to learn effective communication strategies and how to best approach different listening situations. In some cases, auditory training therapy, lip reading training, or other programs may be warranted. Family members are encouraged to take part in the entire process so that they can understand the hearing loss and learn how they can best communicate with someone that has problems hearing.