Attention Deficit Hyperactivity Disorder

Auditory Integration Training Improves Attention

During auditory integration training, parents shared that their child’s behaviors became noticeably calmer with improved attention. However, hyperactivity increased once they finished their listening program. Three months later, the client completes a shorter listening program. During the second program, the client’s behavior once again became calmer. Additionally, attention and listening behaviors steadily improved after completion of the second program.

In auditory studies, researchers found that it takes time for auditory neural pathways to become strong enough to noticeably change behaviors. Berard-based Auditory Integration Training improves attention in those with a neurodevelopmental diagnosis like Attention Deficit Hyperactivity Disorder.

Effects of Attention Deficit Hyperactivity Disorder on Expressive Speech

Researchers found that particpants with Attention Deficit Hyperactivity Disorder struggled with auditory processing skills like expressive speech. Likewise, I see these difficulties in my clients. For example, a client may misspeak, unable to say what they meant to say. Furthermore, some clients struggled to speech fluently only when first starting to speech.  Thus, they would repeat words, a phrase, or even a sentence.  One explanation, client needed extra time to organize their thoughts. As a result, they were able to logically share their thoughts.  For improvements, Cheri uses Dr. Berard’s speech stimulation auditory training protocols when working with clients. Interestingly, approximately 20 percent more volume is sent to the right headphone, Thus, the right ear receive more sound stimulation. Resulting, in more direct stimulation to the speech center when compared to the left ear. It has been very rewarding to observing improvements in clients’ speech fluency.

Sounds are Distracting

Sounds and background competing speech can distract attention. For example, have you ever tried to have a conversation while washing dishes?  Thus, the running water and having your back turned to the person talking makes it more difficult to listen. Imagine feeling like this all day long, especially in a classroom.

Contrary to what most people believe, a weak auditory system results in an inability to ignore sounds. To illustrate why this happens think about the muscles in your legs. What happens if you suddenly start running two miles after spending the winter reclining in your favorite chair? Basically, you are out-of-shape. While running your legs start to hurt. At some point, the pain in your legs will cause you to stop running.

In the same way, an individual experiences discomfort, sound intolerance, when sound energy pushes sound energy along weak auditory neural pathways. Each person’s response differs depending on the strength of their hearing system. Individuals diagnosed with Attention Deficit Hyperactivity Disorder play loudly because they are seeking auditory stimulation. They need to talk loudly to hear themselves speak. In addition, talking loudly covers up distracting background sounds which they are unable to ignore. However, when they listen, they get upset when others talk. Their weak auditory neural pathways are unable to suppress competing background speech and sounds.

Researchers found that vestibular activities, deep pressure, sharing, and dietary changes help improve stress hormonal functions.

(The Whole Brain Child, Trauma-Based Intervention—neurochemistry of fear)

Weak Auditory Processing Skills and Attention Deficits Hyperactivity Disorder

Bellis et al., (2011), found that auditory processing deficits exist in individuals with a diagnosis of Attention Deficits with Hyperactivity. There is evidence that auditory processing difficulties contribute to a reduction in attention in those diagnosed with attention deficits with hyperactivity. 

Research introducing a sound (hum) resulted in the following findings:

• Norm group had equal abilities in auditory and visual attention skills.
• Individuals with a diagnosis of Attention Deficits with Hyperactivity had weaker auditory attention skills when compared to the norm group, but visual attention was almost the same as the norm group.
• Individuals with central auditory processing deficit had the weakest auditory attention scores out of three groups. Visual response scores were also weak, although slightly stronger than auditory attention.

Attention Deficit Hyperactivity Disorder and Central Auditory Processing Deficits

Behaviors associated with Central Auditory Processing Deficits, hearing loss past the cochlear, are similar to behaviors associated with Attention Deficit Hyperactivity Disorder.  Below, the chart shows you similarities between the two.  However, there is one main difference.  The child with Central Auditory Processing Deficits works hard, stays focused and seated in their chair.  However, the child with Attention Deficit Hyperactivity Disorder impulsively moves in and out of their chair for no apparent reason.

Attention Deficits with Hyperactivity can coexist with a diagnosis of Central Auditory Processing Deficits (CAPD). An audiologist completes testing around age eight or older.

Retrieved from The American Speech and Hearing Association, 2011 Conference,
(Neurobiology, Differential Diagnosis, and Treatment of Co-morbid CAPD & ADHD. Presenters: Gail Chermack, PhD., Washington State University; Frank Musiek, PhD.,Univ. of Connecticut; Terri Bellis, PhD., Univ. of South Dakota)

Attention Deficit Hyperactivity Disorder with Visual Processing Difficulties

In a research study, individuals diagnosed with visual processing difficulties have a diagnosis of Attention Deficit Hyperactivity Disorder.

The most common visual processing difficulty, Convergence Insufficiency makes it difficult to sustain clear, single vision while looking at a target. For example, a target can be large like the cows below. However, the target could be small and very close like words in a book. Thus, convergence skills keep vision single and clear while reading and writing. Despite 20/20 visual acuity, clients with convergence insufficiency see print that blurs or doubles while reading.  

Look at the two images of cows below. Now, look at the pupils within each eye. Do you see the difference between the pupils in the picture on the left versus the right? Next, look only at the picture on the left. Do you see how there is a blurred lighter behind the actual cow? You see two cows because one pupil failed to turn inward.

In conclusion, the picture on the right shows both pupils turning inward, converging. Thus, only one, clear cow is seen. However, the picture on the left shows only one eye turning in. Thus, the person has convergence insufficiency, double vision.

In one study, researchers found that 10% of 266 children with a diagnosis of convergence insufficiency also had a diagnosis of ADHD.  Researchers found that 106 children out of 1,700 children with a diagnosis of ADHD were being affected by convergence insufficiency. 

(Granet, D.B., Gomi, C.F., Ventura, R., Miller-Scholte, A. (2005). The relationship between convergence insufficiency and ADHD. Strabismus 13(4); 163-8)

Without Intervention, Children and Teens with Attention Deficit Hyperactivity Disorder are High Risk for:

• Mild language, motor, or social delays during childhood
• Emotional distress, behavioral problems, and social acceptance during the teen years
• Substance abuse, self-medicating, and suicide attempts during the teen years

Cheri Moore’s Experiences and Observations

Cheri Moore’s experiences and observations improved clients’ response to vision therapy. Clients with hearing loss successfully maintained progress when hearing aids like the Roger FM Hearing System were consistently worn.

Cheri’s desire to improve clients’ emotional responses during auditory integration training caused her to track clients for years after they completed auditory integration training. Cheri discovered a high rate of co-existing visual processing difficulties and sound intolerance, with or without a hearing loss.

After some clients experienced increased visual processing difficulties during auditory integration training, Cheri Moore collaborated with optometrists specializing in vision therapy to track each client’s progress. Individualized Auditory-Visual Protocols have resulted in improved responses to auditory integration training and vision therapy.