Case Study: Auditory Processing Disorder

By: NeuroNet
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Student’s Name: Chad, Age 10 years 10 months

Therapist’s Name: Rob Burroughs, MS CCC-SLP
NeuroNet Program Used: Integrated Rhythms
Developmental History: Chad achieved developmental motor milestones when expected. He
was referred for a language assessment within the public school system and qualified for
language therapy as well as resource teaching for math and reading challenges. In January of
2012, Chad was diagnosed with a significant auditory processing disorder with specific deficits
in phonological awareness, auditory figure-ground/integration, auditory memory, temporal
processing, and concept strategy. Chad has a history of recurrent otitis media with pressure
equalization tube placement in June 2004, however, intermittent ear infections persisted. Poor
middle ear health and concomitant flat tympanograms delayed the onset of the NeuroNet
Program for more than 7 months.
Chad is a polite and eager to please adults. He perseveres when tasks are difficult and seems
to always put forth his best effort in therapy. His mother reported the Chad makes friends and
gets along well with his classmates. Chad lives in a bilingual home where English is the primary
language but Hindi is also spoken. Recently, Chad’s home situation has altered with the divorce
of his parents coupled with a recent move from the Northeast to the Southeast.

Symptoms or Circumstances that led the student to NeuroNet: Chad’s mother stated that
would only give him one-step directions using simple vocabulary, always questioning him to
verify comprehension. She further noted that homework consumed a large portion of their
weeknight schedule. Even with resource teaching in math and reading, Chad was barely
passing fourth grade academic subjects. His mother was most concerned with his reading and
math grades in school. The audiologist who diagnosed Chad’s APD (Auditory Processing
Disorder) referred him to the NeuroNet Program.
My primary concern revolved around Chad’s phonological awareness and its impact on his
reading skills, both word decoding and overall comprehension. I felt given his APD, until he
resolved deficits in phonological awareness, his reading accuracy and comprehension would
not improve.

Results of Initial NeuroNet Evaluation: The TAPS-3 (Test of Auditory Perceptual Skills –
Third Edition) was administered to Chad at 9 years and 9 months. Results are based on norms
comparing his skills to others his same chronological age:
Phonological Index: SS=66, 1st percentile

Memory Index: SS=84, 14th percentile

Cohesion Index: SS=90, 15th percentile

Chad’s performance on the Gray Oral Reading Test-4th Edition (GORT-4) resulted in a
standard score of 70, at the 2nd percentile, with a similar score in reading accuracy.

On the NeuroNet Integrated Rhythms Evaluation, Chad scored a 2.66 out of 4 (expected scores
for his age range from 3.5 to 4.0). His strengths were noted in auditory number memory (3.8),
one-foot stool jumping (4.0), stepping up/down with hands on hips (4.0), and front somersaults
(4.0). Significant deficits were noted in one foot standing balance (bilateral) (1.0 & 2.0), auditory
alphabet memory (1.5), red stick pattern (1.0), toe taps with hands on hips (3.0), and copying
and writing numbers and alphabet (both 2.6).

Progress through NeuroNet : Chad and his mother were dedicated to completing his daily
NeuroNet exercises routines, which initially seemed easy for Chad. He was required to turn the
sound off whenever he achieved perfect scores for two consecutive days on any exercise.
Then, he was required to turn away from the computer and complete the exercise by listening
only, using the same performance trigger; a task that proved significantly more challenging for
him. Chad progressed straight through all four levels using this approach and successfully
completed the Integrated Rhythms Program in 5 months. This was, in part, due to his mother’s
commitment and diligence in completing the NeuroNet exercises and keeping all appointments
at my office. Chad also enjoyed good health throughout the program.
Gains Since Beginning NeuroNet and Post Test Results:  Chad’s mother’s first reported
change was that she no longer had to question his understanding of oral directions. She also
noted Chad was completing his homework in less time. Six weeks into the program, his mother
reported, “Chad made straight A’s on his report card for the first time in his life!” From that
moment on, as his therapist, I noticed a marked change in Chad’s self-confidence.
The TAPS-3 was used as a post test assessment, 13 months after the initial testing. The chart
below includes pre and post test results:

TAPS-3 Std. Score Percentile Std. Scores Percentile

1/12 1/2 2/13 2/13
 Indices
66 1 90 25
Phonological
84 14 83 13
Memory
90 25 93 32
Cohesion
79 8 88 21
Overall
The only new intervention Chad received during this 13 month period was the NeuroNet
Integrated Rhythms Program. It was astounding how much improvement was measured by this
test in Chad’s phonological skills. I believe that this one area of improvement led to Chad’s
overall improvements in reading, math, and other academic subjects as reflected by his
improved grades and increased self-confidence. His mother reported that Chad was also
completing his homework assignments in much less time and that was able to do so
independently, requiring less help from her. Chad’s mother shared that, after completing the
NeuroNet Program, her child was much more self-confident and displayed an increased interest
in reading. She noted that for the first time in his life, he picked up a “chapter book” and read it
from cover to cover. She was beaming with pride.