By the time this is published in Pathways the mid term election results should be in the books.
Also, at first glance, the combination of politics and auditory processing would seem to be more than a bit unusual. However, then senatorial candidate John Fetterman’s stroke, in the spring of this year, made auditory processing (central auditory processing) a fairly common term in newsrooms and around kitchen tables. Fetterman’s stroke, according to news reports, resulted in an auditory processing disorder.
Hearing the term auditory processing on the nightly news certainly hastened my attention to the content of news reports which seemed to be focused initially on politics and surprisingly auditory processing. Shortly after hearing this I was contacted by some news organizations for my “pitch” on what auditory processing was. Moreover, I was fascinated as to how the different reporters handled the term, mostly reflecting a complete lack of knowledge on the subject and no real willingness to learn anything in-depth about it. There however, was much interest in whether or not auditory processing was or was not a “cognitive” issue.
In my view, this interest was generated not by the interest in the disorder but by the political slant on either side of the aisle – one group supporting that Fetterman had a cognitive the other not. So despite the media’s pedestrian handling of the term auditory processing, they raised an important issue pertaining to cognition as it may or may not relate to auditory processing. Therein lies the essence of my brief commentary.
As many of you know, over the years, I have been involved in many arguments, discussions, debates and articles on the role of cognition in auditory processing. There are indeed many aspects to this topic—far more than what we can write about here. However, one concept that was totally missed in all the media reports was in fact, in my view, the most salient and appropriate. So let me so briefly explain…….
Cognition and Auditory Processing
Acoustic signals are first and foremost handled by the auditory system—including the peripheral and central systems. Essentially, the processing of acoustical signals is first addressed by the auditory system before it is passed onto other systems – namely the cognitive system. I should note however, that there is parallel processing that takes place but this does not really mitigate the crux of my explanation. So let us continue. If the auditory system is not working appropriately, proper coding of the signal is not achieved and a flawed neural pattern is sent to the cognitive apparatus. Even if the cognitive system is working well it cannot correct the poor input (in most instances) and it will yield flawed cognitive interpretations. If these interpretations are in the realm of a cognitive context it will appear that it is a cognitive problem – when it really is not…..If we take the same situation but place it in the realm of an auditory context – it will appear as an auditory problem – which it is… Conversely, we can play the same thinking game only with a damaged cognitive system.
Depending on which domain the system is operating in, the problem can look either auditory or cognitive. The key point is that the two systems are highly dependent on each other. Separating their functions is indeed difficult to do and may not always be achieved. This is why carefully selected test procedures assessing cognition vs. audition are so important.
Skilled psychologists and audiologists working together have the best chance of diagnosing which of these systems are most involved. Combinations of behavioral and electrophysiological tests are often needed to shed light on this very complex challenge. Defining the problem will lead to more efficacious treatment and understanding of the problem.
Critical Role of Auditory Processing
The news reports in October/November should serve to remind us of the important role of auditory processing in our daily lives. There are many individuals like Mr. Fetterman who suffer from similar circumstances. However, unlike Mr. Fetterman often little attention is provided to these individuals.
Many of these cases go misdiagnosed and never see an audiologist. This is the aspect of our field that sorely needs to be addressed.
We as audiologists need to also reach out to those who have input to the media to make more of our clinical and research entities available and carefully explained so all have some knowledge of what we do.