Monday, June 28, 2010

Auditory Processing Disorder: Me and the Work Place

As Rosie O'Donnel's son will find out later in life,  children with auditory processing disorder do grow up to become adults.  There isn't much written about adaptations needed for adults with APD and the success that people have found trying to get workplace accomodations.  So I've got to roll my own. I found this information at APDUK, an Auditory Processing Disorder (APD) organization in Great Britain.  The colored passages describe some ideas for an APD IEP (Individual Education Plan) that I am modifying to get some ideas for an ADP IWP (Individual Work Plan).

Always ensure the learner with APD is looking at you when you speak to them this allows them to lip-read more easily, a common strategy in those with APD, and to ensure they know you are talking to them.
Me:  I think this will work and I will need to work on stopping what I am doing and paying attention to other people
     Speak clearly and ensure they have understood what you have said, not just by repeating it back to you, which can be done without comprehension.
Me:  I am going to have to play around with this and see what I tend to miss.
     Seat the learner with APD at the front of the class to allow them to lip-read what the teacher says more easily.
Me:  Yup.  Need to change to get there 15 minutes early so I can choose my seat.  I hate showing up early so this will have to change
     Ensure that the learner has a clear view of any board used to provide written information.
Me:  Ditto
     Always provide written information on the board when speaking and always provide written additional instructions on paper for the learner to refer to when they are attempting a piece of work.                                

This will ensure :-

(i)   that the learner has visual reinforcement of the oral instructions, should they forget or experience a delay in processing the information, and transferring the instructions to the kinaesthetic, the action of performing the task.

(ii)  that the learner is given a sense of security in an area that has previously been a situation of failure.

    Try to explain the purpose of the task you want the learner to perform, as many APDs are visual spatial learners who respond better to the whole concept, rather than asking them to perform an abstract exercise                             
      E.g. if they are to practise spellings or “wr” words tell them the purpose is to distinguish them from “r” spelling words etc.

     Use the same vocabulary for specific task requests, and be very precise with your instructions, allowing the learner to complete each stage before going on to the next.
E.g. Ask the learner to “put his pencils in the pot” and then “put his book on the pile”, instead of asking him to “tidy up”.
There is a need to build up a process of associations so that general requests can eventually be used.
     Always present instructions in small easy steps to avoid confusion, allowing sufficient time to complete one section before going on to the next.

    Make sure the learner understands what they are expected to do and encourage them to ask for help.  As a precautionary measure check with them in case they do not have the confidence to do so.
Those with APD are not immediately aware that they have not understood something that has just been explained to them.
Many can train themselves to just listen to a speaker, and try to record the message in their long-term memories and then replay it later to try and make sense of what was said.
When doing this they will not try to ask questions as it stops the recording flow, and cannot answer questions asked of them.

(i)         Oral information may, at first, appear to have made sense, but when they have to reproduce this information they may have not have fully understood or processed (retained) all the information needed to gain a full understanding.

(ii)       Sometimes they will have not processed part of the message, and will be unaware of this,
           e.g. they may go away and complete a task but miss out a vital component.

(iii)      Sometimes they will not have processed any part of the message.
           They will be totally unaware that they have missed anything, until they are asked about that message at a later date.
           They will act as if they have not heard it.

(iv)       It has been noted that the delayed processing coping strategy has been developed by adults with APD and by teenagers with APD.
Most adults have developed this coping strategy subconsciously,
but some teenagers may have developed it and may have been encouraged to use this skill to help themselves.
This delayed processing is done using the long term memory like a video recorder, but like most filing systems it sometimes takes a long time to find the correct file, with the right contents, just when you need it.

(v)      APD learners use their short-term memories for their daily coping routines; which they need for their priority survival needs and young children do instinctively.
Adults may be able to select their priority routines with regard to their careers, or whatever they consider to be their main life priority, and that priority governs the use of the short - term memory (coping strategies and correction routines) everything else is secondary until that task is finished.
Me:  Yup
    Allow extra time to complete tasks to allow for delays in processing and transference of information.
It may help to ask the APD learner a question, and prefix by saying I will ask you this question and come back to you in a moment for your answer.
(The teacher could then go on to ask another pupil a different question, and then come return for the APD learners answer)
                 This will give the APD learner an some extra time to process the question; and to formulate and process an answer
Me:  I don't know how this will play out in a work place.... I have to think about this one.

     Ensure the learner has a quiet working environment as many can be easily distracted by background noise and conversation by other pupils. Try to ensure that other pupils understand that they should not be disturbed when working.
      Some APDs like to use music as a continuous and predictable background noise, which also helps eliminate other random distracting background noises.
      Some APDs find FM audio systems useful in classroom / lecture environments as it concentrates the message, and eliminates background noise.
Me:  I dont know about asking for a quiet working environment.  Most of my life, I have spent in a cubicle.  Asking for a quiet environment comes across as being a bit of a prima donna.  Using headphones helps but not when I have to process speech.  I can't imagine asking a supervisor to wear the special vest with the microphone for an FM audio system.

     Often APDs have a short attention span due to the amount of effort needed to try and follow what is happening in the classroom.
As a result of all the extra effort needed they can become very tired, or irritable and their behaviour may suffer.
They may have episodes of daydreaming or “switching off” for a while when things become too much.
Susceptibility to background noise and bright lights can lead to headaches and lapses in concentration.  
Me:  sometimes I do zone out when I am overloaded.  I have never pondered the effect of bright lights on my work environment.  But I do notice that at home, I tend to work in lower light.   I have never pondered the effect of a short attention span.  Having a attention span problems didn't show up on my neuropsych exam.  I will think this one over.

     APD learners will most certainly be lacking self-esteem and confidence in both educational and social settings. They are often called lazy, slow, stupid or told that the difficulties they are experiencing is a direct result of a bad attitude.
A positive learning environment is essential.
Every effort should be made to promote a sense of self-worth.
Me:  I can have some problems with self-esteem and think that I am a bit lazy or slow... looking back on it, I have been overwelmed at times.
     The lack of confidence and self-esteem in learners with APD means that in many circumstances they may leave things to the last minute.
This is caused by confusion in ascertaining what is expected.
This sometimes means learners find starting a task difficult and this can be misconstrued as laziness or negative behaviour.
They may need a great deal of help in planning a piece of work.
Me:  More often than what I care to admit it, I do leave things to the last minute.  Sometimes starting tasks are difficult because I have been overloaded. 

     Learners with APD are very vulnerable in a social setting because of their difficulty in processing conversation, and in word retrieval.
Which makes them more susceptible to bullying.
Any negativity in this respect shown to them by a teacher can spread to their peers, and this should be not be tolerated.
Me:  Yup.
    APD learners may have some problems absorbing information from text.
           Allow time for delayed processing.
           Use a more visual approach to teaching, such as picture associations, coloured text, and different formatting of                
           text to make information stand out.
Me:   I am very comfortable using pictures and diagrams to learn from.  This is where I am not sure about having a diagnosis of a Non-Verbal Learning Disorder (My optometrist agrees that using pictures and diagrams doesn't conform to that diagnosis).  Delayed processing is definitely an issue.  A number of therapies that I am doing or will be doing such as the Directed Reading Program, the Interactive Metronome, Posit Science's Brain Fitness are supposed to improve processing speed.  So we shall see about that.  However, I do notice that in high-stakes conversations or arguments that I am not always as quick to answer back the way I would have wanted to.

     Provide a printed homework timetable for the learner and a copy for parents.
            So that they can help the learner understand what they have to do, and explain it in terms that they can more
            easily understand.
      Parents cannot help if they do not know what the learner is expected to do.
Me:  I can see work supervisors giving me a schedule... but not in detail. But given today's competitive workforceI can't see anyone acting as my buddy at work and coaching me through the schedule.   Perhaps a job coach can do that.

     Provide a home/school book so that the parents can provide feedback.  This can provide a means of communication between the parents and teachers.
      Enabling the parents to explaining what the learner has found easy or difficult, and the coping strategies they use to complete the task.
Thus helping the teacher build up a better picture of the way the learner learns and increasing the teacher's ability to accommodate their learning style.
Me:  Maybe a job coach can function in place of a parent.

     Help the learner to build coping routines, daily and weekly.
Coping routines are built on life experiences and at a young age this is difficult as the learner does not have too many to fall back on.
Small routines can grow.
The APD learner also needs to continually review these routines both new and old, as some new routines may bypass existing routines.
(One day able to do a task using a coping routine, but not able to do it the next day).
Ask the learner how they coping with a new task.
     Both learner and teacher should be involved in this development process.
Me:  I can't see a supervisor really wanting to get involved in this. This is something I will end up learning in a trial by error fashion. 

     APD learners find it difficult to process more than one source of auditory input.
So group conversations and debates are difficult, if not impossible, to process as they happen.
Many Adult APDs have subconsciously developed the skill of Delayed Processing.
(Which has been noted amongst adults and some teenagers with APD.)
This skill may be accelerated if younger APDs are aware of the nature of their disability at an early stage of their development. 
Me:  This can explain why I tend to focus on one speaker in a group to the exclusion of other people.  I have no idea how to over come this.

     APD learners will need to be able to advocate their disability amongst their peers and they may need help in this.
They may appear to others to be slow in understanding verbal instructions or conversations.
They need to understand and make others aware that they will always be like this, and they will need to be able to explain that they have a disability to friends, teachers, and adults.
They will need to know something about the nature of their disability. Some of the advantages and disadvantages, the latter will be obvious to all.
The advantages will not be so apparent and less obvious to identify. As they develop their own coping strategies, they also develop the compensating skills from their own personal talents, such as a heightened visual perception. 
Me:  Caution is the word on this.   I can't see everyone being so highly tolerant.  It will be very interesting to see what the end result of all the therapies will be... for APD, they are saying to compensate visually... but my vision might still be crappy at times so I don't know how I will compensate and use visual strategies.  We won't know about this until I finish all my therapies for vision, motor skills, hearing and balance and executive function.

     APD learners may have to work out the basic concept of what any theory means from basics each time they want to use it.
And any interruption or break from their thought patterns during this process may require them to restart their understanding from the beginning all over again.
This is particularly relevant to the learning of Mathematics.
This is why some prefer to start a project and see it through to its conclusion, regardless of any time factors. This is partly because it has taken them so long to plan and start the task that they may forget what to do if it is left unfinished.
Me:  I don't see how this applies to me... but I will ponder it.

     Multiplication tables sometimes present problems for APD learners.
If learning tables is an ongoing problem, provide the learner with a ready-printed multiplication square to use, as many learners may never learn them.
Me:  I don't remember having problems with multiplication tables.

     APD learners will always have a problem in reproductive speech.
This is not because they have problems with speech or do not know what they want to say, but are simply trying to retrieve the word they want from their long-term memory.
Word retrieval is also a major problem in producing written work.
Me:  Word retrieval is a problem periodically in written work.  I know there are thesaurus and dictionaries out there but not being able to drum up words can be problematic in writing.  Sometimes it is a problem in speaking, when I am trying to discuss a new idea that I am formulating.
    APD learners may also try to explain something over and over again, repeating themselves in the process.
This is part of the re-assurance process in which they
(i)       Try to show others that they understand something about the
           topic by going over it in their mind
(ii)      Aid their understanding of the topic
(iii)     Seek reassurance that they have understood the topic by   
           repeating it in their own words.
Me:  I think this is a problem... I can see how this can get on other people's nerves.
     APD learners have problems using Telephones.
One of the main reasons why individuals with APD cannot understand speech on the telephone is that the phone companies send only part of the speech signal through the lines. The signal is degraded before it even gets to the recipient phone.
Individuals with processing disorder often have problems understanding the degraded signals and phone conversations can be complicated by this fact. And neither facial nor body cues are available to help the processing-impaired individual to compensate for what they have not processed.
                 This needs to be explained to their friends who may wish to communicate by telephone.
Me:  I am wondering what my problems are with telephones.... I am going to try and track them to see what they are