Auditory Processing Disorder, What does it Mean?

As I explained in my last post, I was liberated by my Auditory Processing Disorder (APD) diagnosis. Of the 4 types of APD – Decoding, Tolerance-fading memory, Integration, and Organization, I have been confirmed to experience 3. My audiologist states I experience issues with Decoding, Tolerance-fading memory and Integration. He states he cannot rule out Organization as a potential component as well.

Post liberation, I find it easier to communicate with people because I can ask for conditions that facilitate my ability to hear and understand speech such as a quiet environment and seating where I can lip read. But people wonder: What was I hearing before?

Let me explain.

Have you ever used speech to text on your smartphone and watched the screen as the program sorts through multiple potential words and spellings until it accurately or inaccurately decides what you were trying to say?

That’s how I hear. It’s almost like Siri and I were separated at birth.

When I hear speech, I sort through multiple potential spellings and meanings and try to match the vague sounds I hear to the context of the conversation. I picture the potential spellings of words in my head nonstop to aid in my understanding. I think of this visual spelling habit as my internal closed captioning system.

I hear sound just fine, but individual speech sounds are very indistinct. When a word starts with the letter P for instance, I simply don’t hear the P. You say the word ‘play’, and I hear ‘lay’. You say ‘piece’, I hear ‘ees’. Well, I hear ‘ees’ if I’m lucky and there’s no background noise. Add background noise to the equation and I’ll only hear a long e  or ‘ee’. That’s a hell of a lot of English words to sort through to figure out which long e word you were using.

Okay, you may be thinking. That’s not that big of a deal, you obviously know people aren’t saying ‘ees’ or ‘ee’ to you, right? Just pay attention and you can sort it out.

Well, compound what I’ve described with other phonemes that challenge me and it becomes more problematic. I can’t hear most L sounds correctly. So ‘puzzle’ becomes ‘uzza’ because both P and L are involved. Imagine playing a game of hangman or Wheel of Fortune when you only have a few letters. That is what auditory life is like for me. I only managed to get this far because I have tremendous puzzle solving skills. Once you understand these dynamics, it is easy to understand how people with APD and fewer problem solving skills remain nonverbal.

In a face to face situation with no background noise I can supplement my understanding with lip reading and get by. On the phone I have no such benefit. You can see how I might fall behind in conversation as I’m trying to sort out sounds and the person to whom I’m speaking is just rambling on full speed ahead as people are prone to do.

Think about the multitude of unnecessary words you sprinkle into phone conversations. Think about the noise behind you when you use the phone. Is there music? Are you sitting at a table where others are having a conversation? Are you in a loud office environment? Are you alternating speaking to the person on the phone and also speaking to someone in the room with you? Ever turn your head from the phone to yell at your kid who was already screaming in the background? And God forbid, are you using the freaking speaker phone?

Now imagine someone like me on the other end of that phone conversation. I already didn’t stand a chance hearing 50% of what you said without visual context clues. Now you’ve just reduced my understanding to 20% or even 10%. I will probably ask you to repeat yourself, and you will probably become impatient and annoyed with me. You will think I’m not paying attention and when you later learn I have completely misunderstood something you said, you will assume I am stupid or that I suffer from a refusal to follow directions.

Think for a second about the social ramifications.

I have been absolutely shamed for my inability to hear, even in places where one might think people are peaceful and enlightened.

I once took a yoga class at a local community center. I had not yet been diagnosed with auditory processing disorder. When I arrived, the only spots left were in the back of the room, quite far from the instructor. Each time the instructor asked us to change asanas, I looked at the mirrors and at the movements of my classmates to understand what I was supposed to be doing. I simply couldn’t hear the instructor. I got through the entire series of classes that way and I really enjoyed the yoga experience.

After the last class, many of the students stuck around to thank the instructor and ask her where they could take more classes. The young woman in front of me told the instructor that she had enjoyed the class but that she preferred to be grouped with advanced practitioners in a private studio environment because she found it irritating that the community center had mirrors and that some people, she said while giving me a hard glare, were always looking at the mirrors and at other students instead of focusing on their own practice. I can hear tones perfectly well and her voice was full of contempt.

I felt so ashamed. I had been waiting in line to tell the instructor how much I had enjoyed the class and I had instead learned that this other student had been horribly offended by the efforts I had taken to follow the teacher’s verbal instructions. I turned and left the room after that woman spoke so cruelly, and it took me years to attempt a yoga class again. I knew I couldn’t participate without using visual cues, but clearly that pissed off other students. I didn’t know how else to get through the class, and I didn’t want to anger another practitioner.

I think of the many times I tried speaking with people I didn’t know well, usually coworkers, when they quickly verbally digress in a direction that I can’t follow. I try my best to keep up and I simply can’t. Before I know it they’re yelling at me. “It was a joke!, Don’t you get it?” It becomes clear that I’ve missed a cue, but I don’t understand what cue.

And I respond by smiling like I understand, just to try make the situation smooth again, but they can tell I didn’t understand at all. Their humor then turns to anger and they begin to berate me. “Don’t you have a sense of humor?” “Always so serious!” “Lighten the hell up!” Then they mutter something about what an idiot I am and walk away. This has happened more times than I can count. It sums up my entire working life.

I remember a Thanksgiving dinner at the home of my stepfather, who due to crazy family dynamics, I had not seen in several years.

“Do ya ha any is?” he asked me. There were lots of people at the dinner and the echo prone raised ceilinged home was filled to overflowing with voices.

I had been staring at his mouth, trying to sort out what he was saying. But I simply couldn’t figure it out.

“Do I have any keys?” I guessed back to him. I knew he was a car enthusiast, maybe he wanted to see what I was driving.

His brows lowered and his expression darkened. I was familiar with this disapproving look from my childhood. It was the look he had given me when as a kid I, “just wouldn’t listen.”

“Do you have any kids!?” he blasted back.

“Um, oh, no,” I replied as my face reddened. I really didn’t like making people angry.

These are examples of the things I hear, or rather don’t hear, and their real life implications for social interactions.

I hope this has shed some light on one presentation of auditory processing disorder. I further hope it encourages you to be patient with people who ask for repetition or exhibit misunderstanding. You can never presume that the person to whom you are speaking hears as you do.