A uditory: Auditory Processing Disorders in children with Autism and PDD:
The auditory system needs to interpret all the sounds of spoken language and attach linguistic meaning to them. For example a dog is able to hear as well or better than humans, however the dogs' ear isn't able to separate the speech stream into meaningful words that he can understand. This requires auditory perception and auditory processing; together they provide the foundation for understanding language. Most children with Autism/PDD have significant auditory processing disorders, and this fact alone contributes significantly to their language delays.


Our ability to analyze sound starts to develop in the womb and makes rapid progress during the first two years of life. In the womb the fetus is learning language largely from hearing his mother's voice. The baby first learns to tune into salient sounds and ignore background noise. During this stage he learns to recognize all the sounds (phonemes) that make up language. With an ear already attuned in listening to language sounds, the baby is ready at birth to make rapid progress in attaching meaning to the sounds he hears.


The ability to analyze sounds accurately and rapidly is crucial to language development. The baby's ear must recognize the blend of the sounds " U and P" to mean the action of rising. He must do this rapidly in order to listen to the rest of the sentence, which may ask him to "stand up" or to "pick up the toy". Children with Autism/PDD have difficulty in multiple areas of auditory processing, including tuning in to the primary message while ignoring background noise, as well as accurately and rapidly analyzing sound. If these processes are not working accurately it is very difficult for children with Autism and PDD to develop language.

L evel of Processing Disorder:

Motor Planning:

  • Severe: Interacts with objects primarily for sensory and motor properties. No imitative actions or purposeful gesturing. Largely expresses self through pleasure and distress.
  • Less Severe: Plays in single actions, such as lines up cars. Plays with simple cause and effect toys. Imitates single acts on request, such as touch a body part.
  • Moderate: Play with simple construction toys. Learns from repeated hand over hand demonstration. Starts to attempt simple multi stepped tasks such as simple clothing.
  • Milder: Simple pretend play such as feeding the baby doll or putting the toy people on the swing. Attempt to draw purposefully. Begins to play games with simple rule such as holding hands and going in a circle. Uses object functionally comb for hair etc.
  • Mild: Starts to attempts most activities appropriate for his/her age, though sequencing and qualitative problems are observed. Not afraid to try new activities.
  • Normal: Performs developmentally appropriate task with good organization and execution. Levels of Processing Disorder:

    Auditory Processing:

  • Severe: Does not register spoken language. Does not respond to name being called. Doesn't imitate sounds or words. No spontaneous or purposeful language.
  • Less Severe: Limited vocabulary of single words on request. Occasional purposeful language when highly motivated.
  • Moderate: Begins to respond to name consistently. Follows some simple directions. Imitates and echo sounds more readily. May use some scripted language purposefully.
  • Milder: Understands more language, Uses gesture to communicate need and to compliment speech. Comprehends and carries out simple directions.
  • Mild: Understands questions such as "Did you go to school? Starts to understand direction with two or more ideas. Organizes language with two or more ideas.
  • Normal: Understands and makes logical bridges between ideas. Understands verbs and uses plurals and prepositions. Starts to ask why questions. Can relate experiences from recent past.

    • W hat changes to expect when doing the listening training.

    Responses vary from child to child depending on the state of self-regulation. If the child is over-reactive he may become calmer and if he is under-reactive he may become more alert. The child will appear more focused and more purposeful in his or her behavior. Often in the early stages there is improved eye contact. Parents report that their children become more affectionate. They seek their parents out and want to join in on more family activities. Often they show a keener interest in their parents' faces. They attempt to study the face as if trying to figure out how the parent's mouth is working. They also show more interest in themselves, studying themselves in the mirror. They begin to imitate gestures and sounds more readily. They show more awareness of their environment. They will start to notice things they seemed oblivious to before. Some of the sensory sensitivities that were especially extreme will start to diminish.


    If the child is non-verbal, he will start to babble more. He will start to make vocalizations the families have not heard previously. Parents will notice that the child responds to his/her name more readily. He may hear words that he can now recognize. If the child is already verbal the family will notice more and increasingly complex phrases. The child will repeat words more readily. He will start to use words spontaneously that he previously had only used rotely. He will demonstrate that he understands more of what is being said by following directions more readily. Communication becomes more purposeful as well as more interactive. Relationships become more of a two-way street.


    Parents describe it as an opening to the world. Not only do their ears open, but also their eyes, and the rest of their senses. At the same time that expressive and receptive language improves, other behavioral changes are observed. There is more purposefulness in their behavior. Children who never played with toys seem to better understand how they work. They understand how things relate to each other. They start to understand prepositions, over, under, behind, besides, and in-front of for the first time. They are learning more readily through imitation and start to follow verbal directions. We also see the children start to play symbolically for the first time - making the toy car go to the store, for example.


    Often there is a change in emotional affect. Children will be observed to be less in their own world and more willing to join our world. They start to develop words that give them more control of their environment. This helps to ease the tremendous sense of frustration they have. In understanding more of what is being said to them, they can be reasoned with and tend to become more flexible and better adjusted in their handling of transitions. As children start to develop a sense of control and mastery over their bodies, they start to feel more confident and their self-esteem improves. With more internal control they develop a greater sense of autonomy and independence. Overall they are happier children.


    These are some of the changes we have seen; yet they vary from child to child and are therefore difficult to predict. While we cannot predict exact changes in a particular child, we are able to observe particular patterns and styles of progress. Counseling throughout the program helps families maximize new behaviors, skills, and communication styles that emerge in their children.