Why littles are more susceptible to APD than ever before.
A look at why the numbers are soaring and how it effects a child’s ability to learn.
It is my belief that auditory processing disorders (APD) are happening at a higher rate than previously thought, but finding the data to support this has been difficult. It is also more than likely the numbers are masked due to children in schools being misdiagnosed and misclassified in special education. But, why would there be such an increase in the numbers?
To answer this, we must know a bit about how the auditory pathway works. The auditory pathway is the only part of the auditory system that is plastic – meaning it can change. That’s important because interventions directed at the auditory system can be measured and proven to get better – or worse. Some of the things that are detrimental to the auditory pathway are:
· Aging
· Genetics
· Stroke
· Head trauma
· Lead poisoning
· Seizure disorders
· Issues linked to birth, such as early birth, low birth weight or a pregnant person using alcohol, drugs or tobacco
· Repeated ear infections – especially at a young age
Although the cause of APD is sometimes unknown, the increase of children who survive prematurity are higher than ever before. A preterm birth is one that happens before 37 weeks of pregnancy. Globally, more than 1 in 10 pregnancies will experience preterm births. Prior to the 1970s, most babies bore more than three months premature died as they lacked the ability to breathe on their own for more than a short time. Reliable mechanical ventilators for these infants did not exist and they did not survive. The World Health Organization (WHO) gives the following definitions for the different stages of preterm birth:
Extremely preterm: before 28 weeks
Very preterm: from 28 to 31 weeks
Moderate to late preterm: from 32 to <37 weeks
Because of medical advances at treating preterms babies, survival rates have increased significantly (1).
· Less than 22 weeks is close to zero change of survival
· 22 weeks is around 10%
· 24 weeks is around 60%
· 27 weeks is around 89%
· 31 weeks is around 95%
· 34 weeks is equivalent to a baby born at full term.
· The earlier the birth, the higher the risk of problems. There is no way to determine how well a baby will do, but in general:
· 1 in 10 of all premature babies will have a permanent disability such as lung disease, cerebral palsy, blindness or deafness
1 in 2 of premature babies born before 26 weeks of gestation will have some sort of disability (this includes mild disability such as requiring glasses)
In a study of 241 children born before 26 weeks gestation, only 20% were found to have no problems.
An increase in the ability to keep babies alive has contributed greatly to adverse effects to the auditory pathway. If a baby survives a preterm birth, the next hurdle is remaining healthy during the childhood years.
Middle ear pathology is the most common cause of hearing loss and the most common disease of the ear in childhood. Eighty percent of all children have had an episode of this disease by the age of 10 years, mostly by the age of 3 years. The prevalence is about 20% at the age of 2 years (2).
If we look back at the list of causes for APD, we discover two of the causes, preterm births and repeated ear infections, occur at higher rates today. In addition to increasing birth rates, we have a significantly larger number of kids with APD than ever before which effects speech/language (3), reading, behaviors, and overall learning.
1. Tommy’s. Pregnancy Hub. (2024, January 9). https://www.tommys.org/pregnancy-information/premature-birth/premature-birth-statistics
2. Minovi A, Dazert S. Diseases of the middle ear in childhood. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2014 Dec 1;13:Doc11. doi: 10.3205/cto000114. PMID: 25587371; PMCID: PMC4273172.
3. University of Florida. (2024, January 3). Chronic childhood ear infections delay language development. https://www.sciencedaily.com/releases/2024/01/240103130838.htm?utm_source=hearingtracker.com&utm_medium=newsletter
