Course Notes: The Auditory System

Hey, are you listening to me? Did you hear what I said? What did I say?

Sound familiar? As parents, we want to believe our kids are paying attention to the things we say. Sometimes they do, but other times it feels like it goes through one ear and out the other. Although we have talked in depth how attention can play a role in why your child may not be listening to instruction, another thing to consider is that the system frequently used could often be abused.

What is the Auditory System?

This system is responsible for our ability to hear and make sense of the sounds around us. Hearing is a basic skill and one of the first to develop in the womb, working in tandem with the vestibular system to assist in movement, balance, and coordination.

It consists of three major parts:

  • Outer ear – the visible parts that capture sound waves and send them to the ear drum
  • Middle ear – an air-filled chamber that protects the ear from excessively loud sounds and regulates fluid pressure in the inner ear
  • Inner ear – fluid-filled cavity that detects movement and gravity (vestibular system) as well as sound (auditory system)

Like vision, hearing has two parts: the physical ability to receive auditory input (which can be addressed with hearing aids) and the capability to process what was heard.

The auditory sense first comes equipped with a defensive component. For example, the startle response in babies is activated when loud and unexpected noises are present. As babies grow, they begin to modulate auditory sensations, allowing them to distinguish between a predictable noise (garage door opening) from a threatening one (thunderclap during a storm), and taking appropriate actions for both. Once our kids develop an adaptive response to noise by engaging with their surroundings, they can gain meaning behind those sounds and develop discriminatory skills needed for speech and language. For the record, we were born to hear, not listen; listening is acquired.

Believe it or not, auditory discrimination evolves and refines as your little one utilizes their other sensory systems to explore their environment. These discriminative functions include:

  • Localization – Identifying the source of a sound and determining how far away it is from us
  • Tracking – the ability to follow the sound
  • Auditory Memory – recalling what was heard, like a simple 3-step direction
  • Auditory Sequencing – putting in order what was heard and repeating it in logical order, like the alphabet
  • Auditory Discrimination – comparing/contrasting environmental sounds and hearing differences/similarities in word sounds, like differentiating between “daughter” and “water”.
  • Auditory Figure-Ground – distinguishing between foreground and background sounds needed to focus on important aural information, like talking to someone in a crowded room
  • Association – relating a new sound to a familiar one, like the hearing a bark and knowing it’s a dog; it’s also the ability to link a sound to a visual symbol, like the letter a makes the “ah” sound
  • Auditory Cohesion – higher level listening skill that unites various ideas into a coherent whole, as seen when making sense of jokes and riddles
  • Auditory Attention – maintaining appropriate focus necessary to listen

When the auditory system is functioning appropriately, we learn to move and adapt to the sounds around us. We can gauge the distance of the garbage truck as it makes its way down our street, detect sarcasm in our friend’s voice in conversation, or mentally prep to handle traffic when hearing multiple car honks.

What Could Go Wrong?

Typically, the muscles in our middle ear will contract to dampen any loud noises present to protect our hearing. It also ensures that we won’t get overwhelmed by extraneous sounds so that we can go about our day. But when we are in fight-flight-fright mode, those ear muscles don’t do that, allowing us to be hypervigilant to any disturbances that could harm us.

Over-Responsive: “Make the Noises Stop”

Kids who have auditory defensiveness are in a constant heightened state to every sound they hear. They are easily distracted and annoyed by sounds that others don’t notice. Their negative reactions to abrupt loud noises can be extreme, from covering their ears to running away or screaming to muffle it (it’s easier tolerate your own sound than others). They may worry if or when the next loud noise will be. It is exhausting for these kids to keep it together throughout the day, using up their energy to tolerate noise, affecting their learning and social participation with peers.

Under-Responsive: “Sorry, Did You Say Something?”

These kids don’t seem to hear you and look like their head is in the clouds. However, it’s tricky to determine if a child is aurally under-responsive. Factors like a slower auditory processing speed can be a reason for their limited awareness. They may not hear quiet sounds or even those at a typical volume. But when they do respond, they may speak softly.

Seeking: “Bring On the Noise”

These children like being in loud noisy environments. From amusement parks to parades, they want to be there. Their volume is at 11, frequently using their “outdoor voice” no matter where they are. They may make their own noises to keep themselves regulated, being told to quiet down or stop as their self-made sounds may be distracting to others. Keep in mind that vocal volume control is also an acquired skill. So if you find your toddler is louder than your typical volume, it could just be their age. You would look for this indicator sometime after 4-5 years old.

Discriminatory: “Oh, I Thought You Said Something Else”

If you’ve ever played Telephone, you know that phrases could alter if someone misheard a word. Imagine that happening on a daily basis for a child with auditory discrimination issues. They may struggle differentiating between sounds and words, having trouble understanding the teacher with background noise present, or can’t decipher verbal information. This can affect their receptive and expressive language skills, resulting in difficulties reading or expressing their thoughts.


A Word About Auditory Processing Disorder

If a child has difficulties understanding what they hear, they may be diagnosed with Central Auditory Processing Disorder (or CAPD for short). Kids with CAPD have normal hearing acuity but can’t recognize and interpret slight differences between sounds in words, especially in speech.

CAPD can only be diagnosed by an audiologist (hearing specialist) who would conduct a series of listening assessments. Because these tests require consistent and accurate responses from the participant, a CAPD diagnosis usually isn’t given until a child is 7-8 years of age.

How can we help?

Give them warning. If you’re about to turn on the vacuum or a loud piece of equipment, let your kiddo know so they’re prepared. They may run to their room for safety or cover their ears in anticipation. Once they’re set (let them tell you they’re ready), turn it on. As they become more accustomed to the noise, you may offer to have them turn on the machine. This serves two purposes: they are in control of the noise, and they are aware of where the noise is coming from.

There are also a bunch of videos on TikTok recommending that you cover up the motion sensor on public restroom toilets. The automatic, unexpected, echoing flushing can be a common auditory trigger for young kids.

Hey there, headphones. Your kid may not control where unexpected sounds are coming from, but they can be prepared when on the go. Bring a set of headphones to places that may be too loud for your child to tolerate. This is very common on planes, for firework displays, parades, concerts, when an ambulance drives by, etc. However, make sure you instill the expectations that you don’t want your child to become dependent on them (ex: only wearing them when expecting a loud noise or having difficulties tolerating a certain sound). The goal is for your child to eventually acclimate to the sounds around them.

Use the other senses. If you’re trying to get your child to listen to you, incorporate the other sensory systems. Get in their line of sight or tap them on the shoulder to get their attention. If you need to them to retain verbal information, let them move around while you’re talking.

Play with pitch. Find what sounds grab your child’s attention. Do they gravitate to a melodic cadence, like the songs on Cocomelon? Give it a try to help them tune into what you are saying. Not your scene? Try whispering as it is completely different from the other surrounding noises. Experiment with different tones and voices, from silly to serious. Keep in mind that yelling out of frustration may confuse or escalate the situation as your child may still be processing what you said or didn’t even know you were talking to them.

Slow and steady. If your kiddo is having trouble understanding and recalling what you’re saying, use less words and speak at a slower rate. Ask them to repeat it back to ensure that they understand what you said. If they need to recall the information later, write it down for them.

Environmental changes. Some kids do well with quiet surroundings while others may prefer ambient noise to function.


For our next Course Notes post, we get into auditory processing and revisit sensory integration for hearing and learning.

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Related Course Notes Posts:
The Whole-Brain Child
Sleep Series


Sources:
Kranowitz, C. (2005). The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder.  New York, NY: A Perigee Book.
Mauro, T. (2006). The Everything Parent’s Guide to Sensory Integration Disorder. Avon, MA: Adams Media.
Ebert, C. (2018, April 18). Sensory Integration & Speech Delays. Retrieved from seminar. Auditory Processing Disorder – Johns Hopkins All Children’s Hospital

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