(a)

1. (1) Central auditory processing disorders may specifically fall into one (1) of the following subprofiles.
2. (2) A definition and characteristics of each subprofile are presented.

(b) Auditory decoding deficits involve:

1. (1) The inability to:

   1. (A) Discriminate fine acoustic differences in speech with poor auditory discrimination or poor auditory closure; and
   2. (B) Hear differences between speech sounds;
2. (2) Poor auditory closure abilities;

3. (3)

   1. (A) Poor performance on tests of monaural low-redundancy speech and speech in noise.
   2. (B) Right ear performance is often poorer than left ear performance.
   3. (C) Errors tend to be phonemically similar to the target (“bite” for “bike”);

4. (4) Listening difficulties in situations where:

   1. (A) External redundancy is reduced;
   2. (B) Child is unfamiliar with vocabulary;
   3. (C) Information is presented without sufficient contextual or visual cues;
   4. (D) Noise is excessive;
   5. (E) Environment is highly reverberant (i.e., large auditoriums, lunchroom, playground); or
   6. (F) Child is engaged in group activities (e.g., sports) or social communication;
5. (5) Becomes fatigued much more quickly than their peers;
6. (6) Demonstrates poor listening habits;
7. (7) Report that they cannot or did not hear what was said;
8. (8) Misunderstands common words;
9. (9) Frequently requests to have information repeated;
10. (10) Processes information slowly and inaccurately;
11. (11) Reaches auditory overload quickly;
12. (12) May perform well in subjects where phonemic decoding is not required, such as math computation;

13. (13) Difficulty with:

    1. (A) Development of vocabulary;
    2. (B) Syntax;
    3. (C) Semantics; and
    4. (D) Second language acquisition;
14. (14) Difficulty with reading, particularly when an auditory phonics approach is applied;

15. (15) Difficulty with:

    1. (A) Spelling;
    2. (B) Note taking;
    3. (C) Following directions; or
    4. (D) Answering simple questions; and
16. (16) May demonstrate problems with retention, discrimination, and/or sound blending of phonemes.

(c) Auditory integration deficits involve:

1. (1) The inability to perform tasks that require intersensory or interhemispheric communication resulting in the inability to synthesize pieces of information into a useable whole;

2. (2)

   1. (A) Difficulty with tasks that require interhemispheric communication, within and/or across modality.
   2. (B) For example, integrating auditory with visual functions or linguistic-based auditory information with nonlinguistic auditory information, such as rhythm and pattern perception;
3. (3) Demonstrates abnormal left ear suppression on dichotic listening tasks, combined with bilateral deficits on tests of temporal patterning which require a verbal report;
4. (4) Difficulty determining how to do some tasks;

5. (5) Difficulty with multimodality tasks, such as:

   1. (A) Note taking;
   2. (B) Drawing a picture from verbal or written instructions;
   3. (C) Dancing to the beat of music; or
   4. (D) Singing/playing an instrument;

6. (6)

   1. (A) Asks many task-related questions.
   2. (B) Requires task parameters;
7. (7) Difficulty putting parts into whole;
8. (8) Tends to watch and wait;
9. (9) Difficulty getting started on or moving quickly from task to task;
10. (10) Requires more time to complete the same task as peers;
11. (11) Easily overwhelmed and often gives up or responds “I don’t know” if given lengthy assignments or instructions;
12. (12) Processes slowly, but may eventually reach the correct answer;
13. (13) May do poorly in some situations where noise is present;

14. (14) Difficulty with:

    1. (A) Sound symbol association;
    2. (B) Reading recognition; and
    3. (C) Use of symbolic language (e.g., math application);

15. (15) Difficulty with:

    1. (A) Sight word recognition;
    2. (B) Spelling;
    3. (C) Writing skills; and
    4. (D) Other sensory integrative tasks;

16. (16)

    1. (A) Inability to perceive and/or use the prosodic aspects of speech, including:

(i) Rhythm;

1. (ii) Stress; and

   1. (iii) Intonation.
   2. (B) Spoken sentences may sound like strings of unrelated words, with no relative stress to emphasize key words and other cues; and

2. (17) Possible problems with visual motor tasks.

   1. (d) Auditory association deficits involve:

3. (1) The inability to:

   1. (A) Apply the rules of language to incoming acoustic signal; and
   2. (B) Receive pieces of auditory information, analyze them, and attach meaning to them;
4. (2) Demonstrates bilateral deficits on dichotic listening tasks;
5. (3) Performance on tests of temporal patterning is often good;

6. (4)

   1. (A) Speech sound discrimination typically is quite good.
   2. (B) However, word recognition itself may be poor;

7. (5)

   1. (A) Exhibits receptive language deficits in:

      1. (i) Vocabulary;
      2. (ii) Semantics; and
      3. (iii) Syntax.
   2. (B) Pragmatic and social communication skills may be poor;

8. (6) Often exhibits difficulty with:

   1. (A) Sentences presented in the passive voice (e.g., The ball was thrown by the girl.);
   2. (B) Compound sentences; and
   3. (C) Other linguistically complex messages;
9. (7) Inability to attach linguistic meaning to phonemic units of speech;
10. (8) Often requests clarification, saying “I don’t know what you mean”, or “I don’t understand”;

11. (9) Difficulty with:

    1. (A) Vocabulary;
    2. (B) Word naming;
    3. (C) Syntax;
    4. (D) Semantics; or
    5. (E) Verbal/written expression;
12. (10) Problems with pragmatic language/social communication;

13. (11) Demonstrates errors of:

    1. (A) Punctuation;
    2. (B) Grammar;
    3. (C) Verb tense; and
    4. (D) Capitalization;
14. (12) Written work may contain stilted language across sentences (e.g., “We went to the park. We went to the store. We went to the movies.”);
15. (13) Does not understand jokes, idioms, multiple meanings, etc.;
16. (14) Adequate reading recognition (decoding) with poor comprehension;
17. (15) Difficulty with word problems in math;

18. (16)

    1. (A) Demonstrates increased academic difficulties with increased linguistic demands.
    2. (B) Difficulties become more apparent about third, fourth, or fifth grade;

19. (17) Difficulty with:

    1. (A) Independent work;
    2. (B) Whole language approaches; and
    3. (C) Self-monitoring of learning behavior;
20. (18) Often able to repeat verbatim instructions given, but does not necessarily comprehend; and
21. (19) Possible early problems with phonology.

(e) Output-organization deficits involve:

1. (1) The inability to:

   1. (A) Organize, sequence, plan, or recall appropriate responses resulting in difficulty on tasks where success is dependent on efficient motor pathway transmission or motor planning skills; and
   2. (B) Sequence, organize, and recall what is heard;
2. (2) Poor performance on tests that require the child to report on multiple elements because of inability to formulate the appropriate response;
3. (3) Demonstrates abnormal contralateral acoustic reflexes and extremely poor speech-in-noise skills;
4. (4) Performance on monaural low-redundancy speech tasks will be unaffected;

5. (5)

   1. (A) Demonstrates expressive language problems that involve syntax and articulation.
   2. (B) Errors often consist of perseverative responses of previously heard words.
   3. (C) Sequencing errors and sound blending difficulties are not uncommon;

6. (6)

   1. (A) Demonstrates poor performance on any task that requires report of more than two (2) critical elements.
   2. (B) Poor memory-based skills, such as word recall or sequential memory;

7. (7) Demonstrates poor organizational skills, reversals, poor recall and word retrieval abilities, and difficulty:

   1. (A) Following directions;
   2. (B) Taking notes; or
   3. (C) Remembering assignments that have several parts;

8. (8)

   1. (A) Listening behaviors are disorganized and impulsive.
   2. (B) Poor planning may look like attention deficit disorder;
9. (9) Spelling, writing, and sound blending are often poor, with good reading comprehension; and
10. (10) Possible difficulty with fine or gross motor skills.