Auditory Processing Unwrapped with Dr. Matthew Barker, Part 2

Dr. Matthew Barker is the Founder and Director of Acoustic Pioneer. With a Doctorate from Texas Tech University Health Sciences Center, Dr. Barker has dedicated his career to advancing the field of audiology, particularly in the area of auditory processing. Part 2 of this podcast series focuses in on what to do once a child has been identified with an auditory processing deficit and how targeted direct interventions can improve this skill; thus improving reading and learning.  His work is driven by a passion for helping children and adults overcome auditory processing challenges, ensuring they have the skills needed to succeed in learning and communication. 

For more information please reach out to Matthew Barker, Au.D. at:

https://acousticpioneer.com/en

info@acousticpioneer.com

If you enjoyed this episode, please leave us a review and share it with others who might benefit from learning more about auditory processing and the groundbreaking work of Dr. Barker. Don't forget to subscribe to our podcast for more insightful conversations with experts in the field.

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For more information about Dr. Carrie Spangler- check out her Linktree at https://linktr.ee/carrie.spangler.

For transcripts of this episode- visit the podcast website at: https://empowearaudiology.buzzsprout.com

Transcript

Announcer: [00:00:00] Welcome to empowEAR Audiology with Dr Carrie Spangler.

Carrie: [00:00:12] Welcome to the empowEAR Audiology podcast, a production of the 3C Digital Media Network. I am your host, Dr Carrie Spangler, a passionate, deaf and hard of hearing audiologist. Each episode will bring an empowering message surrounding audiology and beyond. Thank you for spending time with me today, and let's get started with today's episode. All right, Dr. Barker it is so good to have you back for part two of this podcast talking about auditory processing deficits and disorders. And we talked in part one. If you haven't listened yet, please go back and listen to the first recording with Dr Barker because we really dove deep into, you know, what auditory processing is. And, kind of the foundation of why auditory processing skills are important and how to test for them and who to test. And now we're going to dive a little deeper into what's next. So a student or an individual gets tested Matt. And we find that they have a deficit or an area that is of need for auditory processing. What can we do next?

Matt: [00:01:37] That is a fantastic question. Um, so the there have been quite a few approaches to the auditory processing field to date. Um, all of them share. One kind of common quality is when you do the test battery that you perform, whether that be sort of some automated testing or some CD based testing or some audio testing through audiometric equipment. Um, the one sort of theme that is consistent through all of the approaches is once you discover where the concerns are in your student or client, those are really the areas that you need to target for intervention. So which makes perfect sense. If you go get some blood work done at the doctor, if there are some issues, they don't just give you random random interventions for. If you don't have low blood pressure, you better not be taking low blood pressure medicine. Right, right. So it's kind of the same for for all of the approaches is before you treat an auditory deficit, you need to discover what those deficits are. Mhm. Um and then focus in on those deficits with, with you can do home based therapy. You can do therapy through computer programs. You can do therapy through a clinical audio audiometer in a sound booth. You can do therapy in a language evaluation. So the first step is discovering okay what are the deficits. And some people say how do you treat auditory processing. And my my response is well which area. Where is it down. There's no like here's a program that fixes auditory processing because there are so many areas that that can be deficient or underdeveloped. You only really need to target what's down.

Carrie: [00:03:51] Um, which is my next question. Like what would those areas typically be for auditory processing that you would be intervening.

Matt: [00:04:00] Okay. Yep. So I would probably say there's three more prominent areas that that we test for, um, that seem to be surfacing again and again and again in the studies of if these areas are deficient, then you're going to see difficulties with language, with reading, and with classroom learning. Um, I there has not been enough data to say of the three, which is the most prominent, but the the most in my experience. And again, I'll have data on this later. But in my experience, the most prominent one is what we call a dichotic listening deficit. Now, there's a lot of confusion about this particular topic, because what we do in the testing Room is we create an environment under headphones that requires the listener to use the part of their brain that communicates between the left and right hemisphere. We call it the corpus callosum. Um, and to to. So we have pathways in our brain that go from the right ear up to the right side of the brain, and we have pathways that go from the left ear up to the left side of the brain. But those are not the major pathways. The biggest pathways go from your left ear to the right side of the brain, and your right ear to the left side of the brain. So what we've discovered is if you, um, place a, uh, some headphones on an individual and you, you give them auditory information in the right ear at the same time, you give them auditory information in the left ear.

Matt: [00:05:58] And when you do that, it suppresses those ipsilateral pathways. So you don't go from the left ear up to the left side of the brain or the right ear to the right side of the brain. You go contralateral. So it suppresses the the straight up pathways. And it uses the pathways that go across the brain. Now when we do that, when we present information like that, it requires the individual to get, um, uh, sorry to get that information from both sides over to the other side as well. So you have to use that corpus callosum. Now when the individual gets the information on both ears, if they have very quick neural speed, like the information is able to be transmitted at a normal neural rate, they can transmit that information back and forth so quickly they can understand both sides. They can use the information from both years when they can't use that information quickly, then, um, the the individual loses one side or the other, and there's sort of often there's a righty or advantage if the, if the information is language that you're, if you're giving words in each year, then there's often a right or advantage. But people that see a left ear advantage often think, oh my gosh, the it's the ear that's down. And that's not the case at all.

Matt: [00:07:31] Actually, what we're testing is the pathway in between the brain. So regardless of which ear is down, the transmission speed of the corpus callosum is really what you're testing. So there's there seem to be a bit of an emphasis on focusing on which ear it is. That's down and in in answer, it doesn't matter if it's the left ear on the testing that shows that it's down or the right ear, or both. It means that their transfer of information from both sides of their brain across to the other side, is happening too slow for them to retain the information as a unit and then they can't cope with it. So, um, very rarely in life would you have information coming into your left ear and very different information coming in your right ear. So it's literally just so we can measure that, that interhemispheric transfer speed. Um, but those kiddos that we talked about in our last meet up, that was so much fun. Um, the the the kiddos that have these slow, um, corpus callosum speeds in that neural transmission have dichotic listening deficits and testing, and they're the ones that are struggling or some of the ones that are struggling with language and struggling with reading. And we found 10% of them in in every single class, 10% had a dichotic listening deficit. So I wouldn't say it's the most important, but it seems to be one of the most commonly discovered or commonly seen deficits for whatever reason, whether it be environmental, whether it be, you know, genetic or what, but maybe a combination of both.

Matt: [00:09:24] But there's definitely a prominence in, in dichotic listening. If I had to guess, I would think the probably one of the next most prominent is kind of that localization, spatial hearing, where using your ability to focus on where somebody that you're talking to is coming from versus like, if you're in a restaurant or if you're in a classroom and you're trying to hear the teacher, even though you've got Sally Mae or whoever else. So off to the side talking to their neighbor. Using your ability to focus on where the the speech is coming from. They call that spatial hearing. Um, some don't have the capacity to use that information to really be able to focus well on what they're trying to hear. And there is some great work out of out of Australia. Um, uh, the NAL lab down there, Dr Harvey Dillon and kind of his brainchild, uh, has developed really effective ways to improve using your localization or your spatial hearing so that you can actually focus really well on what you're trying to target, and not so much, um, what you're what you're trying to dismiss. And I think that's probably like, we didn't even have that test. I was going in grad school just to sort of give your listeners how how far we're coming with that, but they have an intervention for that.

Matt: [00:11:05] Um, it's computer based. You can actually do this as a speech therapist in clinic with varying sound sources as well. Like it's it's kind of easy to do if you're already doing clinic, you can do it manually where you have, um, uh, some, some target sounds, whether that be the speech therapist reading a book with the individual. And you can be playing a radio off to the side and to make it more challenging, you sort of just slowly bring that radio up without you bringing stuff up and just training that in a routine fashion. They learn how to focus on where they want to focus, and by doing that, we can suppress information from other locations. So this was I had you know, in life you have those aha moments. Right. So when we I was in psychoacoustics class, I was still of the sort of elementary understanding where, you know, you have your motor systems and you have your sensory systems. And I was, you know, you're taught your ear is a sensory system. And by and large that's true. But when we go to grad school, we're actually taught actually we, we go, sorry. Um, kids, actually, um, we use that information to suppress our ear. So our ear has all these amplifiers in it that take sound that we want to hear, and it boosts it up.

Matt: [00:12:51] It actually amplifies that information. But in the scenario we were talking about where you're in a classroom where you're trying to focus on on the teacher and ignore all the extraneous noise around you. We actually have the ability to un amplify or suppress those listeners that were not focused on, but individuals that don't have that skill are really going to struggle. So Dr Harvey Dillon and his team have shown that actually, if you if you have a dedicated, um, regimen where you just slowly work on that skill, they get much better. And then when the time comes, they can focus on what they're trying to listen to and, and avoid avoid the other. Um, I didn't mention, but I will say now that the dichotic listening deficits are treatable too, and they're treatable in a variety of ways as well. For just for your listeners. So that's that. Those, I think, are probably some of the most prominent areas that we've sort of are finding that are really hindering development. If I had to pick a third one and again there's so many, but the third one would be what I call just auditory patterning. So a good example of this. In fact it's it's almost better example than I need. But um if there are individuals that have been trained Morse code.

Matt: [00:14:29] Mhm.

Matt: [00:14:30] They can take that code and turn it into language. So when I say auditory patterning, language is literally just a pattern of sounds. So if I say car r r right. In that order you hear car. If I take that order and I flip it around and I say R a Rack. Rack. The sounds are identical. I've just changed the order of them, and that changes the meaning. So in auditory processing, what we try to do is say, well, yeah, but that's language. That's using speech sounds. What if we test that ability to follow patterns without speech sounds. So in the case of Morse code you actually only have two stimuli. That's it. You have a short beep and a long beep. And the order in which you put those like Soas is is long, short, long I think like, no, it's dee dee dee dee dee dee dee dee dee dee dee like it's short short short long long long short short short. So that's soas um, I learned that from the dishwasher. Uh, commercial. Um, um, so, so to somebody that knows Morse code, if they hear that, they're like, oh, Soas That's SOS. They're giving me a signal. Whereas in in an auditory processing assessment, we might just tell them. Okay, tell me what you hear. I'm going to play you some sounds and you could say something like doo doo doo doo.

Matt: [00:16:06] So the individual would need to say long, long, short. Or often we use pitches instead of duration. So we can say or high high low right. So they can hum it. Mhm. Mhm. If they struggle to follow sounds that aren't language. So they're not speech sounds, they're just nonlinguistic sounds. Why are we surprised then that they're struggling with language which is just phonemes put in a specific order. So what we found is ah, they're they, they're phonemic classification is fine. Like they can tell the difference between mhm and buh But but the order in which those sounds are coming, they're struggling to put in place. So what we found is if we train the ability to follow nonlinguistic sounds, they can then follow linguistic sounds in patterns more successfully as well. And we see a big improvement in language development and reading development. And let me be I want to be very clear with the studies that I've seen in no study has an auditory processing deficit been administered where you see benefits in reading and there not be reading intervention as well. So an auditory deficit needs treatment, but that doesn't mean it replaces the language therapy or the reading intervention. Both of those are still needed, but the auditory intervention will make your success with those therapies faster and and you get higher scores.

Matt: [00:17:55] Um, so it I want to be very clear. Auditory processing deficits do not replace reading intervention or language intervention. That's it's they're literally on one continuum in that pathway. And we need to be looking at all of it from from the ear all the way up to Wernicke's area. Um, so we need both audiology and speech language therapy. Um, as a group. And I know that we've talked about sort of multi-professional teams. That's true. Uh, but in reality, that's hard to make work. There's not a whole lot of audiologists that do auditory processing work. Um, there's often cases where, um, you don't have, uh, educational psychology available. So if I was a, for example, a speech pathologist and I'm like, well, I hear what you're saying, I understand that I really should be incorporating some more auditory processing testing. I'm not an audiologist. How can I diagnose it? Well, as it my advice to you would be if you can partner with an audiologist. Fantastic. If you can't find those handful that exist that are happy to do that, um, you can test for deficits that is within your scope of practice. Absolutely. Even though you can't label a diagnosis, that doesn't mean you can't, um, discover deficits and intervene for those deficits. That's absolutely within your scope of practice.

Matt: [00:19:36] So I know the the first time I had parents ask me, I did all this testing in grad school and, um, I was explaining all the results, and I was really proud of myself because I sort of explained what we did and how they did. And, you know we found these areas of concern? And I was looking at the parents and they said, okay, what are we going to do about it? Like what's what's the point of of all this testing if we can't intervene? And I looked over there, their son and I thought, that's a genius question. Why have I not asked this in class like, well, okay, great. What's all this testing? What are we going to do about it. Mhm. Um, and that was really the, the impetus for pushing forward with why don't we make ways to treat these interventions. And I know I've been told like you've got it, you've got it for good. Well why don't we test those waters. Let's see if we can actually improve these skills. And if we can fantastic. Then we can actually focus more energy and time on if we intervene on skill. A, do we see a significant benefit in their life, whether it be educationally or socially or whatever? Or if not, well, what about skill B is that does that seem to be more impacted in their life? And I feel like that's where we are now.

Matt: [00:21:04] It's not that deficits occur and can you improve those deficits. Now we're trying to hone in on what's important. What do we really need to highlight for intervention or for discovering those deficits. What do we need to focus on. Like do we need a two hour battery to discover what we need to do, or can we do this in a more efficient manner? So yeah, I think our profession is really at an exciting part where we're we're finding we can improve stuff. So well, what happens if we improve localization? What happens if we improve these auditory patterning abilities? What happens when we improve that dichotic listening that interhemispheric transfer speed. What happens when we we improve that spatial awareness. And there are there are other areas like phonemic classification. Like if somebody can't distinguish in their brain the difference between A and A, that is going to really be difficult for them to parse when they're hearing language spoken at normal rates. So you have to sort of delve into where are these developmental milestones, strong or not milestones areas and where are they underdeveloped. And you sort of create a recipe for that individual as you, as you would for any other health issue.

Matt: [00:22:37] Right?

Carrie: [00:22:38] Yeah. And I mean, for those of us that do have educational audiologists working within the schools, um, I know personally like the power of having that collaborative team to kind of look at the whole child and then individualize what that student needs based on the results that we can get from an audiological perspective. But then also, like you said, the the psychologist and the intervention specialist and the speech language pathologist, all of them bring that important piece. And if you can, um, meet the need through what are those deficit areas for auditory processing through some of the intervention programs that you're talking about? Like how does how does that look for the outcome for that child in the classroom and with reading and more of those life functioning skills? Because that's what we want. We want them to be successful and how can we help them? Does that sound about right?

Matt: [00:23:35] Yeah, absolutely. Yeah. And and there's you have to blossom where you're planted is how my mom would say it. So if you're at a location where you have, like, an amazing Dr Carrie Spangler, or others. Um, that that can help on a team to do, to really hone in on where their expertise lies. And you have educational psychology and speech language, uh, specialists or um, or any other OTs like other. If you have a access to multiple professionals, it just gives you a better ability to know exactly how or prioritize in certain scenarios. Really, what you're wanting to focus on with, with that student in that in where they are. But you're you're absolutely right when you can intervene accurately. So you're sort of not just doing, let's just do general therapy here. Well, no, we know where the deficits are. We know where we need to target in your trajectory of success just increases for those students. And when you see that and see how well they've struggled for two years with developing reading, for example, I've heard this time again and again and again and we finally intervene with the auditory portion. And there's their gains in reading. Just go from a slow hill to a mountain in trajectory, and the parents are like, why haven't, you know, this is fantastic. We're actually seeing progress. The students get excited because they've been hitting their head against the wall. They're trying. It's not like there's a lack of of effort. They just think they're they're they're not a smart enough to do it, which is not the case.

Matt: [00:25:33] We just need to re redesign how they're processing that information and then voila, they can really shine and develop. And it's that's the goal. The goal is like let's target where we see these deficiencies and and also target the higher level stuff. You know like there's top down things there's attention if there's attentional difficulties those need addressed. There's working memory that, you know, if there's a working memory component is your auditory processing testing be affected from that. So all of these things have to be kept in mind whether you're lucky enough to be, um, working alongside psychology and audiology and speech therapy and others or you're, uh. Look, I'm, I'm the only professional at my district. We're a small school. Well, then you just have to do your best to try to fill in the gaps as good as you can. You like just saying. Well, I just won't do any auditory processing work or I won't do any. I won't check for any, um, cognitive abilities or any working memory skills. It's if it's in your scope. Don't be afraid to go out there. Even if you can't diagnose ADHD. You can still do some some measures to determine actually, there's some some concerns with attention here. And use that information to really, um, modify your approach for, for the students. There's there's no one approach to fix everybody. You need to have a deficit specific approach. So the more information that you can garner, the more accurate your deficit specific treatment will be for that individual. So yeah, fun times.

Carrie: [00:27:26] Exciting times. Well, I think what excites me so much is the fact that, um, we can get deeper into what their deficit areas are. We know that having that strong foundation for auditory skills is so important from a bottom up perspective. But then the impact that it has on reading and language and classroom performance. And if you develop some therapy, you know, specific programs to acoustic pioneer. And I know other companies have to to really like kind of just target those areas so that we can see the success. So we, we no longer can say like we can't do anything about it. We can't. And so that's the exciting part. I know we've talked a lot today, um, about auditory processing and therapy and things like that, but I want to give you just a chance to say, like, did I miss anything? Is there anything that, like, you wished I would have maybe asked that you wanted to maybe summarize? And then I also want you to share a little bit, um, how people can get Ahold of you and, um, where to find you, too?

Matt: [00:28:45] Sure. Sure. Let me start with that before I forget. So if. If you would like to get a hold of me, you can call me directly. My number is (806) 424-3436. You can call or text me if I'm not available. Just leave a message. Uh, you can email me at info info at Acoustic pioneer.com. And then there's all of course, the social media, the Facebook, the Instagram, all that sort of stuff we can check as well. Um, but yeah, email me, call me. I promise I don't bite. I try. I'm a friendly guy.

Matt: [00:29:24] So yeah, very responsive.

Carrie: [00:29:27] And what I can do is I can link all that information in the show notes, too, so people can go to the show notes and find that information as well.

Matt: [00:29:36] Perfect, perfect. No. Like, Carrie, this has been so fun. Like this is literally one of my favorite topics. So inviting me to come talk about one of my favorite topics since I was a little boy. It was almost like Christmas morning.

Matt: [00:29:48] Today I'm like, yay me!

Matt: [00:29:51] And how much it helps others if it. If intervention is needed. 

Carrie: [00:31:19] Well, I just appreciate your time today because I know this is such an exciting topic and your excitement shines through. So I know you have so much passion, um, and you have done so much to advance this part of the field and to the way you explain things. It makes it very applicable to real life for students and those that we are seeing in the school and what that impact is. So I think a lot of people will be excited to hear this interview today and get started wherever they can, and kind of just make an impact with students within the school, because as you said earlier, probably about 10% of those students sitting in the classroom have some sort of auditory processing deficit, which is impacting how they read, learn, process, language and some other things that impact the classroom learning or listening. So again, Matt, thank you so much for being a part of today's interview on the empowEAR audiology podcast.

Matt: [00:32:25] Fantastic. Thank you.

Announcer: [00:32:27] Thank you for listening. This has been a production of the 3C Digital Media Network.