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What are Auditory Processing Problems, and How do They Affect Speech and Language Development? Auditory processing problems affect many boys with fragile X syndrome. These range from auditory attention problems, through memory and higher level conceptual disorders. Attention disorders may underlie many receptive language (listening and comprehension) disorders in boys. It is often difficult to separate more generalized attention deficit disorder (ADD) from an auditory processing disorder, as the child may not attend to the language spoken to him for a variety of reasons. Hearing tests should be conducted to rule out hearing loss before determining that an auditory processing problem is present. Auditory processing problems are also seen in children who have word retrieval problems. They cannot come up with the word for which they are searching. This may result in a dysfluent, cluttered speech output, as they search for the word they wish to say and stumble over others. Dyspraxic characteristics are seen when a boy cannot make the oral motor movements in sequence to form clear speech. Besides the oral-motor causes of dyspraxia, there may be underlying formulation and expression problems. Auditory memory, particularly for sequences, is frequently an area of difficulty for boys with fragile X. When a teacher gives a series of directions, they may not remember all of them. They may have difficulty sequencing steps in a task and sequencing words in sentences. Auditory comprehension problems are usually in keeping with overall cognitive level. Both boys and girls with fragile X may have difficulty with higher level cognitive tasks. While they understand concrete questions (What? Who?), they may not understand the most abstract (Why? What do you think about?). Gail Harris-Schmidt, Ph.D., CCC-SLP
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