Auditory Processing Unwrapped with Dr. Matthew Barker: Part 1

In this episode, we sit down with Dr. Matthew Barker, Founder and Director of Acoustic Pioneer, and a renowned Audiologist with a specialization in auditory processing. Dr. Barker completed his Doctorate at Texas Tech University Health Sciences Center in 2004, where he focused on testing auditory processing and its crucial role in language development and reading skills. He shares his insights on the significant impact of underdeveloped auditory processing skills, which affect over 10% of elementary/primary school children, causing them to struggle with learning.

In Part 1 of this 2 part series, Dr. Barker takes a deep dive into the importance of auditory processing and the impact it has when someone experiences a deficit.  He also shares more about the areas of auditory processing that will impact students who are struggling to read and learn in school. 

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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You can listen to this episode wherever you stream podcasts and at www.3cdigitalmedianetwork.com/empowear-audiology-podcast

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 episode 69 of empowEAR Audiology with Dr Carrie Spangler.

Carrie: [00:00:15] Welcome to the empowEAR Audiology podcast, a production of the 3C Digital Media Network. I'm Dr. Carrie Spangler, your host and a dedicated audiologist who is part of the deaf and hard of hearing community. My mission is to bring you empowering insights on audiology and beyond. Today we begin part one of a series, a special two part series on auditory processing with Dr Matthew Barker, who is a passionate researcher and fellow audiologist. In this episode, we'll explore what auditory processing is, common red flags and how auditory processing deficit can affect individuals. In part two, we'll dive into what can be done once a deficit is identified. Thanks for tuning in. Let's get started. Hello listeners, I am so excited today to welcome Matthew Barker today, and I'm going to share a little bit before I bring him live on to the podcast. Dr Matthew Barker is the founder and director and he is an audiologist that specializes in testing auditory processing. He completed his doctorate from Texas Tech University Health Sciences in 2004, and Dr Barker saw how much of a negative impact underdeveloped auditory processing skills caused people when learning language and learning to read, and he found some strong evidence that indicates over 10% of elementary and primary school children struggle in learning because of an auditory processing deficit.

Carrie: [00:02:06] He also discovered that over 98% of audiologists were not doing any auditory processing testing, and he found out that most audiologists are put off by how long the testing took to administer, how long reports took to write, and so on. So that, coupled with the fact that there were no deficit specific therapies available, he raised the question, what good is testing for a problem if there's nothing that can be done for it? Moving forward, I just want to say that, you know, Dr. Barker, who said he was driving down the road minding his own business one day when God put into his head, um, that the idea to develop a way to test auditory processing skills and a fast and fun way and create some deficit specific auditory therapies to help. And so the. His company, Acoustic Pioneer was launched back in 2013. And today I have Dr Barker with me who is going to share a lot about auditory processing today as well as what we can do about it. So Dr Barker, welcome to the EmpowEARAudiology podcast.

Matt: [00:03:25] It is absolutely a pleasure to be here with you, Dr. Carrie Spangler. Thank you for having me.

Carrie: [00:03:31] Thank you for being here. And one of the things on my podcast when I interview professionals is my first question is, I am just curious of how you actually got into the field of audiology, because everybody seems to have a different road to get there.

Matt: [00:03:49] Yep. Um, mine was sort of. That's a great question. Uh, mine was sort of Faceted. Um, uh, growing up, one of my childhood best friends had a severe high frequency hearing loss. And, uh, when the first time I was around him without his hearing aids was an eye opener, like, I was like, you cannot function at all without those things. It was just. It was it was stunning to see how much they changed him in versus out. Um, and down the road, you sort of, you hum about different professions, right? You're like, oh, you know, law school would be okay or, or I want to open my own. I was going to sell mattresses at one point. Kerry. Um, there was there was an array of options. Uh, and my mom's, uh, school counselor, um, and she said, you know, there's a lot of testing that's available that you can sort of go see what your interests are, see what what you like to do, and it'll compare those results to other people doing other jobs. And on that list was speech therapist or speech language pathologist. And I at the time was down at, um, Texas State used to be called Southwest Texas. And the audiologist that was at the speech therapy, um, office that I was sort of asking about speech therapy stuff.

Matt: [00:05:22] She was like one of the coolest people I ever met. So I'm like, I think audiology is a really good road. Um, it seems to attract cool people. And, you know, I don't want to be in a profession where there's a bunch of uncool people around. Let's go to the audiology one. It'll be so. So just exposure to an audiologist, seeing what benefits it it did for for my good friend, it just seemed like a good fit. And my first year in grad school. After after you pick. You're always wondering, second guessing yourself, thinking, was this right? Was this the profession? I hope it was the right one after I took the psychoacoustics class. Most people hate that class. I loved it like I was that weirdo. Like, oh my gosh, the brain can do what the brain just does that automatically and we don't really think about it. So once I discovered how complicated the ear was, which, you know, I thought it just was like a microphone of sorts. Way more complicated than that, of course. Um, and how it functioned. I knew after that class that I was in the right profession, and I've never looked back. It's been it's been a wonderful road. It really has.

Carrie: [00:06:40] I love how.

Carrie: [00:06:41] People. And it just took one conversation with someone to really change how, you know, the trajectory of your career, right?

Matt: [00:06:49] Yeah. I could have been a speech therapist like it was. I almost flipped a coin.

Carrie: [00:06:55] Yeah, well, either way, you would have been cool. We love our speech pathologists, especially the ones who are listening today.

Matt: [00:07:03] So, 100%. 100%. And what's funny is I feel like the the reason I had difficulty choosing between audiology and speech therapy is because I like the therapeutic aspect of it as well. I like the science aspect and the therapeutic. So auditory processing is probably that that field or the portion of the the internal communication system, auditory communication system where the audiologist and the speech pathologist really share the most ground because it's, it's sort of that, that um, uh, relay race where this is where we hand the baton over, like we're both sort of in the auditory processing area together. So it's it's a good fit for me. Works well.

Carrie: [00:07:52] Good. And kind of going along with that. I know, at least in my experience of going through my audiology program, there wasn't a huge focus on like learning about auditory processing and that. So how did you kind of find out about that and learn about auditory processing? Mhm.

Matt: [00:08:14] Um, yep. So I've had a lot of conversations with audiologists globally about this. And at Texas Tech I happened to to have a professor that was very into the auditory processing area. So we had an entire class like a three hour class all semester long on it. We did a lot of practicum or like, you know, clinic with auditory processing testing. Um, I will say that my classmates, I thought my four classmates were oddballs because they would avoid the auditory processing area and they would trade me out. They'd say, look, I'll do two of your hearing aid patients if you'll do this, my APD assessment on Friday. So it was a funny bartering. Like they wanted to give all of them to me, and I wanted to take as many as I could get. So I thought they were the weirdos until I got out into the the field and realized that, oh, it's me and my professor that really are the more oddballs than the other way around. Um, so I kind of like, lucked upon a professor that was very into the to the field. I've had conversations with audiologists with their masters or Dr.ate that said that they had one class on on APD, but it was literally one afternoon class, like it was not an entire semester. It was. Well, yeah, we touched on it very briefly one day and I think like oral rehab or something like that. So. Right. So the, knowledge base across the profession in both speech therapists and audiology is very varied depending on on where you got your training and what what you were exposed to and things like that. But, um, the from my own data points, the exciting part is that more and more and more are getting involved.

Matt: [00:10:12] And I think it's like a just a just like anything in a profession if, if things are changing, especially organically, not like from a top down structural standpoint, it just takes a while for that information to sort of reach others. But the, the again, based on the conversations that I've had, a lot of the professionals that that have started to use some auditory processing testing and some interventions when they actually see the benefit in front of them. That's the, like the green light moment. Like, oh, this is actually helpful for my the students that I service or for my patients. And thankfully not just with Acoustic Pioneer, but there's there's we're 11 years past when Acoustic pioneer launched now. And there's there's other options available, not just acoustic pioneer therapies, but there's other therapies that have been proven effective. And like what an exciting time where we can be in a field where we can actually make some significant progress in these areas. Whereas when I was going to school, I was focused on how do you test it? How do you analyze it? How does how do you administer things? How do you really get the patient or the client really focused and engaged? So you're getting the best data possible? Um, to then like you read on the website. Wait a minute. If there's nothing you're going to do about what you find in the testing, what is the point of that? So. Yeah. So it's really exciting to be in a profession where we're kind of breaking down barriers and figuring out ways to help. What? What we couldn't ten years ago or more?

Carrie: [00:12:05] Yeah.

Carrie: [00:12:06] No, I agree, I feel like the ripple effect is definitely happening within our field. And, you know, I related fields to the information that's out there. But just for our listeners to kind of give a more like 360 degree like view. Um, can you just share just what is auditory processing like? Just a definition so that we can dive a little bit deeper on the same page with some other questions?

Matt: [00:12:34] Okay, okay. This is an excellent question. And there is there are very long like page long definitions like ASHA has papers that are literally pages long. To define this, and I don't think it's that difficult. I think it's easier to. Define if you the definition I use and I can defend this all the auditory information that enters your ear heads up toward your cortex, all of it. Eventually it gets up to the cortex, all of the processing that leaves your cochlea, your inner ear, the processing that's done from that point where the eighth nerve begins to fire all the way up to the auditory cortex, is is auditory processing. As soon as you get to one further step into the into Wernicke's area where language is processed, the auditory processing is finished and and the sound is now language. So if the auditory information has meaning to it, That's language. So I use as a as an example because some people say I don't understand the difference between language processing and auditory processing. So this is a very easy example to use. Let's say you're driving down. No, you're just walking down a sidewalk next to a road.

Matt: [00:14:02] If you're walking down a sidewalk and a and a semi-truck is coming up from behind you, you know that there's a semi truck coming up from behind you. You don't have to turn and look. You can see you can hear what it is. You know what? It's coming. And you can even tell, like what speed it's going, what direction. As soon as it's going to be near you and pass by, you can do all of that without looking. That's called we call that localization, right? So if somebody is in a park and you're walking down that same sidewalk and they yell out, hey, Carrie. You can localize where they're coming from too. So if you can do the processing to both speech and non-speech, then it's not a language processing skill. It's an auditory processing skill. So locating a sound in space has nothing to do. Whether the signal is somebody speaking or another noise made by a car engine or a jet or something falling over or anything like that. So my definition in summary is the the processing of the auditory information from the ear to the auditory cortex is where the auditory processing happens.

Carrie: [00:15:22] Okay. That's a great definition. And so kind of going along with that though. And I'm just going to put this out here at the beginning because I think this this question always comes up. Um, it doesn't always come up. I think it's getting better, but there has been some conflicting views in the past about does auditory processing really exists? So can we just dispel this once and for all? Um, that that I guess statement that comes up.

Matt: [00:15:56] Absolutely. Yep, yep. So historically there have been some research studies published in the auditory processing field that were fine studies, but there were, there weren't like the the scientific gold standard. There was a lot of anecdotal information or data, and rightfully so. Some other critical professionals said, well, look, these studies really aren't the highest standard. We can't really draw too many conclusions from them. There's a lot of variables that aren't accounted for. And fair enough. But the conclusion that auditory processing doesn't exist was also not their statement. Their statement was we actually, as a profession, need to raise our standard on on how we do research. So, um, there is a class that we spoke about this before we hit record, um, that every audiologist goes through and that most, I would say over 90% would say is the most challenging course that you take in graduate school. And it's a class called psychoacoustics. And if you ask any audiologist, is psychoacoustics real? They will all say, of course it's real. It's how we hear. It's the study of what our brain does with the sound that's going into the ear canal. And, um, auditory processing is a just a synonym of psychoacoustics. That example that I gave just before about. Are you able to locate a sound in space? No. Nobody that has a functioning cortex and has been alive on Earth would say that's not a skill that humans have. Like, everybody can locate sound unless there's, you know, significant hearing loss involved or unilateral deafness or whatever.

Matt: [00:17:54] But like people that have normally developed hearing develop the ability to locate a sound in space. That's auditory processing, that's psychoacoustics. They're they're one and the same. Um, I never threaten this, but if if somebody would say, look, auditory processing doesn't happen, then psychoacoustics doesn't happen. And if you if that were true, then you could remove the eighth nerve from your ear to your cortex and nothing would change. But that would cause some pretty severe issues, I'm pretty certain. So. So, yeah. Um, to me, it's it's it's just not defined well. And that's a problem. Uh, there's been studies, not all. There's been a lot of really good studies as well, but there's been a few studies that were were highlighted a bit too much about how the scientific gold standard wasn't followed. But, uh, in recent years, even we've seen studies with the highest, um, uh, gold standard in research where there's a placebo, uh, double blind, um, control groups, all of all of what has been considered lacking up until now. So the, the scientific rigor is really coming along. So my if I had to do what do they call that, an elevator answer. If somebody says is auditory processing real and does it really matter? I would say, well, if it didn't matter, why does helping the auditory processing improve their lives? Like if you make it better, you see significant benefit. So if it didn't matter, why would that happen?

Carrie: [00:19:45] Yeah, that thank you for kind of helping to dispel that statement that seems to come up every once in a while to kind of going along with that. You mentioned like localization and like how an intact auditory processing system is important for just everyday life. What happens when an individual struggles with auditory processing? What do you see then?

Matt: [00:20:13] Okay, that's a great question. So in hearing, just like in vision, there's a lot of varied skills involved. Localization is probably the easiest one to give as an example there. And that's a very basic skill. Like we locate sound very low in our brainstem, as you know. So that's a very early neural skill. Um, the higher that you go in the brain, the more complicated and more complicated and more complicated the analyzes become, so that we can do what we're doing right now having a conversation. The more you understand on how much is happening in your brain, for you to be able to hear me utter a whole lot of sounds and understand the meaning of them is a phenomenally difficult task. And we just like we just think, oh, this is easy. What do you mean? We just naturally do this? But as a as a scientist and researcher on this, the more you drill down into what's happening, to make that easy is unbelievably complicated. So, um, what a lot of the research mine, as well as many others are, seem to indicate as of late. And Asha has this listed at their website as well. If you have some underdevelopment in areas of your auditory processing system or psychoacoustic system, those those deficits have recourse downstream from where the deficit lies. So what we're what we see are about three major red flags.

Matt: [00:22:05] The first is if there's an auditory processing deficit you were very likely to see just struggled classroom learning. So they're in a classroom. They're trying to to follow along. It's just not easy. And the the um there was a study done where they wanted to get students recruited for potential therapies. And they thought, well, if we if we recruit a lot of those that are struggling in the classroom and test them for this particular deficit because they're struggling, we'll probably have a higher incidence rate versus testing the ones that are absolutely the top of the class. The likelihood that they're have an auditory deficit is probably lower. So so the researchers tested the bottom 20% of the classroom for one auditory processing skill, the Dichotic listening test. And that showed that 50% of those 20%, the bottom 20% in the classroom, half of them had that dichotic listening deficit. Um, so that's where on the website, when you said around 10% or more have an it's based on that data that if you test the bottom 20%, half of them will struggle with with dichotic listening. Um, and then they went on to, to do some research on can we improve that? And I'll let the cat out of the bag. We can we can make that better.

Carrie: [00:23:48] Which is exciting, right.

Carrie: [00:23:51] Fantastic. Really.

Carrie: [00:23:52] But that can and that was one of my questions too. Um, a lot of our listeners, um, work with the pediatric population. And so you kind of indicated some of those red flags that you might see. Um, I don't know if there's any more, but about 10% of kids who are in classrooms could be like having some kind of auditory processing. And what you said about, you know, that, I mean, I, I was visualizing a foundation Basically, when you are talking about the auditory processing piece where, you know, if we don't remedy, like it's almost like building a house and, you know, a foundation, a strong foundation versus building a house on sand. Right? Like, there's a very much of a difference. And if we're not looking at that strong foundation first, then everything else is not going to be built up correctly. Correct?

Matt: [00:24:49] 100%. So I didn't even finish answering the question. So I'm glad you kept going. So the other two, uh, red flags that you will see in in these cases, a very high likelihood of an auditory deficit are children that are also struggling to develop language. Mhm. And lastly you you said the house the foundation part. So you cannot develop auditory language without auditory input. Like it's literally impossible. What won't happen. So you have to have intact auditory input to develop intact language. So language is nothing more than understanding the utterances of somebody speaking through the auditory system. Typically unless we're talking Braille or some different system of input.

Carrie: [00:25:42] Mhm.

Matt: [00:25:43] Beyond that what's built on language is reading. So if you don't have an intact language set you are going to struggle with reading. So if you see a struggling reader or somebody struggling with language or somebody struggling in the classroom, you're going to have a very high incidence of finding a significant auditory deficit in those individuals. Um, because I when I try to explain how when people say reading is auditory, it confuses people a lot because they think I thought reading was visual, like you use your eyes and that's true. You use your eyes to look at the the letters, but then you use your auditory system to assign sounds to the letters and then group the sounds into words. And then you use your language system to extract the meaning from those words. So when I say reading is auditory, if you look at the brain scans, there's a there's a higher activity in the auditory cortex than there is in the visual cortex. But it's a I would yes, it is a visual skill, but it's also an auditory skill. One of my favorite examples is if you read a quote or a text or a letter from somebody that you're really familiar with, you will often even read it in their voice, like you'll hear them reading to you through your phone. It's really I mean, it's it that's obviously an auditory, Um, event. Not a visual one, but it involves the eyes as well. So. So yeah, those those three are the the big downstream ripple effects. If your auditory system is not intact, how can you build higher level systems that are reliant on that base to give the information or to process the information upstream efficiently and effectively is really the point? Yeah.

Carrie: [00:27:45] Yeah. Great.

Carrie: [00:27:46] So kind of taking those red flags you talked about like students that may be having difficulty in the classroom, students that may have difficulty with any kind of language, you know, skills or processing or reading skills. Those are kind of would those then be maybe the red flags that an educator or a parent might see in their own child or a student? Um, to maybe make a referral or look more into that?

Matt: [00:28:16] Yes, absolutely. So I've done multiple studies now on this, and your listeners are probably going to be shocked. I was shocked as well. I was kind of under the impression that the in the profession, instead of what recent data show, that north of 10% of an elementary or primary school population has a deficit. We were thinking closer to 1%. So when we started seeing the numbers a lot more substantial, uh, it was very surprising. I was not expecting that. Um, the, uh, studies that we've done, we've done three of them currently, and we did a, did a vast testing of individuals that that were already diagnosed with a language delay or disorder and had reading difficulties. And of the studies. Two of them came back with 82% of these individuals that were struggling with language and reading had a significant auditory. So two of them had 82% and the third one had 83%. So this has been replicated three times. And if if you speech pathologist out there, if you've never done auditory processing work and you want to hold my feet to the fire on this and say, are you sure if I test my kids, I'm going to find like about eight out of ten of them have an auditory deficit. I will I will work with you to test your your clientele. It's and then I'll have another study up my sleeve to show the same thing. So yeah, I will I will if you're interested. Contact me and I will. I will work with you to to show you what I've seen again and again and again.

Carrie: [00:30:18] Yeah.

Carrie: [00:30:19] And that 10% is. Yeah. When I was in grad school, I mean, we were learning, like maybe 1%, maybe 2% of the population. And when you kind of put it that way, um, it's much more prevalent. And then we think about all of those students who are sitting in classrooms with these, you know, reading and language and classroom learning difficulties. And we haven't maybe touched that foundation yet. And, and discovered what, you know, the key point in that is but thinking about that, like, uh, I know and when I was in school, we learned like who? Like who should be tested for auditory processing. And I know that has changed a lot over the last, especially ten years. Can you maybe give a background of, you know who besides these red flag kids like what? What would a profile of someone that needs to be tested for auditory processing?

Carrie: [00:31:22] Okay.

Matt: [00:31:22] Yep, yep. So, um, I want to I want to start by saying what I've seen in the field since I graduated, which I will say is literally 20 years from now or ago. Um, so the profession has changed quite a bit. When I was going through grad school, the general consensus was there are children that are struggling with reading. Those might be children with dyslexia, or there might be children struggling with language. So those are your receptive language, kids. Um, and then there's a group that struggle with auditory processing. So those are your auditory processing kids. However, the studies have shown again and again and again that actually. So one of my favorite eye opening studies was out of England and they wanted to see what is the profile. So that's your question is what is what is the profile of somebody with an auditory deficit. What do they behave like. What are the what are the issues. And they so they did a group of children that had an APD diagnosis. And they questioned them with questionnaires. They questioned them just with um interview. They talked to the parents and the teachers just to get kind of a functional profile, okay. These kids with APD. And remember back when the study was done, there weren't really interventions. There were just labels. So you have an auditory processing deficit. How do you perform? And then they had another group of kids, um, that had a language disorder diagnosis or a language delay diagnosis. So two two separate groups. One had an auditory processing deficit.

Matt: [00:33:14] The other one had a language deficit. And then they they did these profiles of of strengths and weaknesses. And both groups presented identically in how they were showing difficulty. So back then we thought, oh language is one thing and your auditory processing is something completely different. And now we're refocusing and thinking actually the auditory processing deficit is causing these downstream delays because you need those earlier processes to occur correctly and efficiently for those higher level skills to actually be processed well. And what these researchers concluded was these two skills are related, not these are separate groups. So they found the reason they got an APD diagnosis versus a language delay diagnosis was who the parent was recommended to go see. If the parent said, my kiddo is really struggling and somebody said you should go see an audiologist, they got an APD diagnosis. If the parent was recommended, you should go see a speech language therapist. They got a language delay diagnosis. So the biggest variable in that study was the referral route. If you were referred to both, you would have probably got a diagnosis of both. Because language is auditory. Auditory occurs before the language. So they're literally hand in hand. So yeah. Um, so that was pretty exciting. So if there's struggles in the classroom, if there's struggles in noisier environments, if there's delays in language, if there's delays in reading, there's a very high chance that some of those lower auditory skills aren't developed, but I the exciting part is we can help develop those with targeted intervention.

Carrie: [00:35:17] Mhm.

Matt: [00:35:18] Acoustic pioneer and others, they just show fantastic results. It's really cool. We can fix it. Yay!

Carrie: [00:35:26] Yay!

Carrie: [00:35:26] And I can't wait to get into that part too. But before we get there, one other question I have about the testing part or like who to test would be can you just share? I mean, should we be testing like we we can't test a one year old? Well, I mean, maybe through electrophysiologic ways. Yeah. But, um, yeah, maybe just share a little bit about, like, ages and then, um, the other question I have would be like other like students who may have an additional diagnosis.

Carrie: [00:36:00] Mhm. Mhm.

Matt: [00:36:01] So that is fantastic. So the um. Previously. Historically. Uh non-physiological testing. So behavioral testing really started around age seven historically. Um, and that was based on the norms and how low the norms went. So you can't test anybody if you can't compare to normative data because you have no idea what these scores mean.

Carrie: [00:36:29] Mhm.

Matt: [00:36:30] Today, um, generally we're norm down to about age five for, for what I would call specific auditory processing deficits or psychoacoustic deficits, simply because the individual has to understand enough about the task that you can actually get a, get a reliable measurement. And some of those definitions or instructions just get too complicated for kiddos that are below five. So we know as a profession. The sooner that you find a concern, the the faster or the sooner that you intervene for that, the better result you see later down the road. Like if somebody has a, um, uh, an auditory deficit that you don't treat until ten, that's going to have longer term effects than if you treated them at six. However, below five, because it's really too tricky to get those auditory processing or psychoacoustic measures on those individuals, then you really sort of lean on the higher level checks like your language checks and just normal hearing check, because we still think a lot of these under developments can be due to like an undiagnosed Most otitis media or an occluded ear canal that nobody knew was occluded for a year or months. So, so normal hearing checks as well. But if there are language concerns at a three year old doing top down intervention or even some bottom up language intervention are still very helpful for for helping develop the early years skills. So, um, two things have been shown to be phenomenally useful for your clients exposure to very good language and exposure to music. Not loud crazy music, but just general music is a fantastic stimulation of the brain. It uses skills like localization, you know, like when you get that stereo going on, where the drum solo is coming out, the left speaker in the guitar or whatever you like to listen to piano, it's coming out of the other speaker.

Matt: [00:39:06] It's developing all of those skills. So, um, as a as a parent, we, uh, allow our children to use audio books pretty much as much as they want, because the more that you bombard that, that language system with good, solid language input, it is, it is. There's never too much good language to give to those. So, um, if I had concerns as a speech therapist or as a parent doing a language eval as young as you can and doing any bottom up language intervention that you can, um, that is appropriate, as well as exposing them to as much good language and music as possible, is the best thing you can do at that young age. So when they are older, five, six and up and we can test those more nuanced auditory processing areas. Um, hopefully they're going to be good to go by that point, because they've had enough of that stimulation that their brain can develop those skills early enough. But if not, hey, that's okay. We can we can focus more specifically the the higher or the older they get, the more developed they get. So um, so yeah, this is a we kind of again, we talk about that that baton handover between a speech speech language pathologist and an audiologist. And it's whoever put us together in graduate schools knew already that our professions should be side by side. Hearing and language go hand in hand.

Carrie: [00:40:46] Absolutely. So for so for a more specific like diagnoses or like testing about age five, there are other students That maybe should not be tested or should be included, that might have some additional needs or diagnosis.

Matt: [00:41:09] So I try to take as practical of approach as possible when I'm trying to determine who should be tested and who shouldn't. Um, if somebody is performing well, like they're they're doing well socially. They're doing well educationally. If you tested them and found a deficit, it doesn't seem to be impacting them. And we know from the studies that the incidence rates are far lower for those kiddos that are being very successful. But if they're already successful, do they really need an intervention? Even if you even if you did testing and found oh yeah, you do have a bit of a deficit here, we should fix that up. Well, fine. Like I'm not opposed to them getting intervention, but if they're already doing really well with language and reading and social environments in the classroom learning, then they're winning, you know. Good for you, buddy. I'm proud. That's great. Uh, but I think focusing on the ones that are struggling with language and reading, um, or classroom learning, those are the ones that really are swimming. You know, they're trying to keep their head above water. They're just doggy paddling through that information as much as they can. So if we give them some better skills to where they can really hone the language and the reading, uh, more rapidly and successfully, that's really the goal is to help those that are struggling the most.

Matt: [00:42:44] Now, there are some that, you know, you have cases that are multifaceted and there's there are neurological development issues and, um, uh, all sorts of other variables that that make, um, the auditory processing skill maybe not their top priority. You know, maybe mobility is is a limitation and they, they need physical therapy. Or there are times when even me would say, yeah, the auditory processing in this case is not your top priority. So, um, one of one of the approaches to to acoustic pioneer in particular, it was very early on before we released that, we decided, you know, what this these tools, this set of, of programs that we're trying to develop. The one thing that we can't replace with the computer program is a professional brain. We need we need speech therapists, and we need audiologists or educational psychologists to be involved, to make decisions like, okay, what are what are the areas of concern for this client or this student and what's the highest priority for them? Mhm. Um, so all of our programs require a brain like yours. Amazing. Dr. Spangler. So you can use the information available and then make the best case for how to move forward with that, with that student in school or with that client out of school. Um, and it's we will never replace that.

Matt: [00:44:31] That's always we need a professional to help us make those decisions. So, um, along with that. So sometimes the auditory processing is not the most important in a case, but other times it it could be the most important. So if you were a speech therapist working on a kiddo with their language and they're really struggling to develop that. If you haven't targeted the auditory deficit, your your progress in your language development is going to be hindered. Same with reading. If you're trying to develop reading skills in an individual and you don't address the auditory deficit, the the progress track is going to be a lot slower than if you do treat the auditory deficit. So it's um, I've heard multiple professionals start to get into it to see what happens. And they they tell me they go in these meetings and there's usually like a reading trajectory for success or whatever the skill, whatever the education skill is, spelling or math or whatever, they have these trajectories, like the way they're progressing, we expect them to be here by the end of the year. And then you put in some auditory deficit and those, those trajectories of predicted success increase. And they're like what? We we change the auditory system and now they're going to learn how to read faster. Yes that's right.

Carrie: [00:46:02] And that's so exciting right.

Carrie: [00:46:04] Fantastic.

Carrie: [00:46:05] It's really cool.

Matt: [00:46:06] When when you get to see those those cases, it's it's exciting. It's sort of, you know, hair on your arm like oh my gosh. It's really this is fantastic. Yay. We're doing good by our clients. And I think the more data that that we show, more more of the population has this issue than we anticipated.

Carrie: [00:46:30] Mhm.

Matt: [00:46:31] We can actually fix the deficit, which was that that was highly debated 20 years ago. Can we can know that there were many that said if there's a deficit you have a deficit. There's nothing you can do. So that's been shown to be not true. Mhm. Um, and if we fix the deficit You.

Carrie: [00:46:51] See.

Matt: [00:46:51] Life like real life changing skills improve in those individuals. So yeah, it's just fantastic time to to be in our profession. I'm loving it.

Carrie: [00:47:03] Yeah. No I it is it is fantastic. Is there a certain criteria like for diagnosing auditory processing. And do you call it a deficit. Do you call it a disorder. Does it does it really matter what you call it?

Matt: [00:47:23] Um this is a great question. So this is where our profession needs to really go back to the drawing board and come up with an accepted definition of auditory processing disorder. Um, I've tested many, many children. Uh, and I only apply a label of auditory processing Reprocessing disorder. If they're not receiving services in an education system or otherwise, that they would receive if I gave them that label. So with individuals that are already receiving special services because of a language disorder diagnosis, if we do some testing and discover there's also some auditory deficiencies in this in these students, then we I just call it a deficit at that point. Let's treat the deficit. Because when we do treat the deficit some months later, when the when the intervention is finished, when we retest it, the deficits are not there anymore. So I try to avoid applying the label of an auditory processing disorder because it seems kind of permanent. Whereas if we say deficit kind of lends a little bit more like this actually might be something that that is interminable or fixable or treatable, whereas disorder doesn't. So the current definition by both Ashton triple A of of criteria to qualify for an auditory processing disorder is very stringent and and um requires multi skills to be down and very significant results on both skills or more.

Matt: [00:49:14] Um and a lot of the science on who can benefit from intervention is uses criteria that's a lot less stringent. So I, I think we need to go back to the drawing board and not not so much. Ask what is the diagnostic criteria for a label. But ask who can receive significant benefit from intervention and what's that criteria. And use that more as a as a diagnostic criteria versus I'm just going to draw, you know, a very difficult score in multiple areas as the criteria. I so I know ASHA has altered their criteria, their recommended criteria a fair bit. But we need to have one of those good old audiology meet ups and say, look, we've done a lot of research in the last 5 to 10 years, whereas these criteria haven't been updated for longer than that. So we really need to to modernize our our criteria. In my humble opinion, I would I would love to be on that committee to to help make it where it's, it's a, it's an, it's a criteria that is going to highlight those that can really see benefit um, and not really include those that even if they have some concerns, they're really not going to see a whole lot of benefit from intervention. That's really the approach I would take if I could.

Carrie: [00:50:50] Yeah, no, that's good. And you can answer my question too, about that long standing like once diagnosed with a disorder, you know, auditory processing disorder, they have it for life. And that's not the case, which I think is, um, a good stopping point for like right this second, because I want to do part two of this podcast, which would be really we talk a lot about what auditory processing is and um, kind of the diagnosis and, you know, the testing piece of it and what happens. But I would like to do part two with what do we do next. What do you think about that Matt What do you think we can do it part two?

Matt: [00:51:37] That sounds really fun. I would love to join you again. That sounds great.

Carrie: [00:51:41] Okay.

Carrie: [00:51:43] Thank you for listening to part one of our series on auditory processing. I hope you found our discussion on the basics, red flags and the impact of auditory processing deficits. Insightful. Be sure to catch episode 70 where Dr. Barker and I will continue the conversation, focusing on next steps for managing auditory processing challenges. Don't forget to subscribe to the EmpowEAR Audiology podcast so you never miss an episode. If you're enjoying this show, please take a moment to leave a five star review and share it with your colleagues and friends.

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