APD – Auditory Processing Disorder -helping your GP understand the need for assessment

Recently, I have recommended to parents, their child may require a full APD assessment but it’s becoming clear that GPs may not recognise the need for APD assessment or the difference between APD and hearing loss.

As a dyslexia specialist, over recent year I began to notice that many students, both young and old were struggling to hear close sounds such as /nd/ or /nk/ or /ng/, quite often they couldn’t hear the /n/ sound and others couldn’t distinguish the end sound. Others might struggle to differentiate between vowel sounds such as the long vowel /a/ and /i/ or short vowel /i/ and /e/. I also found that many may have struggled to process language or instructions. Of course, for the untrained, non-specialist an immediate response is to suggest a visit to the GP and a hearing test.  These would 90% of the time come back within normal range.  Sometimes some students would be referred to a local audiology department at the hospital, yet they would still return results within normal ranges.  I knew that what I observed during lessons was not usual and could not understand why hearing test were coming back within normal ranges.

I continued to  investigate my thoughts and discovered the condition Auditory Processing Disorder (APD).  It was a ‘light bulb’ moment when everything began to fall into place and the condition described many of my students.

The next step was then understanding; “Why did audiology depts at local hospital not identify this condition?”  Local audiology teams are not looking for APD, as APD is not hearing loss.  

Upon realising this, my next problem was to identify; “How do I get my students assessed?”  Initially, I was able to contact a team who make preliminary tests but unfortunately the funding provision was not for a full assessment and it soon became clear that the level of assessment required was not available at a local level.

I have since had the pleasure of learning more about APD from Alyson Mountjoy who has written many documents about APD and has kindly directed me to the NHS information about APD CLICK and GOSH (Great Ormond Street Hospital for Children) who are one of the UK’s leading teams in the diagnosis of APD. CLICK.  These are excellent links to show your GP and help them understand the need for assessment.

Unfortunately, the cost of full assessment is  expensive and the level of intervention received from your school/LA is dependent on funding, knowledge and expertise on the subject of APD.  However, this should not deter from pursuing an assessment.  It is possible that your local Primary Care Trust who funds your GP surgery may accept an application for an individual funding application to have the assessment conducted.  It may be that your GP is happy to make an immediate referral.  As always, it’s  postcode lottery but we hope that the information above can help your GP feel more informed about APD.

If you do get referred, Alyson Mountjoy has kindly advised of your rights:

For those who are having trouble getting a referral for full APD testing, please note – you are entitled to a referral to a testing centre/hospital of your choice if your child meets the criteria under NHS Patient Choice. “If you are referred for your first outpatient appointment then, in most cases, you have the right to choose which hospital in England to go to. This will include many private and NHS hospitals that provide services to the NHS.

You are also able to choose which consultant-led team will be in charge of your treatment, as long as that team provides the treatment you require.

Therefore, if you wish to be treated by a particular consultant for a procedure, you can choose to have your first outpatient appointment at the hospital where the consultant works and to be treated by that consultant’s team. But this doesn’t necessarily mean you will be seen by the consultant themselves.

This choice is a legal right, if you are not offered a choice at the point of referral, ask your doctor why and say that you wish to go through your options. If you are still not offered, or refused, a choice, contact your local CCG.”