Auditory Processing Disorder

[Guest guest]

Auditory Processing Disorder in Children

Diagnosed With Nonverbal Learning Disability

 

Warren D. Keller

East Amherst Psychology Group, East Amherst, NY

Kim L. Tillery

State University of New York at Fredonia

L. McFadden

Western Illinois University, Macomb

Purpose: To determine whether children with

a nonverbal learning disability (NVLD) have a

higher incidence of auditory processing disorder

(APD), especially in the tolerance-fading memory

type of APD, and what associations could be

found between performance on neuropsychological,

intellectual, memory, and academic

measures and APD.

Method: Eighteen children with NVLD ranging in

age from 6 to 18 years received a central auditory

processing test battery to determine incidence

and subtype of APD. Psychological measures

for assessment of NVLD included the Wechsler

Scales, Wide Range Assessment of Memory and

Learning, and Wechsler Individual Achievement

Test. Neuropsychological measures included

the Category Test, Trails A and B, the Tactual

Performance Test, Grooved Pegs, and the

Speech Sounds Perception Test. Neuropsychological

test scores of the NVLD+APD and

NVLD groups were compared using analysis

of covariance procedures, with Verbal IQ and

Performance IQ as covariates.

Results: Sixty-one percent of the children were

diagnosed with APD, primarily in the tolerancefading

memory subtype. The group of children

with APD and NVLD had significantly lower

scores on Verbal IQ, Digit Span, Sentence

Memory, Block Design, and Speech Sounds

Perception than children without APD. An

ancillary finding was that the incidence of

attention deficit/hyperactivity disorder was

significantly higher in children with NVLD

(with and without APD) than in the general

population.

Conclusion: The results indicate that children

with NVLD are at risk for APD and that there

are several indicators on neuropsychological

assessment suggestive of APD. Collaborative,

interdisciplinary evaluation of children with

learning disorders is needed in order to

provide effective therapeutic interventions.

Key Words: auditory processing disorder,

nonverbal learning disability, tolerance-fading

memory, attention deficit/hyperactivity disorder

Individuals with a nonverbal learning disability (NVLD)

have a characteristic pattern of neuropsychological

assets and deficits that give rise to a specific pattern of

strengths and weaknesses on measures of intellectual,

academic, neuropsychological, and socioemotional functioning

(Rourke, 1989, 1995). Individuals with NVLD

syndrome present with strong measured verbal intelligence

and weak visuospatial abilities. Academically, they may

experience a lag in reading acquisition early in development.

Word recognition skills may then improve substantially,

but ultimately, their greatest academic difficulty is in

mathematics. Reading comprehension is typically an area

of weakness, with word recognition skills far exceeding

measures of comprehension (Rourke, 1995).

Neuropsychological assets of individuals with NVLD

have been described as including auditory perceptual

capabilities, simple repetitive motor tasks, and rote learning,

especially rote verbal learning (Rourke, 1989, 1995).

Neuropsychological deficits involve tactile perceptual abilities,

which are usually more marked on the left side of the

body, impaired discrimination and recognition of visual

detail, and an inability to successfully deal with novel

experiences. Memory for tactile and visual input is poor.

Marked deficits occur in problem solving, concept formation,

Research and Technology Paper

American Journal of Audiology • Vol. 15 • 108–113 • December 2006 • A American

Speech-Language-Hearing Association

1059-0889/06/1502-0108

108

and hypothesis testing. Speech prosody may be atypical, and

verbosity of a repetitive, rote nature can be characteristic.

Whereas these individuals can engage in hyperverbosity, they

exhibit poor memory for complex verbal material and

weak pragmatics of language (Rourke, 1989, 1995).

Neuropsychological examination reveals weaknesses on

nonverbal reasoning tasks such as the Category Test and

on measures of tactile learning such as the Tactual Performance

Test, as well as deficits on sensory perceptual tasks

(Harnadek & Rourke, 1994). In general, performance on

neuropsychological measures believed to be sensitive to right

hemisphere functioning is compromised. Right cerebral

dysfunction is believed to be a sufficient condition for the

manifestation of an NVLD. The syndrome is also evident

in a range of individuals where there is believed to be

perturbations in many different regions of the brain. Rourke’s

(1995) “White Matter Model” hypothesizes that the NVLD

phenotype will be more likely to manifest to the extent

that long myelinated fibers (white matter) are underdeveloped,

damaged, or dysfunctional.

Socioemotionally, individuals with NVLD experience

extreme difficulty adapting to novel, complex social situations.

Impairments are evident in social perception, judgment,

and social interaction skills. With advancing age,

there is a marked tendency toward the development of internalizing

psychopathology with excessive anxiety, depression,

and social withdrawal being common (Rourke, 1989).

NVLD syndrome is believed to be the “final common

pathway” (Rourke, 1995) for a variety of neurological

disorders including, but not limited to, agenesis of the

corpus callosum, velocardiofacial syndrome, fetal alcohol

syndrome, neurofibromatosis, Asperger syndrome, and

traumatic brain injury (Rourke et al., 2002).

The language disturbances that children with NVLD

experience are becoming of increasing interest. Despite

verbal fluency and presumably well-developed auditory

perceptual skills, their actual language strengths can be quite

superficial. Nonverbal communication is typically believed

to be impaired, and while sophisticated vocabularies are

evident, pragmatics and semantics are areas of apparent

weakness. Typically, language interpretation is quite literal,

perhaps promoting some of the socioemotional and peer

relationship difficulties that children with NVLD often

experience. In addition to displaying limited expression and

comprehension of prosody, speech can become rather

monotonic and lacking in affective modulation (Rourke

& Tsatsanis, 1996). Despite high verbal output, language

is often lacking in content, meaning, and organization. Most

of the observations of the speech and language abilities

of these children are based on anecdotal evidence, with little

empirical investigation having been conducted. In one of the

few empirical investigations of language skills in children

with NVLD, they were found to experience language

inference difficulties as severe as a group of children with

learning disorders due to verbal impairments, with measures

of spatial and emotional inference especially impaired

(Worling, Humphries, & Tannock, 1999).

We have previously noted certain parallels between

symptomatology characterizing NVLD and the types of

behaviors present in some children diagnosed with auditory

processing disorder (APD; Keller, 1998). APD may be

defined as an observed deficiency in auditory discrimination,

pattern recognition, sound localization, temporal ordering

and integration, and the correct interpretation of speech

signals within the context of competing or other forms of

degraded signals (American Speech-Language-Hearing

Association [ASHA], 2005; ASHA Task Force on Central

Auditory Processing Consensus Development, 1996). Individuals

with APD do not effectively use auditory information,

often misunderstand complex and lengthy directions, may

behave as if they have a peripheral hearing loss, and show a

variety of academic difficulties in language, reading, and

spelling skills (Katz & , 1991).

Katz and (1991) have delineated four subtypes

of APD: decoding, tolerance-fading memory (TFM), organization,

and integration. The decoding subtype is characterized

by misinterpretation of speech signals due to weak

phonemic awareness. The phonemic zone is associated

with the left posterior temporal lobe (Katz & , 1991;

Luria, 1965), perhaps explaining why receptive language and

word-finding problems are seen in this subtype of APD

(Masters, 1998). Difficulty integrating visual and auditory

information is seen in the integration type of APD, resulting

in poor reading and spelling skills. Risk factors include

coexisting language and learning disabilities due to poor

interhemispheric (corpus callosal) function (Katz & ,

1991). Reversals and sequencing difficulties are associated

with the organization type of APD, possibly related to

pre-and postcentral gyri and anterior temporal areas (Katz,

1992; Katz & , 1991). Interestingly, individuals with

attention deficit/hyperactivity disorder (ADHD) have

been found to show more reversals than normal in dichotic

listening tests (Keller & Tillery, 2002).

Children with TFM profiles have been described in the

speech-language and audiology literature as having a variety

of characteristics strikingly similar to children with NVLD

syndrome (Keller, 1998). Whereas articulation skills with

isolated words are often satisfactory, children with TFM

demonstrate a reduced ability to make inferences, are

impulsive, display poor reading comprehension, and have

weak handwriting (Katz & , 1991). They have also

been noted to display more internalizing symptoms highly

characteristic of children with NVLD—such as insecurity,

fearfulness, and anxiety—than children with other APD

subtypes (J. Katz, personal communication, March 16, 1991).

Individuals with TFM profiles evidence a characteristic

pattern of performance on the Staggered Spondaic Word

(SSW) Test (Katz, 1962), with a greater number of errors on

the left ear competing condition. The frontal and corpus

callosal areas of the brain have been postulated to be involved

in this type of APD (Katz & , 1991). However, this

remains to be validated by neuroimaging studies.

Given the increasing observations of the language

impairments displayed by children with NVLD syndrome,

the present study investigated the relationship between

NVLD and APD. The primary aim was to determine

whether children with NVLD have a higher incidence

of APD, especially the TFM subtype, than the general

population. In addition, we explored associations between

performance on neuropsychological, intellectual, memory,

Keller et al.: APD in Children With NVLD 109

and academic measures and APD status in order to determine

the relationships between APD and specific neuropsychological

impairments.

Method

Participants

Thirty-seven children (36 Caucasian and 1 American

Indian) ranging in age from 6 to 18 years (M = 10.3 years,

SD = 3.1) were diagnosed with NVLD after presenting for

psychological evaluation in a private practice setting due

to a range of behavioral and academic difficulties. The

diagnosis of NVLD was made on the basis of comprehensive

neuropsychological examination, administered by a neuropsychologist

with 25 years of clinical experience. Each

participant was assessed using theWechsler Scales (Wechsler,

1991) and an assessment of memory functions, which included

performance on the Wide Range Assessment of Memory

and Learning ( & Sheslow, 1990). Academic measures

were obtained on the Wechsler Individual Achievement

Test (Psychological Corporation, 1992). Neuropsychological

measures included performance on the Grooved Pegs (Klove,

1963) and the Category Test, Trails, the Tactual Performance

Test, and Speech Sounds Perception Test (Reitan &

Wolfson, 1993). Of the 35 children old enough to be clinically

diagnosed with ADHD, 10 (29%) met the criteria specified

in the Diagnostic and Statistical Manual of Mental Disorders

(American Psychiatric Association, 1994) and were placed

on stimulant medications with a positive therapeutic effect.

Assuming that the incidence of ADHD in the general population

is 6% (Barkley, 1990), this proportion was significantly

higher than in the general population, c2(1, N = 35) = 31.62,

p < .001. The average test time for the neuropsychological

evaluation was 6 hr (six 1-hr sessions).

The principal features of NVLD are continuing to be

defined. In order to make certain that our sample met the most

recent criteria for NVLD, children who met the most stringent

principal identifying features described by Rourke and his

colleagues defining NVLD syndrome (Harnadek & Rourke,

1994; Pelletier, Ahmad, & Rourke, 2001) were selected

for this analysis. The analysis group consisted of 18 children

(10 boys and 8 girls) who scored 1.5 SD or more below

the mean on two or more of the following tests: Category

Test, Trails B, Grooved Pegs (dominant hand, nondominant

hand), and the Tactual Performance Tests (dominant hand,

nondominant hand, both hands), and had aVerbal/Performance

split greater than 15 points. The average age of the 18 children

in the NVLD group was 10.4 years (SD = 2.6). Average

Verbal IQ score was 108.6 (SD = 17.4), mean Performance

IQ score was 79.2 (SD = 14.6), and the mean Verbal/

Performance split was 29.4 points (SD = 11.2). Three of

the children (17%) had also been diagnosed with ADHD.

Auditory Processing Evaluation

All participants were referred for comprehensive auditory

processing evaluation, administered by an audiologist

with 14 years of clinical experience with APD assessment.

Each participant was administered video-otoscopy, tympanometry,

and speech and pure-tone measures for the

peripheral hearing assessment. All participants were found

to have normal middle ear compliance, normal peripheral

hearing thresholds (0–25 dB HL) across speech frequencies,

and normal word recognition scores in quiet.

The APD test battery consisted of the SSW test (Katz,

1962, 1968), Phonemic Synthesis (Katz & Harmon, 1982),

and speech-in-noise tests (Mueller, Beck, & Sedge, 1987).

The failure of a minimum of two or more of these tests

by 2 SDs was necessary for the diagnosis of APD, consistent

with other studies (Tillery, Katz, & Keller, 2000).

There is a general consensus that different auditory processing

abilities need to be assessed for the diagnosis of

APD (ASHA, 2005; Jerger & Musiek, 2000; Katz, 1992; Katz

et al., 2002). The tests used for APD evaluation were chosen

for their recognized validity (Katz, 1997) and successful

identification of APD in children (Berrick et al., 1985; Katz,

1992; Musiek, Geurkink, & Kietel, 1982; Tillery et al., 2000).

The SSW test items (List EC) contain two equally stressed

words with a staggered presentation at 50 dB above the

participants’ pure-tone average (500, 1000, and 2000 Hz),

bilaterally. The first word presented is in isolation, followed

by dichotic presentation (overlap) of the last word in one

ear and the first word in the other ear, leaving the fourth word

to be presented in isolation. The participant must repeat

the words. This 40-item test is scored for the number of errors

and compared with age-appropriate national norms (Katz,

1997). Below normal scores with the four staggered words

results in four test measures: left competing, right competing,

left noncompeting, and right noncompeting along with other

qualifiers (i.e., reversals, delays, perseverations) that give

evidence of difficulties with binaural integration, decoding,

and sequencing (Katz, 1997; Medwetsky, 2002).

The Phonemic Synthesis Test (Katz & Harmon, 1982) is

a diotic measure in which sounds are presented one at a time

to each ear. The participant must properly discriminate the

sounds and put them together to form a single word (e.g.,

/s/ and /he/ = /she/). Below normal scores are compared

with grade level and may indicate difficulty in discrimination,

memory, and phonemic blending (Katz & , 1991).

The speech-in-noise test is a monotic test in which

25 monosyllabic words are presented at 40 dB above the

participant’s average hearing threshold. The noise is speech

spectrum noise presented at a level 5 dB below the level of

the monosyllabic words. Difference scores are calculated

by subtracting the percentage correct in the noise condition

from the percentage correct in quiet, and compared with

age-appropriate norms, indicating difficulty associated

with the TFM type of APD (Katz, 1997; Katz & ,

1991; Medwetsky, 2002).

The State University of NewYork at Fredonia institutional

review board approved this study.

Results

Incidence of APD

Eleven (61%) of the 18 children diagnosed with NVLD

also met criteria for APD. Currently there are no reliable

estimates of APD in the general population. Estimates vary

from 3% (Chermak & Musiek, 1997) to 20% (J. Katz,

110 American Journal of Audiology • Vol. 15 • 108–113 • December 2006

personal communication, March 16, 1991). Assuming that the

incidence in the general population is 20%, the incidence of

APD in this sample of children with NVLD was significantly

higher than expected by chance, c2(1, N= 18) = 19.01, p < .001.

Ten (91%) of the children with APD manifested the TFM

subtype of APD; 1 child manifested the decoding subtype

exclusively. Three (30%) of the children with the TFM

subtype also manifested the decoding subtype, and 3 other

children with the TFM subtype also manifested the integration

subtype.

General Characteristics of NVLD

and NVLD+APD Groups

The average age of children in the NVLD+APD group

was 9.45 years (SD = 1.63), compared with 12.00 years

(SD = 3.26) for the NVLD (no APD) group. This difference

did not reach statistical significance in this relatively small

sample. As shown in Table 1, scores on the three IQ measures

were higher for the NVLD group than the NVLD+APD

group, and the verbal IQ difference reached statistical

significance, t(16) = 2.287, p = .036.

Neuropsychological Test Scores of NVLD+APD

and NVLD Groups

Neuropsychological test scores of the NVLD+APD and

NVLD groups were compared using analysis of covariance

(ANCOVA) procedures, with Verbal IQ and Performance

IQ as covariates. As summarized in Table 2, ANCOVAs

yielded four measures in which APD status accounted for a

significant proportion of the variance over and above the variance

associated with IQ. The NVLD+APD group had significantly

lower scores on Digit Span, Block Design, Sentence

Memory, and Speech Sounds Perception tests. The largest effect

(h2 = .521) was obtained for the Speech Sounds Perception test.

Discussion

The present study provides further evidence of the wide

range of neuropsychological deficits children with APD

experience. It would appear that not all children with NVLD

syndrome manifest the well-developed auditory perceptual

abilities described in the early literature, with well over

one half of this sample (61%) of children meeting the criteria

for an APD. It may well be that these basic auditory processing

weaknesses contribute to the range of language

difficulties beginning to be described in the literature on

children with NVLD. Furthermore, it should not be surprising

that children with NVLD, with presumably weaker right

hemisphere functioning, would exhibit more errors on the left

competing condition of the SSW test as characterizes the

TFM profile. This would be consistent with the implicated

right hemisphere processing weaknesses and/or impaired

corpus callosal functioning as suggested by audiological tests

(Katz, 1992; Musiek et al., 1982). Neuropsychologically,

children with NVLD often perform poorly on those measures

associated with right hemisphere function; however, children

with other syndromes, such as agenesis of the corpus

callosum, also present with similar neuropsychological

profiles. Therefore, NVLD syndrome may well be a “final

common pathway” for a variety of neuropsychological

deficits involving both hemispheres.

The behavioral descriptions of children with a TFM

profile on auditory processing evaluation closely parallel

those of children with NVLD syndrome (Keller, 1998).

They have been described as exhibiting poor reading comprehension,

weak expressive language, poor handwriting,

anxiety, and insecurity. APD has been criticized as a

diagnostic entity given the lack of data relating APD to

specific learning disorders (Cacace & McFarland, 1998,

2005). The present study provides some validation for the

subtypes of APD as described by Katz and (1991).

Rather than merely suggestive of an auditory processing

deficit, these subtypes of APD may be associated with

specific learning disability subtypes as well. Given that a

TFM profile is associated with both NVLD syndrome, as

indicated by this study, and ADHD (Keller & Tillery,

2002), the audiologist should refer for a comprehensive

neuropsychological evaluation when this particular APD

subtype is diagnosed.

The present study showed significantly lower measured

verbal intelligence in children with NVLD+APD than in

children with NVLD but no APD. One possibility is that APD

is truly less common among children with high measured

intelligence. A second possibility is that particular auditory

perceptual difficulties present in highly intelligent children

Table 1. Means and standard deviations for the NVLD+APD

group (n = 11) and the NVLD (no APD) group (n = 7) on different

neuropsychological measures.

Test

Group

NVLD+APD NVLD (no APD)

M SD M SD

Verbal IQ 101.91 15.33 119.14 15.99

Performance IQ 75.18 8.94 85.43 19.86

Full Scale IQ 87.91 12.61 103.00 19.48

Digit Span 6.78 1.56 10.43 2.99

Block Design 5.22 3.63 6.71 4.19

Sentence Memory 5.44 2.70 9.71 2.63

Speech Sounds Perception j1.90 1.51 j0.39 1.08

Note. NVLD = nonverbal learning disability; APD = auditory

processing disorder.

Table 2. Results of analyses of covariance in which APD status

accounted for a significant proportion of the variance after

Verbal and Performance IQ were taken into account.

Test

Verbal IQ Perform. IQ APD status Partial

p p p h2a

Digit Span .658 .129 .022 .322

Block Design .026 .003 .031 .291

Sentence Memory .030 .931 .046 .254

Speech Sounds

Perception

..008 .012 .004 .521

aPartial eta squared is the effect size for the APD status factor.

Keller et al.: APD in Children With NVLD 111

can escape detection using current APD assessment measures.

Intelligence may act as a buffer to the detection of

APD. While there is little longitudinal data on APD, there

may be a maturational component to APD, with some

children improving over time. There is a suggestion of this

in the age differences of children with and without APD in

the present study. Although not statistically significant in

this sample, the mean age of children in the APD group was

9.45 years, compared with 12.0 years for children without

concurrent APD. In the larger sample of 37 children diagnosed

with NVLD, the mean age of children with concurrent

APD was 8.9 years, compared with 11.8 years for children

without APD, and this difference was statistically significant.

The present study found specific measures routinely obtained

during the course of a neuropsychological evaluation to

be associated with APD. Children with NVLD+APD had

significantly lower scores on Digit Span, Block Design,

Sentence Memory, and Speech Sounds Perception tests.

Specific weaknesses on these intellectual subtests, measures

of memory functioning, and neuropsychological tasks

should alert the neuropsychologist to the possibility of a

comorbid APD.

The greatest difference between the children with and

without APD was in their performance on the Speech Sounds

Perception test, evidenced by an effect size of .521 (see

Table 2). Thus, poor performance on the Speech Sounds

Perception test in a child with NVLD should serve as a red

flag to alert the neuropsychologist to the possibility of

auditory processing dysfunction. It has been presumed that

children with NVLD evidence intact auditory perceptual

skills generally (Rourke, 1989, 1995). However, a substantial

portion experience difficulty on this particular neuropsychological

measure. Audiologists have suggested that

individuals with TFM profiles may manifest weak short-term

memory (Katz & , 1991), and the current results

provide strong preliminary evidence of this.

Although weak Digit Span performance is traditionally

associated with weaknesses in sustained attention and

concentration, it can also be associated with specific auditory

processing weaknesses, as the current data show. It is not

clear at the present time why children with NVLD+APD

would have poorer performance on the Block Design test than

children with NVLD but no APD. Future studies should

examine the reliability of the current findings and explore the

relationships among the various measures.

Although not a specific focus of the present study, it is

worth noting that the incidence of ADHD was significantly

higher in children with NVLD (n = 35) than in the general

population (29% vs. 6%). The possibility exists that children

with NVLD may compose a specific subtype of children with

attention disorders. The attentional weaknesses that these

children experience may be related to maturational delays in

right hemisphere processing abilities, with their attentional

weaknesses more likely to be outgrown with development.

Clinically, children with NVLD presenting with accompanying

attentional problems do not present with the motoric

hyperactivity characterizing most children with ADHD.

Milich, Balentine, and Lynam (2000) have argued that

children with ADHD predominantly inattentive (ADHD-PI)

subtype have characteristics and associated features that are

so different that ADHD-PI may constitute a diagnostic entity

separate from ADHD. In the absence of comprehensive

evaluation, children with ADHD-PI subtype may actually

be children with a specific APD and/or learning disorder who

are mistakenly and prematurely placed on stimulant medications.

While some clinicians have argued that a diagnosis

of ADHD can be made in the absence of comprehensive

neuropsychological evaluation, the range of factors that can

lead to inattentiveness in a classroom situation—including

APD—makes thorough, comprehensive, multidisciplinary

evaluation necessary for effective treatment. Further longitudinal

research with children diagnosed with NVLD should

be able to shed more light on the nature of the attentional

weaknesses that children with NVLD syndrome experience.

The results of this study strongly argue for collaborative,

interdisciplinary research as well as evaluation of children

so that management strategies will result in successful

evidence-based treatments (Keller & Tillery, 2002). The

present investigation suggests that children who present with

NVLD syndrome, especially with weaknesses on measures

sensitive to short-term auditory memory, would benefit

from referral to an audiologist in order to directly assess

the integrity of auditory pathways and possibly to receive

specific auditory processing therapies. Conversely, when

an audiologist diagnoses a child with a TFM profile, a

neuropsychological evaluation may be warranted to determine

whether NVLD may also be present. Continued

research needs to investigate the construct validity of

measures used across disciplines.

Acknowledgments

This study was supported by a Scholarly Incentive Grant at

the State University of New York at Fredonia to compensate

Dr. Peggy Lichtenthal, Ken Ton Hearing, P.C., for equipment rental.

The authors express the deepest appreciation to her and the

families who participated in this study.

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Received February 8, 2006

Revision received June 30, 2006

Accepted August 23, 2006

DOI: 10.1044/1059-0889(2006/014)

Contact author: Kim L. Tillery, Department of Speech Pathology

and Audiology, SUNY Fredonia, Hall, Fredonia,

NY 14063. E-mail: tillery@....

Love, Gabby. :0)

http://stemcellforautism.blogspot.com/

 

" I know of nobody who is purely Autistic or purely neurotypical. Even God had

some Autistic moments, which is why the planets all spin. " ~ Jerry Newport

 

 

 

[Guest guest]

What is " Auditory Processing Disorder " ? I wonder if most of autism kids have

this problem. My son, ten years old, hard to process oral information such as

" 25 people share 5 tents equally. How many people in each tent? " (I repeat this

several times). He repeated as " Each people share 5 tents... " . I wonder if this

is the auditory processing disorder?

Thanks,

From: eli8591@...

Date: Sat, 12 Sep 2009 05:00:34 +0000

Subject: [ ] Re: Auditory Processing Disorder

>

> Does anyone have a child with both Autism and an Auditory Processing Disorder?

>

--->my older daughter, imho..no official diag. I did do alot of info slams on

her behalf, on auditory processing disorders, when she was grade & middle school

age...chuckling, info slams are soooo not a new thing for me - before internet,

there was the library

> http://kidshealth.org/parent/medical/ears/central_auditory.html#

>

> My son fits this almost to a 'tee'. I realize many of the criteria are also

spectrum criteria, but I've been wondering about this for a few years now. He is

old enough for the testing.

>

> Interestingly, it says lead poisoning is one possible cause. Lead is our issue

according to the French Urinary Porphyrins testing. We are chelating.

>

> Just thought someone might have some insight or advice.

>

> Thanks

>

> Pam

>

--->specific to her...auditory issues right along, including (not limited to)

always talking with an accent - very cute as toddler, but...autistic

issues/behaviors as older child - school said " would be, but is too old. "

I scraped lead paint from kitchen windows while pregnant with her...clueless

until she was a year or two old....etcetcetc.

Supplements & chelating & diet & such have provided huge, huge gains for

her...pretty much using same info as with 5yo, but she has different details,

different answers that work...ummmm, used to worry about her alot, how she would

fare/thrive as an adult. Not so much anymore. That rocks.

She is a tad " immature " for her age, (she seriously " lost time " during worst tox

moments, imo), but if you lop off a couple years from her actual age, she is

doing just fine, moving forward and such.

Because my other kids were not so very affected (autistically speaking) by their

own merc tox exposures, I have found that I do consider lead a much larger

contributing factor than it seems most people do, when it comes to autism

itself.

Connected to that idea - her auditory issues did not progress to

vestibular/sensory/autistic issues until AFTER hg exposures, most apparent in

later grade school years - accumulative effect is my theory. (btw, my older kids

received the " catch up " versions of vaccinations)...In hindsite, it has been

possible to link her rather extreme " regressions " with her/our known hg

exposures.

However, I do consider lead to be the primary underlying cause of her particular

range of auditory issues.

elizabeth

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http://www.nidcd.nih.gov/health/voice/auditory.htm