What is the auditory system?

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC October 27, 2021

What is the auditory system?

The auditory system is how we hear sounds within our environment. This system is made up of the outer structures (your ear) and inner structures and brain regions (cochlear nuclei, superior olivary nuclei, lateral lemniscus, inferior colliculus, medial geniculate nuclei, and auditory cortex), which then process those sounds so that we can understand what they mean. These systems also help us determine the location and frequency of the sound.

Not to get too technical, but sound is basically just energy waves moving through the environment. These energy waves pass through the outer structures of the ear and move into the inner structures, causing movement and vibration to the inner ear bones. Here, the energy waves continue through the fluid-filled cochlea, move into the auditory nerve (you can read more about the specifics here), and continue through various channels to be processed into information that we can interpret and respond to.

The auditory system allows us to hear sounds, process what those sounds mean, and then respond accordingly. If we hear a car horn honking, we are alerted to something that might be dangerous. If we hear a baby crying, we look around for the distressed baby to try and help. If we hear words of encouragement from a loved one, we are motivated to keep going.

Additionally, our auditory system must filter out unnecessary information. For example, suppose you are at a holiday party, and several conversations are happening. In that case, you must filter out those conversations to hear and process the one specific conversation you are engaged in. This is specifically part of our auditory processing.

 

Auditory processing

Auditory processing is how we perceive and interpret auditory information. It’s more than just hearing sounds; it’s also understanding where the sound is coming from, filtering out unnecessary sounds, understanding speech patterns, and attaching meaning to words. When our auditory processing system works well, we can turn towards an incoming sound, hold a conversation, filter out unnecessary sounds (like in the example above), and communicate successfully.

However, sometimes there may be something that goes wrong. Now, we’re not talking about hearing loss, as that has to do with the inner ear's structure. We’re talking about the messages that get sent from the inner ear to the brain - when these messages get mixed up, the auditory processing system does not work correctly and challenges arise.

 

Auditory Processing Disorder

The main challenge people think of when talking about auditory processing is Auditory Processing Disorder (APD). This is when a sound, typically speech, is heard but cannot be processed accurately - the signals from the ear to the brain are getting mixed up.

Sensory Issues

Children who suffer from this, also known as Central Auditory Processing Disorder (CAPD), typically have “normal” hearing - meaning they do not have any hearing loss. Instead, they struggle to understand and process speech sounds, resulting in challenges with communication and attention during conversations or in school. They struggle significantly to attend to and process speech sounds within a busy, loud environment.

Children with APD are more likely to have other challenges or diagnoses, such as speech and language delays, attention disorders, learning disorders, Autism Spectrum Disorder (ASD), etc. It is easy to see why these are all connected. To have proficient speech and language skills or to sustain attention in a classroom to learn, a child must hear, process, understand, and respond to sounds and speech.

According to the ASHA (American Speech-Language-Hearing Association) website, some signs and symptoms of APD may look like:

  • Difficulty localizing sound
  • Difficulty understanding spoken language in competing messages, in noisy backgrounds, in reverberant environments, or when presented rapidly.
  • Taking longer to respond in oral communication situations
  • Frequent requests for repetitions, saying “what” and “huh” frequently.
  • Inconsistent or inappropriate responding
  • Difficulty comprehending and following rapid speech
  • Difficulty following complex auditory directions or commands
  • Difficulty learning songs or nursery rhymes
  • Misunderstanding messages, such as detecting prosody changes that help to interpret sarcasm or jokes
  • Poor musical and singing skills
  • Difficulty paying attention
  • Being easily distracted
  • Poor performance on speech and language or psychoeducational tests in the areas of auditory-related skills
  • Associated reading, spelling, and learning problems
  • Difficulty learning a new language

This list is not exhaustive, and age must also be taken into account when determining if a child is truly struggling with one or more of the above signs. Additionally, APD cannot be diagnosed from a checklist; there are many factors to consider and not all language or communication challenges are due to APD, or vice versa.

APD must be diagnosed by an audiologist, who will complete a series of tests. Most tests require the child to be at least seven years of age.

Learn more about the signs of APD and take our at-home assessment.

 

Auditory hypersensitivity

Auditory hypersensitivity is when a person is sensitive to sounds. However, it goes much deeper than that, and one research paper even discussed the connection between emotions and auditory hypersensitivity. This is due to the connection between hearing a sound that causes a fight or flight response and that fight or flight response being largely controlled by the limbic system (the limbic system is the part of the brain that controls emotional responses).

Generally speaking, auditory hypersensitivity can cause many challenges, including not being able to tolerate daily sounds such as a vacuum cleaner or a blender. This also affects children in the school environment and in social situations. A quick note - when we talk about auditory hypersensitivity in this article, we are not talking about sensitivity caused by an infection or damage to the ear structures.

Instead, we are talking about how the brain processes incoming sounds - it pays too much attention to certain sounds and finds some sounds to be noxious. When this happens, the individual may have a bigger response than is necessary. They may experience sensory overload (the brain is overloaded with information and cannot process efficiently) and have a fight or flight response.

Some signs that your child (or even you!) is experiencing auditory hypersensitivity:

  • Easily distracted by small, often unnoticeable sounds - may even hear sounds that others cannot, such as the hum of a refrigerator
  • Easily distracted during class time, while doing homework, etc.
  • Unable to tolerate daily sounds such as a vacuum, blender, etc. - may scream or cry, cover ears, run away, etc.
  • Anxiety in social situations and/or crowded environments
  • Easily startled and may have trouble calming down afterward
  • May experience pain with certain sounds

If an individual experiences auditory hypersensitivity, they may often experience hypersensitivity in other sensory systems, such as tactile hypersensitivity. Children with diagnoses of ASD or ADHD often experience auditory hypersensitivity.

 

Tips and tricks

Let’s go through some tips, tricks, and strategies to help if your child is experiencing auditory processing challenges and auditory hypersensitivity.

Challenges with speech and language

First, if you suspect CAPD, have your child tested. Remember, testing for this is typically done only if the child is at least seven years old.

Get a referral for Speech Therapy. A Speech-Language Pathologist (SLP) may be specially trained to help children struggling with symptoms of CAPD, as well as other speech and language challenges that may be present.

If your child requires extra time to process auditory information, allow them that extra time. They may need 3-5 seconds to process what they’ve heard and formulate an appropriate response. Communicate this need with other adults and caregivers.

If your child struggles with social communication, an SLP or Occupational Therapist (OT) can help. You can also role-play different situations that your child is encountering - this provides practice, and the more you do it, the easier it should become.

Challenges with attention and focus

If your child is struggling to attend in school, have a meeting with the educators. There may be specific strategies that can be implemented in the classroom to help improve attention and focus. Oftentimes a different seating arrangement, a special cue between the teacher and student, or more sensory breaks can be helpful.

Sensory Diet

Sensory breaks are simple, easy to implement movement breaks that can be incorporated into the day. Young children benefit from more frequent sensory breaks, while older children and adults can complete longer periods of focused tasks between sensory breaks. However, every person’s sensory needs are different.

Incorporate music or a metronome into learning and focused tasks. Classical music is great for sit-down tasks. Using a metronome during spelling or math activities can help improve attention, memory, and processing speed while simultaneously working on auditory processing. (link podcast episode about the metronome here)

Auditory hypersensitivity

First and foremost, empathize! Children will do well when they can and if your child is experiencing auditory hypersensitivity, this is truly impacting their ability to get through their day successfully.

Try a therapeutic listening program. There are several out there, including The Listening Program (TLP) from Advanced Brain Technologies. TLP uses scientifically-designed music to rewire the brain connections and is a great tool to utilize for anyone struggling with auditory hypersensitivity.

Over-the-ear, noise-canceling headphones are a great option for a variety of situations, such as busy, crowded areas and events. They can also be useful in the school setting. However, use caution here, as it has the potential to cause your child to socially “stand out” and impact their social interactions. Always chat with your child about whether they want to use headphones in different environments.

More proprioceptive input (aka heavy work) and deep pressure. Proprioceptive input calms the nervous system and can help a child feel more secure, especially if they are experiencing auditory overload. Use heavy work before a loud event. Use a weighted compression vest at school. Find the right proprioceptive input for your child - this takes trial and error as well as consistency.

Provide cues prior to overwhelming sounds. If your child experiences auditory overload at school, specifically when a bell or fire alarm sounds, provide a cue before the sound happens. Also, chat with your child’s teacher about strategies and modifications during fire drills. If your child hates the sound of the vacuum at home, allow them to use calming strategies such as heavy work, leaving the area, or noise-canceling headphones.

Sensory diets are a great way to provide your child with the sensory input they need throughout the day to help regulate their nervous system, which can also help modulate and process noxious auditory input. (link podcast episode and sensory diet course)

 

End thoughts

We all have an auditory system, and everyone’s auditory system functions a little bit differently. If you notice that your child is struggling with processing auditory information, struggling with attention during class, having adverse reactions to sounds that are not otherwise troublesome, chat with your child’s pediatrician about referring out for testing. Try some of the strategies provided in this article. And empathize!

Be sure to check out our Podcast Episode #34 - All About Auditory Processing Disorder.

If you'd like to dive deeper on other sensory systems, make sure to read our comprehensive article on Sensory Processing Disorder

Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC
Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC

Rachel Harrington, COTA/L, AC and Jessica Hill, COTA/L both Certified Occupational Therapy Assistants (COTA). They have been working with children for over 6 years in outpatient settings. Rachel and Jessica specialize in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Rachel and Jessica are the in-house experts, content creators, and podcast hosts at Harkla! To learn more about Rachel and Jessica, visit the Harkla About Us Page. Make sure to listen to their weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.


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