The Unsatisfying IEP (Individual Educational Placement) and CAPD: An Instructive Commentary

Cydney Fox, AuD, Audiology Solutions LA, Los Angeles, CA

Why are IEPs so difficult? Supposedly, a time when the child’s educators sit with other contracted professionals, determine the student’s educational path, and make recommendations and accommodations, which always result in successful academic achievement. Right?? WRONG.

It’s a meeting of education vs science. The educators often do not understand the audiologist and cannot understand why an auditory processing disorder would affect education. The audiologist presents scientific evidence explaining why this student has a diagnosis of Auditory Processing Disorder. The educators tend to ignore this information, disregard the recommendations, and refuse to spend money on therapeutic methods. Eventually, the district may get sued by the parents.

Why do educators disregard our input? Because they do not understand it; we do not speak the same language. They speak “Education,” and we speak “Medicine, Anatomy and Physiology.” Normally, the audiologist reads their report to the educators who do not understand a thing that has been said. When I finally realized this after some 10 years of IEPs, I changed my presentation to use visualization and a very animated voice. Since changing my methods, I have been more successful getting what I want for the student.

Let me demonstrate. Somewhat inaccurate, but it works.

Thanks for allowing me to be here. It occurs to me that we don’t understand each other. You speak “education,” and I don’t understand that.  I speak “medicine,” and many of you don’t understand that. So let me take you on a quick trip around the brain.

I want everyone to visualize an orange. The orange is our head. Now the orange has a thick orange skin around it which stands in for our skull. Let’s peel the skin off and see what is underneath. There is all this whitish yellow flesh on top of the orange. Those are neuron tracts that allows one part of the brain to communicate with another part. When we remove the fleshy stuff, we see the cortex of our brain. (I add a colored picture of the cortex.)

The cortex is the CEO/Board of Directors of our body and makes all the decisions how to interact with our world. There are certain problems that live in the cortex: autism, ADHD/ADD, sensitivity issues, visual processing, auditory processing, emotional issues, dyslexia, etc. Because neuron tracts run from one side of the brain to the other, these problems can talk to each other and make certain problems worse than they appear.

So let us cut the orange in half. Look at the beautiful orange fruit. This is the sub-cortical area, which collects all the input from our world and sends it up to the cortex to act on it. However, we have divided the brain in half, a right brain and a left brain. They must be able to talk to each other, so we are going to build a long bridge called the corpus callosum. It goes from one end of the orange to the other. This is where signals cross from the right side to the left and vice versa. This is where integration happens, and this is where a lot of Johnny’s problems occur. If there are potholes on this bridge, the information gets stuck in the pothole and doesn’t get across the bridge in the amount of time it needs to, and we have an integration problem.

         Now let’s look at the auditory pathways and what an auditory processing is. We’ll use the word “cat.” Johnny hears the word “cat.” “CAT” travels to his ear via acoustic energy, goes down the ear canal, through the eardrum and is changed to mechanical energy. This mechanical energy goes to the inner ear, that snail looking structure, where it is turned into electrical energy. Now it is no longer the word “cat.” It has been broken into frequencies, intensities, and durations to form a distinct pattern. This informational pattern jumps onto the acoustic nerve and travels into the brain where it is met by a traffic cop. The traffic cop says, “This is auditory information. You must go to the acoustic cortex. Get on the 405 N.” So, the information gets on the freeway and every time there is an off-ramp, it gets off. A bunch of worker bees start tuning the information; it’s like a pit stop in a car race. If someone forgets to fill up the tank with gas, the race car gets back on the track, runs out of gas, and is out of the race. That is not what happens with this auditory signal. If something didn’t get done or didn’t get properly manipulated, it still gets back up on the freeway where it finally arrives at the Auditory Cortex. The Auditory Cortex is the decoding center.

The Auditory Cortex says,” We have a /c/ sound, an /a/sound and a /t/sound.” But suppose something didn’t get processed correctly? We may have a /c/ sound, an /O/ sound, and a /t/ sound. When you merge these sounds, you get cot, not cat. Next, the phonemes are sent to the Associative Cortex where they are merged into cat. IT’S NOT A WORD YET! CAT must be sent to the linguistic cortex which takes out its huge dictionary to see if “cat” is a word. The visual cortex starts screaming, “I have a picture.” This picture gets sent to the linguistic cortex to be put in a file folder with information about “cat.”. That’s the reason when someone says “cat” or you read “cat”, you visualize a picture of a cat. This file folder gets put into a file cabinet in memory so that the linguistic cortex can pulls out the information when needed.

This is what we call a bottom-up or input process. Once “cat” gets to the linguistic cortex, it becomes an output or top-down process.

My job is to determine if the bottom-up information is correct so that the linguistic cortex does not get faulty information. If the information is correct but the linguist cortex “misinterprets” it, that is a top-down process. To use the Military as an example, it is like the spy giving the General information, but the General misinterprets it and sends the wrong orders to the troops.

I find that this explanation puts us all on the same page – it is a good communication tool. I frequently get the therapy and accommodations I ask for. I just keep referring to my orange and tying it back to what changes I want to make so that the auditory pathways are functioning better. Try it and see if you get better results.

About Pathways

Pathways is both a column that covers topics related to CAPD and Neuroaudiology and a society for people interested in central auditory disorders that regularly meets to discuss these issues.

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