How can you recognize AVWS in children?

Typical signs include difficulty concentrating, trouble remembering verbal instructions or rhymes, and confusing sounds that sound similar. Affected children also often have difficulty pinpointing the source of a sound and quickly become restless in noisy environments. AVWS is frequently accompanied by reading and spelling difficulties.

How is AVWS diagnosed?

First, an ENT specialist determines whether the hearing problems are caused by a condition within the ear itself. If the specialist rules out such a cause, further evaluation is conducted by a pediatric audiologist or at a specialized clinic. Only there can a diagnosis of AVWS be made.

Is AVWS curable, and how is it treated?

AVWS cannot be cured medically, but significant improvements can be achieved through targeted exercises. Speech-language pathologists or occupational therapists typically work with children to improve their attention and memory, often using computer-assisted methods. In addition, daily auditory therapy helps ensure that affected children have similar developmental opportunities as healthy children.

What can parents do to support their child with AVWS at school?

A designated seat near the teacher—ideally in the front row—makes it much easier to follow along in class. It’s also important to inform teachers about the AVWS diagnosis and to encourage close communication between therapists and the school. Special headphones or a microphone for the teacher can also help filter out background noise.

Auditory Processing and Perception Disorder

Q: What is an auditory processing and perception disorder (APPD)?

In AVWS, the ear itself is not damaged, but the brain does not process what is heard correctly. The disorder affects about 2 to 3 percent of all children, with boys being affected twice as often as girls. Affected children often have difficulty locating sounds or distinguishing between similar sounds.

Recognizing AVWS in Children

In auditory processing and perception disorder (APPD), the ear itself is not damaged, but what is heard is not processed correctly by the brain—the disorder affects about 2 to 3 percent of all children, with boys being affected twice as often as girls.
Children with this condition often have difficulty locating sounds, distinguishing between similar sounds, or concentrating in noisy environments, which frequently leads to reading and spelling problems as well.
Even though AVWS is medically incurable, speech-language pathologists or occupational therapists can achieve significant improvements through targeted exercises and audio therapy—and having a designated seat close to the teacher also helps in the daily school routine.

Is your child—or the child of friends or family members—often distracted or unable to concentrate? Do they have trouble remembering verbal instructions or tasks, as well as rhymes? Do they confuse sounds that sound similar—both when speaking and when writing? If so, the cause of these symptoms may be an auditory processing and perception disorder (APPD). Children with this condition also have difficulty pinpointing where a sound is coming from; they quickly become restless and are easily distracted. In addition, these children often struggle to write without mistakes.

If these symptoms are noticed in children, it is essential to contact an ENT specialist or a clinic specializing in these issues to determine the underlying cause. During the initial consultation with a specialist or clinic, it is always important to determine whether the hearing problems in young patients are potentially caused by issues within the ear and whether hearing aids could provide a solution. If the ENT specialist rules out causes related to the ear, patients should consult a pediatric audiologist—an ENT specialist who focuses on hearing disorders—or a specialized clinic to determine whether they may be suffering from AVWS.

What is an auditory processing and perception disorder?

With AVWS, patients have trouble hearing even though their ears aren’t damaged. The hearing loss stems from the fact that what they hear isn’t processed properly. “Imagine a highway that’s still under construction—the cars can’t move forward there either. It’s the same with information—it doesn’t reach your son’s brain because the synapses haven’t formed yet,” the speech therapist explained to me back then when my son was diagnosed with AVWS, says a mother whose child is affected.

An overview of research on the prevalence of AVWS shows that this condition occurs in about two to three percent of all children, with boys being affected twice as often as girls. This diagnosis is also found among adults; for example, about ten to 20 percent of all older adults have AVWS.

What are the consequences of AVWS in school?

At school, AVWS can quickly lead to fatigue and difficulties with learning and concentration, especially when the classroom is noisy. Many children who suffer from an auditory processing and perception disorder also have a reading and spelling disorder. This is because if they do not understand words correctly, they cannot spell them correctly either.

Depending on which specific areas of information processing are particularly affected by the auditory processing and perception disorder, additional problems may arise. For example, if children have a difficulty with sound discrimination, they are unable to filter out specific information from a multitude of sounds.

If they have a phonological discrimination disorder, they cannot distinguish between similar sounds or syllables, such as “po” and “bo.” “Our son had a combination of these weaknesses: When he took a dictation in the classroom, twenty mistakes were not uncommon. But when the German teacher sat down with him alone in a quiet place, he made significantly fewer mistakes,” explains the mother of an AVWS elementary school student.

Constantly changing seats in the classroom is counterproductive

Frequently rearranging children’s seats in the classroom—a practice commonly used in first grade to encourage interaction among the children and help them get to know one another better—is very harmful for children with auditory processing and perception disorders and should be avoided. This is because these students need about two weeks to get used to the new ambient sounds at their new seats. And due to their difficulties with sound discrimination, it is already very taxing for children with AVWS to follow the lesson at all.

How is AVWS treated?

Even though there is no medical cure for auditory processing and perception disorders, treatment can help patients learn compensatory strategies that enable them to better remember what they hear. For young patients in particular, there are various therapy programs that are typically conducted by speech-language pathologists, but also by occupational therapists. The exercises typically focus on the affected child’s attention and memory. Many of the exercises used to treat auditory processing and perception disorders are performed on a computer; they train specific auditory perceptions.

In addition, there are also treatment options involving auditory therapy exercises that children should do—ideally every day. With these exercises, they gain the same developmental opportunities as healthy children, and their problems at school generally diminish. “Fortunately, thanks to a year of auditory therapy with a speech-language pathologist and a few minutes of daily practice, our son is now doing well in school,” says the concerned mother.

Since AVWS therapy can significantly improve quality of life, it is all the more important to consult a clinic or specialist early on. There, you can immediately receive an overview of possible interventions, and the problems can be greatly reduced.

Get an overview of the challenges your child faces due to AVWS.
Inform the teachers that your child’s problems have medical causes, explain AVWS, and provide everyone affected by the situation with an overview of potential challenges.
Ask that your child be assigned a permanent seat in the classroom.
Ideally, the child should sit in the front row directly in front of the teacher and not next to any loud children.
Encourage close contact and communication between the speech-language pathologists or occupational therapists and the teachers to discuss your child’s current status and progress, as well as what should be the focus in the coming weeks.
Encourage your child to speak up if the listening conditions in the classroom are poor.
Suggest that the teacher use a microphone and that your child wear special headphones or hearing aids so that background noise can be filtered out and comprehension made easier.
Check with the homeroom teacher to see if the school can provide AVWS accommodations.

Even if your child has a hearing loss, school isn’t always easy. In our article “School Days with a Hearing Aid,” 22-year-old Cindy describes her experience using her hearing aids at school.

You can also find more information about hearing problems, medical causes, symptoms, and treatment options using hearing aids on the various subpages of our website. In our main menu, you’ll find an overview of hearing aid types, hearing aid styles, and the benefits of hearing aids. From there, you can browse through all of our expert articles and blog posts on topics such as experiences with hearing aids and how to support loved ones with hearing problems.