Day: December 14, 2022

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Let’s Listen…..

Has it ever happened to you that you kept on calling your child and he completely ignored you, as if he could not hear you at all, but the moment his favourite advertisement jingle was being aired on the television you see him rushing to the T.V. and listening with rapt attention. This actually leaves you confused what happened when I was calling him, and now how could he hear a T.V. advertisement from the next room.

We all hear sounds around the environment our brain has the innate capacity to filter out unwanted noises, help us focus on what is required at the moment and respond to the sound as required. For our children in the spectrum this process becomes a Herculean task. Children or a person with autism have problems in social communication and processing the auditory input from the environment. Which is a critical component for any communication. For example when Kartik was 15 years old, he was quite verbal and very communicative, when I asked him one to leave the door open, (so that I could get some natural light) he simply could not understand the message, though Kartik knows both “door” and the word “open”. Again and again he would try to close the door because that is what he has always done. I understood that it is not his unwillingness to comply with my instructions, he just could not process what was being said to him.

Another major challenge here is the vocabulary he has in his personal dictionary, the more a child is exposed to vocabulary, The more he understands language and responds, but that I will take up in another blog. Today let’s start with the base of the pyramid, how to develop auditory attention.
It has been noted that generally children with autism have associated Auditory Processing Disorder, this basically means that it’s difficult for these children to correctly identify and interpret auditory information from the environment. One of the major issues which we face because of this is, either hypersensitivity (you will find children covering their ears or avoiding a particular sound) or hyposensitive (trying to seek sounds by continuously throwing things or banging on things to produce sounds or continuously humming to themselves).
As laymen parents hardly notice it and insist on the child speaking and finally get frustrated when he/she does not do so. Speaking or expressive language that too meaningfully to & fro is one of the last stage of communication.

Auditory processing is a mixture of several skills in perfect synchronisation, there is no specific hierarchy in this roughly it can be listed in this way:

1. Auditory Awareness

An infant typically at first startles when he hears a sound, and starts crying, from the din of those noises he hears his mother’s voice, he turns his head towards the sound, which soothes him and he stops crying.
Three things happened here
• Auditory awareness: The ability to understand that there was a sound.
• Sound Localisation: The ability to locate the source of the sound. The child turned towards his mother’s voice.
• Auditory Attention or Auditory Figure Ground: The ability to identify the relevant sound from all the background noise. Here it was the mother’s soothing voice.

2. Auditory Discrimination

This is the ability which enables us to identify, compare and contrast different sounds in the environment and recognise the object even if it is not in front.
It is also an important factor which helps us to recognise us the pitch, intonation, intensity, rate of the speech in spoken language.
It also helps the students to discriminate similar sounds but not get confused like “thirty” and “thirteen”, or “bought” and “brought”. It’s an important skill to understand, separate and blend phonemes, understand or following directions given in the class, reading and writing. Here the child seems to hear but does not listen.

3. Auditory Memory

This means taking in the information presented orally, storing it in our memory and retrieving it when required at the appropriate place & time. This is really a tough task for children with ASD and other associated language development issues. This is one reason why our children struggle in classroom or any social environment. They pick only bits & pieces from whatever was heard and are able to recall even lesser information. These children are constantly struggling with words. They cannot recall rhymes or story. Comprehension exercises are tough because listening and then answering or reading a passage & then answering all are an uphill task as they can’t remember or retain so much.

4. Auditory sequence

As the name suggests children with issues in auditory sequence will have problem in recalling the order of sounds and words , or even remembering a sequence of events what came , first then in the middle & at last.
By the time mommy finishes saying , “Rahul can you close the door, keep the cup in the kitchen and get me a glass of water”. Rahul misses almost everything. He hears something related to water goes to the kitchen and again is equally lost and trying to recall what mom said first.
So what do we do to improve Auditory Intelligence?
One of the preliminary checks we as special educators do is, to check if the child responds to his name? We also notice does the child orient towards the sound he hears, i.e. The direction it is coming from.

Some of the activities me & my team have practiced in the Early Intervention centre were.
1. Ringing a bell in different directions and ensuring the child turns his head towards the sound. This could be bells, cymbals, drums, xylophone, flute, party whistles etc.
Do ensure that instead of moving the whole body towards the sound, the child moves his head and neck, as adults most of the time we move our head and neck towards sound. This shows more brain maturity.
2. A variety of low pitched or high-pitched sounds were used to attune the child to different sounds.
3. Animal sounds were played and the child was asked to select the picture of the animal whose sound he had heard. Example if it was the barking of a dog that was played then from an array three or more animals (cat, dog, elephant) he had to pick the picture of the dog.
4. A fun activity I used to do, was to make the child , e.g. press my nose and I used to make “oink”, “oink” sound, if he pressed my one cheek, a dog barking sound, the other cheek a cow would moo. This when done daily, worked on identifying sounds the fun way, it worked on memory as he could hear, the piggy whenever he pressed my nose, undivided attention and awesome eye contact. My bonus, a child laughing and again and again touching my face to hear each sound. What more does a therapist require?
5. Similarly sound of vehicles, mixer grinder, cooker etc were also played and the children were asked to identify the sounds.
6. We used to play music and hide the phone around the room. The child had to locate the phone just by the sound . This was an important activity for auditory location or to find the source of the sound.
7. Lots of poems like “I am a little tea pot”, “head shoulders knees & toes” or “Old Mac Donald” etc. were used to teach children the poem as well as an activity to inculcate auditory motor coordination.
This was an important stimulation to the brain where we are forcing it to multi task, listen as well as move the body as per the instructions thus creating stronger neural pathways, and as children haven’t, we enjoyed these action rhymes?
8. Next came on table top one step instruction, from an array of toys or flash cards, we would ask the child to give a car, a ball, a mango etc.
9. This then would move on to two step instructions, give me the car & cup or give me the tiger , banana & bed.
10. Prepositions was another activity I used, it was a fun way to teach auditory intelligence as well as to check if the child remembers the instructions & stays on task. This is an important life skill and a prerequisite for school readiness, i.e. staying on a task and not fleeting from one task to another without finishing any.
11 . Predictable & Unpredictable commands- This is one of my favourites and really develops auditory intelligence.
Predictable commands would be, “keep the glass in the kitchen and comb on the dressing table”. This was easy as these are mostly where you will find these two items. Similarly, you can give many such predictable two to three sets of commands and let the child move around the house and gently bring him back to task if he forgets the errand on the way while moving from one room to another.

Once the child becomes proficient in this we move to Unpredictable commands ,e.g. keep the glass on the bed and the comb in the bookshelf. Now this is not the usual position of these things, the child really has to keep in memory the instruction and follow it. The child also should follow the same sequence as instructed, so first task mentioned has to be done first and so on.
A prerequisite here is that he should know all the names of things you are using and also be able to identify the places & objects where he has to keep the things. Otherwise, the child would lose interest and get lost while following the instructions.

12. For older kids with better communication skill, I usually play auditory games asking them questions, some examples (They just had to listen & answer)
a. Do dogs moo?
b. Is ice-cream hot ?
c. Do we get wet in rain?
d. Is elephant a tiny animal?
e. A pilot flies an aeroplane…(yes/no)
f. We feel hot in winters…(yes/no)
g. Apple is blue in colour (yes/no)
Here the students had to answer in one word, or yes/no after listening to the question.
13 .Barrier Games : Another favourite game of mine ,there are many videos in YouTube, for barrier games. These are excellent to build auditory skills, language development, following instructions etc.

Sharing some links so that you can understand the concept. Again, the prerequisite here is the child should have a good vocabulary and should be able to follow the therapist. One can always tone down the game as per the child’s level. Some of the links for barrier games:
a. https://youtu.be/OWCa8mQDAjU
b. https://youtu.be/2ikYuHM3wKI
c. https://youtu.be/Vxcb8siSDZA

There are loads of auditory games and activities online, I have shared some which I have used extensively. Remember listening is the most basic prerequisite for communication. When you are a good listener then, you can create a visual image of the objects being talked about. This then helps in development of good language skills too. In the adult world poor listening skills can lead to lots of disastrous miscommunication.

Only a good listener can communicate well and yes, and we all love a person who just doesn’t only talk but listens too.

So , “Let’s Listen”.

Author Simmi Vasu

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The creative representation for this blog is done by our extremely talented CreativeSaathi associate Morpheus Nag.

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