My Visit to the Audiologist

It took a whole lot of waiting and battling with the insurance company to figure out what was covered, but I finally made it to the audiologist to find out exactly what is going on with my auditory processing disorder.

The audiologist used a series of tests based on the Buffalo Model.  (For a detailed description of the tests, read APD Evaluation to Therapy: The Buffalo Model.)

After all the testing, she explained to me that I have the Tolerance-Fading Memory (TFM) type of auditory processing disorder.  In the chart she gave me, the school and communication problems listed under TFM were: reading comprehension, auditory figure-ground, short term memory, expressive language, and distractible.

ALICE & CAPD has a detailed description of TFM, but the two main components are

1. Tolerance – reduced tolerance to noise, trouble distinguishing speech from background noise, hyperacusis

2. Fading – difficulty with short-term auditory memory, “part of the message fades away”, trouble formulating long sentences, trouble following instructions, reading difficulty

Fading?  In Plain English, Please?

At first I thought, what do you mean I don’t follow directions, I always do what I’m told! Then I remembered the blank looks I gave the audiologist every time she explained how to do a test and how I had to figure it out as I went along.  And that’s how it’s always been.  Directions never make sense unless I see a diagram or get a chance to practice step by step.

It’s not just instructions; it happens in everyday life.  If someone is telling me a story or anecdote, I’ll start getting very confused after the second sentence.  Can you imagine how hard this makes it to watch TV?  News shows are okay because each auditory snippet registers as a fact that I can deposit or dump and then move on, but shows based on characters and emotion require you to keep storing dialogue in your memory.  Same goes for meetings and other conversations – I’m lucky if I can just pretend to keep up.

Here’s a visual to show how the auditory thing works for me.  The cursor on my phone blocks out words before and after the word I’m looking at:

I can hear and generally understand the word I’m processing at a given moment, but anything in the past is gone, and I can’t anticipate anything the speaker is going to say.  Another analogy would be the professor who used to write on the chalkboard with his right hand while erasing with his left.  It was NUTS.  If you couldn’t take notes fast enough, you were doomed.

This is how it works for expressive language too, and I can’t tell you what a relief it is to have an answer for this!  While I’m talking, I don’t have a road map for what I’ve already said or where I’m going with my current utterance. Hence why I used to repeat it to myself as a child to hear what it sounded like.

What About Tolerance?

I was less surprised to hear about the Tolerance bit (having written about it here) although I was amazed to learn what kind of effect noise had on me without having to deal with socializing too.

Simply repeating one-syllable words with a bit of background noise was enough to bring me to the verge of meltdown, and the audiologist had to give me a break.  I really could not believe it.  There was no restaurant, no people.  Just me, the sound booth, a little background noise, and simple words, yet I was in pain.  It really opened my eyes to how much I struggle with noise in everyday life.

If You’re Considering It

So did I think it was worth it?  Yes, absolutely.  Would I recommend it to other adults?  Only if you can find a good audiologist experienced in CAPD evaluation.  The person I went to was able to discuss with me some accommodations I should request in different situations and made sure to give me information in visual format, which let me know that she knew what she was doing.