Texas School Neuropsychology and Educational Services recommends these books for further understanding specific issues.

Explanation of Auditory and Visual Processing Disorders

  • Auditory Processing Disorder

    What is it?

     

    An auditory processing disorder interferes with an individual's ability to analyze or make sense of information taken in through the ears. This is different from problems involving hearing per se, such as deafness or being hard of hearing. Difficulties with auditory processing do not affect what is heard by the ear, but do affect how this information is interpreted, or processed by the brain.

    An auditory processing deficit can interfere directly with speech and language, but can affect all areas of learning, especially reading and spelling. When instruction in school relies primarily on spoken language, the individual with an auditory processing disorder may have serious difficulty understanding the lesson or the directions.

     

    Common areas of difficulty and some educational implications:

     

    Phonological awareness

     

    Phonological awareness is the understanding that language is made up of individual sounds (phonemes) which are put together to form the words we write and speak. This is a fundamental precursor to reading. Children who have difficulty with phonological awareness will often be unable to recognize or isolate the individual sounds in a word, recognize similarities between words (as in rhyming words), or be able to identify the number of sounds in a word. These deficits can affect all areas of language including reading, writing, and understanding of spoken language.

     

    Though phonological awareness develops naturally in most children, the necessary knowledge and skills can be taught through direct instruction for those who have difficulty in this area.

     

    Auditory discrimination

     

    Auditory discrimination is the ability to recognize differences in phonemes (sounds). This includes the ability to identify words and sounds that are similar and those which are different.

     

    Auditory memory

     

    Auditory memory is the ability to store and recall information which was given verbally. An individual with difficulties in this area may not be able to follow instructions given verbally or may have trouble recalling information from a story read aloud.

     

    Auditory sequencing

     

    Auditory sequencing is the ability to remember or reconstruct the order of items in a list or the order of sounds in a word or syllable. One example is saying or writing "ephelant" for "elephant."

     

    Auditory blending

     

    Auditory blending is the process of putting together phonemes to form words. For example, the individual phonemes "c", "a", and "t" are blended to from the word, "cat".

     

    Information was taken from http://www.ldonline.org/article/6390/

  • What to do if you suspect a problem

    The following suggestions are presented in a sequence which should help ensure that your concerns do not go ignored. Of equal importance, this sequence should help avoid setting off any premature alarms, which may not be in the child's best interests.

     

    Write down the reasons you suspect a problem might be present or developing, carefully documenting examples in which the concerning behavior is taking place.

     

    This will help in two ways. First, it will help confirm or alleviate your concerns. If there is cause for concern, it will help you get a more focused idea of where the difficulty lies. This list will also be helpful if further action or meetings with other professionals are necessary.

     

    Interventions:

     

    First, a few words about interventions in general. Interventions need to be aimed at the specific needs of the child. No two children share the same set of strengths or areas of weaknesses. An effective intervention is one that utilizes a child's strengths in order to build on the specific areas in need of development. As such, interventions need to be viewed as a dynamic and ever changing process. Although this may sound overwhelming initially, it is important to remember that the process of finding successful interventions becomes easier with time and as the child's learning approach, style, and abilities become more clear.

     

    The following examples provide some ideas regarding a specific disability. It is only a beginning, which is meant to encourage further thinking and development of specific interventions and intervention strategies.

     

    The following represent a number of common interventions and accommodations used with children in their regular classroom:

     

    Do not rely solely on an area of weakness.

     

    If instructions are given orally, try to supplement this with written or other visual cues. While it is important to address the area of need directly and try to build up areas of weakness, it is also necessary that the student be able to function successfully in the classroom. A simple accommodation like backing up verbal directions with visual or written cues is one way to facilitate this.

     

    Keep the area of difficulty in mind.

     

    Simplifying verbal directions, slowing the rate of speech, and minimizing distractions can make a big difference to a person with auditory processing difficulties.

     

    Plan specific activities for the areas of difficulty.

     

    There are many activities that can help build auditory processing skills, whether it be in the area of phonological awareness, auditory discrimination, or any of the other areas in this realm. Rhyming games, for example, can help build phonological awareness as well as discriminating between similar and different sounds. Sorting games can help build auditory memory, as the number of variables and steps involved in the sorting can be easily controlled to adjust the level of difficulty.

     

    Information was taken from http://www.ldonline.org/article/6390/

  • Visual Processing Disorder

    Common areas of difficulty and some educational implications:

    Spatial relation

     

    This refers to the position of objects in space. It also refers to the ability to accurately perceive objects in space with reference to other objects.

    Reading and math are two subjects where accurate perception and understanding of spatial relationships are very important. Both of these subjects rely heavily on the use of symbols (letters, numbers, punctuation, math signs). Examples of how difficulty may interfere with learning are in being able to perceive words and numbers as separate units, directionality problems in reading and math, confusion of similarly shaped letters, such as b/d/p/q. The importance of being able to perceive objects in relation to other objects is often seen in math problems. To be successful, the person must be able to associate that certain digits go together to make a single number (ie, 14), that others are single digit numbers, that the operational signs (+,,x,=) are distinct from the numbers, but demonstrate a relationship between them. The only cues to such math problems are the spacing and order between the symbols. These activities presuppose an ability and understanding of spatial relationships.

     

    Visual discrimination

     

    This is the ability to differentiate objects based on their individual characteristics. Visual discrimination is vital in the recognition of common objects and symbols. Attributes which children use to identify different objects include: color, form, shape, pattern, size, and position. Visual discrimination also refers to the ability to recognize an object as distinct from its surrounding environment.

    In terms of reading and mathematics, visual discrimination difficulties can interfere with the ability to accurately identify symbols, gain information from pictures, charts, or graphs, or be able to use visually presented material in a productive way. One example is being able to distinguish between an /nl and an Imp, where the only distinguishing feature is the number of humps in the letter. The ability to recognize distinct shapes from their background, such as objects in a picture, or letters on a chalkboard, is largely a function of visual discrimination.

     

    Visual closure

     

    Visual closure is often considered to be a function of visual discrimination. This is the ability to identify or recognize a symbol or object when the entire object is not visible.

    Difficulties in visual closure can be seen in such school activities as when the young child is asked to identify, or complete a drawing of, a human face. This difficulty can be so extreme that even a single missing facial feature (a nose, eye, mouth) could render the face unrecognizable by the child.

     

    Object recognition (Visual Agnosia)

     

    Many children are unable to visually recognize objects which are familiar to them, or even objects which they can recognize through their other senses, such as touch or smell. One school of thought about this difficulty is that it is based upon an inability to integrate or synthesize visual stimuli into a recognizable whole. Another school of thought attributes this difficulty to a visual memory problem, whereby the person can not retrieve the mental representation of the object being viewed or make the connection between the mental representation and the object itself.

    Educationally, this can interfere with the child's ability to consistently recognize letters, numbers, symbols, words, or pictures. This can obviously frustrate the learning process as what is learned on one day may not be there, or not be available to the child, the next. In cases of partial agnosia, what is learned on day one, "forgotten" on day two, may be remembered.

     

    Whole/part relationships

     

    Some children have a difficulty perceiving or integrating the relationship between an object or symbol in its entirety and the component parts which make it up. Some children may only perceive the pieces, while others are only able to see the whole. The common analogy is not being able to see the forest for the trees and conversely, being able to recognize a forest but not the individual trees which make it up.

    In school, children are required to continuously transition from the whole to the parts and back again. A "whole perceiver", for example, might be very adept at recognizing complicated words, but would have difficulty naming the letters within it. On the other hand, "part perceivers" might be able to name the letters, or some of the letters within a word, but have great difficulty integrating them to make up a whole, intact word. In creating artwork or looking at pictures, the "part perceivers" often pay great attention to details, but lack the ability to see the relationship between the details. "Whole perceivers", on the other hand, might only be able to describe a piece of artwork in very general terms, or lack the ability to assimilate the pieces to make any sense of it at all. As with all abilities and disabilities, there is a wide range in the functioning of different children.

     

    Information was taken from http://www.ldonline.org/article/6390/

  • What to do if you suspect a problem

    The following suggestions are presented in a sequence which should help ensure that your concerns do not go ignored. Of equal importance, this sequence should help avoid setting off any premature alarms, which may not be in the child's best interests.

     

    Write down the reasons you suspect a problem might be present or developing, carefully documenting examples in which the concerning behavior is taking place.

     

    This will help in two ways. First, it will help confirm or alleviate your concerns. If there is cause for concern, it will help you get a more focused idea of where the difficulty lies. This list will also be helpful if further action or meetings with other professionals are necessary.

     

    Interventions

     

    First, a few words about interventions in general. Interventions need to be aimed at the specific needs of the child. No two children share the same set of strengths or areas of weaknesses. An effective intervention is one that utilizes a child's strengths in order to build on the specific areas in need of development. As such, interventions need to be viewed as a dynamic and ever changing process. Although this may sound overwhelming initially, it is important to remember that the process of finding successful interventions becomes easier with time and as the child's learning approach, style, and abilities become more easily seen.

     

    The following examples provide some ideas regarding a specific disability. It is only a beginning which is meant to encourage further thinking and development of specific interventions and intervention strategies.

     

    The following represent a number of common interventions and accommodations used with children in their regular classroom:

     

    For Readings

     

    Enlarged print for books, papers, worksheets or other materials which the child is expected to use can often make tasks much more manageable. Some books and other materials are commercially available; other materials will need to be enlarged using a photocopier or computer, when possible.

    There are a number of ways to help a child keep focused and not become overwhelmed when using painted information. For many children, a "window" made from cutting a rectangle in an index card helps keep the relevant numbers, words, sentences, etc. in clear focus while blocking out much of the peripheral material which can become distracting. As the child's tracking improves, the prompt can be reduced. For example, after a period of time, one might replace the "window" with a ruler or other straightedge, thus increasing the task demands while still providing additional structure. This can then be reduced to, perhaps, having the child point to the word s/he is reading with only a finger.

     

    For Writing

     

    Adding more structure to the paper a child is using can often help him/her use the paper more effectively. This can be done in a number of ways. For example, lines can be made darker and more distinct. Paper with raised lines to provide kinesthetic feedback is available. Worksheets can be simplified in their structure and the amount of material which is contained per worksheet can be controlled. Using paper which is divided into large and distinct sections can often help with math problems.

     

    Teaching Style

     

    Being aware and monitoring progress of the child's skills and abilities will help dictate what accommodations in classroom structure and/or materials are appropriate and feasible. In addition, the teacher can help by ensuring the child is never relying solely on an area of weakness, unless that is the specific purpose of the activity. For example, if the teacher is referring to writing on a chalkboard or chart paper, s/he can read aloud what is being read or written, providing an additional means for obtaining the information.

     

    Information was taken from http://www.ldonline.org/article/6390/

Being aware of developmental milestones may aid you in detecting if there is a problem or an area that your child may need encouragement.

Developmental Milestones

  • Adaptive

    Adaptive skills incorporate the area of self-help skills such as eating, drinking and dressing.

     

    By one:

    feeds self cracker

    holds cup with two hands; drinks with assistance

    holds out arms and legs while being dressed

     

    Between ages one and two:

    uses spoon, spilling little

    drinks form cup with one hand, unassisted\d

    chews food

    unzips large zipper

    indicates toilet needs

    removes shoes, socks, pants, sweater

     

    Between ages two and three:

    uses spoon, little spilling

    gets drink form fountain or faucet independently

    opens door by turning handle

    takes off coat

    puts on coat with assistance

    washes and dries hands with assistance

     

    Between ages three and four:

    pours well form small pitcher

    spreads soft butter with knife

    buttons and unbuttons large buttons

    washes hands independently

    blows nose when reminded

    uses toilet independently

     

    Between ages four and five:

    Cuts easy foods with a knife

    laces shoes

     

    Between ages five and six:

    dresses self completely

    ties bow

    brushes teeth independently

    crosses streets safely

  • Cognitive

    By one:

    follows moving object with eyes

    recognizes differences among people; responds to strangers by crying or staring

    responds to and imitates facial expressions of others

    responds to very simple directions

    imitates gestures and actions

    puts small objects in and out of container with intention

     

    Between one and two:

    imitates actions and words of adults

    understands and follows simple, familiar directions

    responds to words or commands with appropriate action

    is able to match two similar objects

    looks at storybook pictures with an adult, naming or pointing to familiar objects on request

    recognizes difference between you and me

    has very limited attention span

    accomplishes primary learning through own exploration

     

    Between two and three:

    responds to simple directions

    selects and looks at picture books, names pictured objects, and identifies several objects within one picture

    matches and uses associated objects meaningfully

    stacks rings on peg in order of size

    recognized self in mirror, saying baby, or own name

    can talk briefly about what he/she is doing; imitates adult actions

    has limited attention span; learning is through exploration and adult direction

    is beginning to understand functional concepts of familiar objects and part/whole concepts

     

    Between three and four:

    recognizes and matches six colors

    intentionally stacks blocks or rings in order of size

    draws somewhat recognizable picture that is meaningful to child if not to adult; names and briefly explains picture

    asks questions for information: why and how questions requiring simple answers

    knows own age

    knows own name

    has short attention span; learns through observing and imitating adults and by adult instruction and explanation; is very easily distracted

    has increased understanding of concepts of the functions and grouping of objects and part/whole

    begins to be aware of past and present

     

    Between four and five:

    plays with words: creates own rhyming words, says or makes up words having similar sounds

    points and names four to six colors

    matches pictures of familiar objects

    draws a person with two to six recognizable parts, such as head, arms, and legs; can name or match drawn parts to own body

    draws, names, and describes recognizable pictures

    rote counts to five, imitating adult

    knows own street and town

    has more extended attention span; learns through observing and listening to adults, as well as through exploration; is easily distracted

    has increased understanding of concepts of function, time, part/whole relationships; function or use of objects may be stated in addition to names of objects

    time concepts are expanding; can talk about yesterday or last week, about today, and about what will happen tomorrow

     

    Between five and six:

    retells story from picture book with reasonable accuracy

    names some letters and numerals

    rote counts to ten

    sorts objects by single characteristics

    is beginning to use accurately time concepts of tomorrow and yesterday

    uses classroom tools meaningfully and purposefully

    begins to relate clock time to daily schedule

    attention span increases noticeably; learns through adult instruction; when interested, can ignore distractions

    concepts of function increase as well as understanding of why things happen; time concepts are expanding into an understanding of the future in terms of major events

  • Language

    By age one

    Milestones

     

    Recognizes name

    Says 2-3 words besides "mama" and "dada"

    Imitates familiar words

    Understands simple instructions

    Recognizes words as symbols for objects: Car - points to garage, cat - meows

     

    Activities to encourage your child's language

     

    Respond to your child's coos, gurgles, and babbling

    Talk to your child as you care for him or her throughout the day

    Read colorful books to your child every day

    Tell nursery rhymes and sing songs

    Teach your child the names of everyday items and familiar people

    Take your child with you to new places and situations

    Play simple games with your child such as "peek-a-boo" and "pat-a-cake"

     

    Between one and two

    Milestones

     

    Understands "no"

    Uses 10 to 20 words, including names

    Combines two words such as "daddy bye-bye"

    Waves good-bye and plays pat-a-cake

    Makes the "sounds" of familiar animals

    Gives a toy when asked

    Uses words such as "more" to make wants known

    Points to his or her toes, eyes, and nose

    Brings object from another room when asked

     

    Activities to encourage your child's language

     

    Reward and encourage early efforts at saying new words

    Talk to your baby about everything you're doing while you're with him

    Talk simply, clearly, and slowly to your child

    Talk about new situations before you go, while you're there, and again when you are home

    Look at your child when he or she talks to you

    Describe what your child is doing, feeling, hearing

    Let your child listen to children's records and tapes

    Praise your child's efforts to communicate

     

    Between two and three

    Milestones

     

    Identifies body parts

    Carries on 'conversation' with self and dolls

    Asks "what's that?" And "where's my?"

    Uses 2-word negative phrases such as "no want".

    Forms some plurals by adding "s"; book, books

    Has a 450 word vocabulary

    Gives first name, holds up fingers to tell age

    Combines nouns and verbs "mommy go"

    Understands simple time concepts: "last night", "tomorrow"

    Refers to self as "me" rather than by name

    Tries to get adult attention: "watch me"

    Likes to hear same story repeated

    May say "no" when means "yes"

    Talks to other children as well as adults

    Solves problems by talking instead of hitting or crying

    Answers "where" questions

    Names common pictures and things

    Uses short sentences like "me want more" or "me want cookie"

    Matches 3-4 colors, knows big and little

     

    Activities to encourage your child's language

     

    Repeat new words over and over

    Help your child listen and follow instructions by playing games: "pick up the ball," "Touch Daddy's s nose"

    Take your child on trips and talk about what you see before, during and after the trip

    Let your child tell you answers to simple questions

    Read books every day, perhaps as part of the bedtime routine

    Listen attentively as your child talks to you

    Describe what you are doing, planning, thinking

    Have the child deliver simple messages for you (Mommy needs you, Daddy )

    Carry on conversations with the child, preferably when the two of you have some quiet time together

    Ask questions to get your child to think and talk

    Show the child you understand what he or she says by answering, smiling, and nodding your head

    Expand what the; child says. If he or she says, "more juice," you say, "Adam wants more juice."

     

    Between three and four

    Milestones

     

    Can tell a story

    Has a sentence length of 4-5 words

    Has a vocabulary of nearly 1000 words

    Names at least one color

    Understands "yesterday," "summer", "lunchtime", "tonight", "little-big"

    Begins to obey requests like "put the block under the chair"

    Knows his or her last name, name of street on which he/she lives and several nursery rhymes

     

    Activities to encourage your child's language

     

    Talk about how objects are the same or different

    Help your child to tell stories using books and pictures

    Let your child play with other children

    Read longer stories to your child

    Pay attention to your child when he's talking

    Talk about places you've been or will be going

     

    Between four and five

    Milestones

     

    Has sentence length of 4-5 words

    Uses past tense correctly

    Has a vocabulary of nearly 1500 words

    Points to colors red, blue, yellow and green

    Identifies triangles, circles and squares

    Understands "In the morning" , "next", "noontime"

    Can speak of imaginary conditions such as "I hope"

    Asks many questions, asks "who?" And "why?"

     

    Activities to encourage your child's language

     

    Help your child sort objects and things (ex. things you eat, animals. . )

    Teach your child how to use the telephone

    Let your child help you plan activities such as what you will make for Thanksgiving dinner

    Continue talking with him about his interests

    Read longer stories to him

    Let her tell and make up stories for you

    Show your pleasure when she comes to talk with you

     

    Between five and six

    Milestones

     

    Has a sentence length of 5-6 words

    Has a vocabulary of around 2000 words

    Defines objects by their use (you eat with a fork) and can tell what objects are made of

    Knows spatial relations like "on top", "behind", "far" and "near"

    Knows her address

    Identifies a penny, nickel and dime

    Knows common opposites like "big/little"

    Understands "same" and "different"

    Counts ten objects

    Asks questions for information

    Distinguished left and right hand in herself

    Uses all types of sentences, for example "let's go to the store after we eat"

     

    Activities to encourage your child's language

     

    Praise your child when she talks about her feelings, thoughts, hopes and fears

    Comment on what you did or how you think your child feels

    Sing songs, rhymes with your child

    Continue to read longer stories

    Talk with him as you would an adult

    Look at family photos and talk to him about your family history

    Listen to her when she talks to you

  • Motor

    There are two categories within the area of motor skills: gross motor and fine motor. Gross motor skills deals with large muscle groups such as walking. Fine motor incorporate the small muscles such as writing.

     

    By age one

     

    Gross Motor

     

    sits without support

    crawls

    pulls self to standing position and stands unaided

    walks with aid

    rolls a ball in imitation of adult

     

    Fine Motor

     

    reaches, grasps, puts object in mouth

    picks things up with pincer grasp (thumb and one finger)

    transfers object from one hand to the other

    drops and picks up toy

     

     

    Between ages one and two

     

    Gross Motor

     

    walks alone

    walks backwards

    picks up toys from floor without falling

    pulls toys, pushes toys

    seats self in child size chair

    walks up and down stairs with hand held

    moves to music

     

    Fine Motor

    builds tower of three small blocks

    puts four rings on stick

    places five pegs in pegboard

    turns pages two or three at a time

    scribbles

    turns knobs

    throws small ball

    paints with whole arm movement, shifts hands, makes strokes

     

     

    Between ages two and three

     

    Gross Motor

     

    runs forward well

    jumps in place with two feet together

    stands on one foot (with aid)

    walks on tiptoe

    kicks a ball forward

     

    Fine Motor

    strings four large beads

    turns single pages

    snips with scissors

    holds crayon with thumb and fingers (not fist)

    uses one hand consistently in most activities

    imitates circular, vertical, horizontal strokes

    paints with some wrist action; makes dots, lines, circular strokes

    rolls, pounds, squeezes, and pulls clay

     

     

    Between ages three and four

     

    Gross Motor

     

    runs around obstacles

    walks on a line

    balances on one foot for five to ten seconds

    hops on one foot

    pushes, pulls, steers wheeled toys

    rides tricycle

    uses slide independently

    jumps over six inch high object and lands on both feet together

    throws ball overhead

    catches a bounce ball

     

    Fine Motor

     

    builds tower of nine small blocks

    drives nails and pegs

    copies circle

    imitates cross

    manipulates clay material (rolls balls, snakes, cookies)

     

     

    Between ages four and five

     

    Gross Motor

     

    walks backward toe-heel

    jumps forward 10 times without falling

    walks up and down stair independently, alternating feet

    turns somersault

     

    Fine Motor

     

    cuts on line continuously

    copies cross

    copies square

    prints some capital letters

     

     

    Between ages five and six

     

    Gross Motor

     

    runs lightly on toes

    walks on balance beam

    can cover 2 meters hopping

    skips on alternate feet

    jumps rope

    skates

     

    Fine Motor

     

    cuts out simple shapes

    copies triangle

    traces diamond

    copies first name

    prints numerals 1 to 5

    colors within lines

    has adult grasp of pencil

    had handedness well established

    pastes and glues appropriately

  • Social Skills

    By one:

     

    smiles spontaneously

    responds differently to strangers than to familiar people

    pays attention to own name

    responds to no

    copies simple actions of others

    Between ages one and two:

    recognizes self in mirror or picture

    refers to self by name

    plays by self; initiates own play

    imitates adult behaviors in play

    helps put things away

     

    Between ages two and three:

     

    plays near other children

    watches other children; joins briefly in their play

    defends own possessions

    begins to play house

    symbolically uses objects, self in play

    participates in simple group activity

    knows gender identity

     

    Between ages three and four:

     

    joins in play with other children; begins to interact

    shares toys; takes turns with assistance

    begins dramatic play, acting out whole scenes

     

    Between ages four and five:

     

    plays and interacts with other children

    dramatic play is closer to reality, with attention paid to detail, time, and space

    plays dress-up

    shows interest in exploring sex differences

     

    Between ages five and six:

     

    chooses own friends

    plays simple table games

    plays competitive games

    engages in cooperative play with other children involving group decisions, role assignments, fair play

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