Recent news stories here in Pennsylvania feature discussions of the “auditory processing disorder” (APD) of our senatorial candidate, John Fetterman. As he explained prior to his nationally watched debate with his Republican opponent: “I might miss some words during this debate, mush two words together….” He was provided with a monitor on which he could view transcripts of the questions and his opponent’s responses—but was still clearly struggling. How tragic it would be if his temporary affliction cost him the election, especially given how many of us also suffer from “auditory processing disorder.”
The good news is that the concept of auditory processing disorder as an adult problem has entered our awareness. Previously, APD was primarily associated with children and learning difficulty, often with autism and ADHD. One study reports that 42% of children identified as learning disabled have APD. There have been few studies and fewer statistics about the incidence of APD in adults, particularly in the elderly. And yet, we elders know it exists; we reveal the existence of APD in regular conversation….
- recently, one of my neighbors asked for computer help, saying that the Geek Squad guys spoke too quickly for him to understand,
- a long time friend recounted with great sorrow that his cochlear implant wasn’t effective because his “brain was simply too slow” even when he could hear;
- on our recent cruise, some passengers insisted that the guides speak better English, as their accents made them hard to understand.
- My husband and I routinely use closed captioning when watching TV; when we are not straining to comprehend, we are better able to comprehend the plot.
So why is there so little attention on adult and elderly APD? To some degree, APD is compounded by the inevitable hearing loss in elderly adults –two thirds of those over 70 have hearing loss—and the prevalence of cognitive decline. To quote from a 2017 online publication
“Successful communication and navigation in cocktail party situations depends on complex interactions among an individual’s sensory, cognitive, and social abilities. Older adults may function well in relatively ideal communication situations, but they are notorious for their difficulties understanding speech in noisy situations such as cocktail parties. However, as healthy adults age, declines in auditory and cognitive processing may be offset by compensatory gains in ability to use context and knowledge….. “
We elders regularly see advertisements for cochlear implants, and more recently for hearing aids. None of these sales pitches mention that the communication problems attributed to hearing may not be simple hearing loss. Rather, studies and therapies addressing the complex interplay of auditory and cognitive processing in the elderly are desperately needed. Thanks, John Fetterman for helping us “normalize” auditory processing disorder. His APD may be temporary, a consequence of a recent stroke. For we elders, APD has been an un-named, untreated path to permanent cognitive decline.