I seem to have Auditory Process Disorder as a result of my long covid (completely separate from the reason for my aid). Self-diagnosed as it seems completely out of my hospital’s wheelhouse in both testing and rehab…
The result of my BrainHQ exercises point to issues with auditory discrimination, auditory memory, auditory sequencing. With the discrimination part, I do not have too many issues with typical conversations as there’s context but lots of difficulty without context or a new or shift in topic. For example, I have lots of difficulty watching the beginning of non-subtitled tv and movies, listening to adult audiobooks, learning new things, understanding GPS (street names), etc; it sounds like a garbled mess or a foreign language.
There actually is training/treatment for various types of auditory processing disorder, lots of scams but some legitimate. However, proper diagnosis comes first. My advice is to see a neuropsychologist.
I can’t get another neuropsych; there’s a limit in how often one can be assessed and I had one in 2021. My assessment did not differentiate between visual and auditory issues; not sure if my neuropsych does not conduct testing for this or I had too many/severe issues at the time and there wasn’t a point.
All of my PT/OT/ I ask for without any testing/diagnosis but it seems this is a bit outside my SLP (and audiologist) knowledge.
So, you had this same hearing loss prior to covid but without auditory processing issues?
When you were self-diagnosing, were you streaming the audio into your good ear or into both ears at a comfortably loud volume? When you have difficulty with TV and audiobooks, are you streaming into your ears at a comfortably loud volume?
My hearing loss in my is something I’ve likely had since birth. I started trialing one aid (left only, most basic kind without bluetooth) beginning of last year, but not because I had any additional hearing difficulty.
Ive never had difficulty with TV/movies/audiobooks/GPS, etc prior to covid; these things I listen to through TV/laptop/cell phone speakers with my aid; have also tried with over-ears headphones. I don’t have issues listening to easier things like Nancy Drew.
Am in long covid clinical trial using BrainHQ on iPad and I noticed some “strange” results which was confirmed when I asked them about my results. All the exercises I had difficulty fall under auditory processing; there is a giant difference between my visual vs auditory performances.
I realize it’s not for diagnosing and I may have more encompassing brain issues, but I see no harm try some exercises to see if it helps, whether or not I have an actual diagnosable disorder. I searched here and someone had mentioned Angel Sound; I have difficulty in modules on that too.
Interesting. How long has the long covid been now? I’ve heard that it can cause a lot of symptoms similar to post-concussion syndrome, but I guess we probably still don’t know a great deal about it. Have you been seeing improvements in some areas?
Do you have difficulty with live speech, or just recorded speech?
Since Mar 2020. I experienced trauma/shock end of last year and overnight my vitals, bloodwork, etc returned back to pre-2020 . Now, along with massive deconditioning, I imagine I have a bit of “resulting damage” from all those years like how an organ gradually stop functioning and completely died last year. But, I can now slowly get better.
The results of the exercises was quite shocking to me; I do not feel I have auditory discrimination issues live and I would have sworn it was the program malfunctioning. It’s possible this is part of what causes me to be unable to respond to people sometimes though. I am very aware that I have memory and sequencing issues live, just didn’t realize it was auditory related.
I experienced trauma/shock end of last year and overnight my vitals, bloodwork, etc returned back to pre-2020 .
Oh, interesting and strange. Sometimes it feels we know so much in this modern world and then suddenly we’re reminded of what we DON’T know.
What area are you in? It may be worth having a full auditory processing assessment with an audiologist who does that if you can find one nearby.
Evidence for the efficacy of auditory training is still a bit weak overall. For children with auditory processing issues I believe the most powerful emerging intervention is on-ear technology (put a microphone on the speaker and pipe it right into the child’s ears with devices that essentially look like hearing aids). This is convenient, because it was something we were doing in classrooms anyway to provide support, but it turns out that in addition to increasing the signal-to-noise ratio and helping them out directly with their difficulty, it actually appears to have long-term therapeutic effects whereby after 1-2 years of semi-consistent daily classroom use there are lasting improvments in the auditory system when use is discontinued, as measured by EEG as well as behaviourally, and improvements seem to generalize well. This makes sense from a brain function perspective–neurons that fire together wire together, and by providing a consistent, clear speech signal the pathways in the brain dedicated to processing that signal become stronger/fire in better synchrony.
Auditory training for specific auditory skills is. . . a pathway that is still being pursued and something many clinicians are enthusiastic about with limited scientific evidence. I think that there is reasonable indication for benefit in certain circumstances right now. For example, in the case of amblyaudia where one ear is ‘weak’ in dichotic listening tasks, this seems to be affected relatively quickly with training to good benefit. On the other hand, there are a lot of other attempts at targetted auditory training where there is evidence that the individual gets better at the particular game (or whatever) that they are playing, but it doesn’t appear to generalize to other aspects of life. In some ways I also think that specific skills training might be a bit of a red herring: When we test for auditory processing disorder we select a handful of tests that assess a small subset of our auditory skills. It seems likely that if a couple of those are disordered there may well be other untested skills that are also disordered. Trying to boost each skill individually with artificial stimuli may not make practical sense compared to trying to just using the target complex auditory stimulus of speech.
So that is my perhaps-unasked-for rundown of the current state of auditory training, and keep in mind that my opinion is my own and there is actually no gold standard for diagnosing and treating auditory processing disorder yet, although at this point there is a general consensus that it is a real thing. Clinicians and scientists are still arguing and researching. It’s a new area where clinical practice is running a bit further ahead of scientific evidence than we might prefer. But I also have a heavy scientific research background and I can sometimes be more demanding and skeptical than other in my field. Clinical audiologists are eager to help the person in front of them.
Your case is a bit further complicated by the facts that: A) You already have a unilateral hearing loss, though mild, which is reason enough to consider your hearing a bit disordered and would be expected to result in speech-in-noise difficulty all by itself, and B) your current symptoms are acquired from a new disease rather than developmental in childhood, which is what a lot of the literature is focussing on right now, Plus, long covid and may well be associated with other cognitive impacts.
As an aside, this is anecdotal, but a fair number of my concussion patients (who often struggle with sound and noise sensitivity and auditory processing issues of their own) report that they have specific difficulty with recorded speech while live speech is okay. I have no idea why this is. There appears to be some way in which the post-concussion brain is more sensitive to the distortions associated with recorded audio. I’ve heard other clinicians mention it, but I don’t think it is something under investigation right now.
What does all of this mean for you? I think it is just a caution that it may not be worth pursuing anything that might present a financial burden to you. Nothing in current auditory training is risky or damaging, apart from using up your time and money. So as long as you feel that you are up for taking a chance you can likely try anything, but if someone quotes you $10k for lengthy training sessions I might hesitate, even if they are enthusiastic about it. (Or insert whatever amount of money becomes difficult for you rather than acceptible experiment for your disposable income.)
And then additionally, you can probably chase some of this on your own. You mentioned Nancy Drew audiobooks were fine. You can probably work on spending some time doing focussed listening at a comfortable but loud-ish volume, and up the difficulty over time. You can also be more aware of the ways in which distance and noise rapidly degrade a speech signal and that this might be impacting you, so organize your environment a bit to manage that.
Sorry again for the long post; it’s an area of interest for me.
Doesn’t the Buffalo model for go back to the 1950s with later refinements? Are you saying those treatments do not help APD or that other forms of training are less proven?
Does recorded audio as it’s being reported to you include telephone or live but amplified? I wonder whether the distinction may be connected to digital audio versus live and unamplified.
I don’t believe formal testing would be helpful, especially since I have other cognitive and neurological issues. Like many of my other long covid tests, the results would probably be inconclusive or just plain wrong.
I have seen many apps, and my was looking at one too, but they are all fairly pricey without knowing the efficacy. I feel though, getting an app that’s more targeted, versus just back and forth conversations (which is what my SLP is doing) is better as I don’t have issues with general conversations.
They used Buffalo model in this study The Hearing Journal8 The three training they conducted seems exactly what I need too
So I was hoping my SLP or audiologist would be familiar but nope…
The author of that paper is the same audiologist providing training as was linked above by user490, if that interests you. It’s the same therapy, but she did it in person for that young doctor whereas the above website offers self directed virtual training, which will be cheaper.
Hi, new member here, signed up just to reply to this thread and hopefully get some help.
I’m also someone who has been diagnosed with , due to long-COVID-like symptoms since COVID vaccination in 2021. (I have never caught COVID, verified by repeated medical tests.) is “normal” though I suspect there are more losses than before in the extended high frequencies (particularly 12-16kHz.) Despite conventional wisdom suggesting I should be fine hearing-wise, I’m having many hearing difficulties that I never had before. Subjectively, it is clearly much worse than before. APD is just one of a very, very long list of issues since vaccination.
I’m wondering about the “long COVID clinical trial” - how do we get into this (if I’m eligible)? I had also read on reddit etc. that BrainHQ can be helpful for APD so was looking to start doing that as well, regardless of the trial.
So sorry to hear about the issues you are having (which sound at least they overlap a bit with mine) and hopefully the trauma/shock has put you on a path to recovery since last year. I’d be interested to know more if that is possible in some way. Thanks!
I have been chasing to get diagnosed and therapy since I posted this to no avail as my hospital puts as a learning disability despite it being documented in an updated neuropsych evaluation as well as from a neurologist, and having an updated that actually says I hear better in noise! However, I just got scheduled to have testing done virtually in Jan; I was assured there’s no difference in-person vs virtual as long as you have the technical/computer requirements. Additionally, the doctor I’ve decided to move forward with is a musician so they have better understanding of some of my struggles; I have music related issues that other doctors completely brush off.
The clinical trial I was in was RECOVER-NEURO, which is now over. It was for brain fog, not APD, which showed that brain training is ineffective against brain fog.
Most people who have this issue have it as part of the long covid umbrella of issues and once their long covid resolves, these issues disappear along with it. I have also heard people taking medication for brain fog which helped their APD issues. In my case, my long covid issues are gone, I don’t have brain fog any more, and I’m dealing with resultant or triggered issues. Additionally, as my neurologist pointed out, I may have had some level of APD previously but was able to compensate as my other cognitive functions were incredibly high. Since I’ve lost some of that compensation (e.g. processing speed is at 20%), even if this area of my brain was not affected, which it clearly was, I’d still experience issues.
Hi, thanks for that additional information. I have been struggling with many similar issues to you (and more) since 2021, and some music-related struggles (that most people brush off) include worse frequency discrimination (even though within normal range), absolute perfect pitch is now worse (but not completely gone, but less confident or off by a semi-tone), difficulty telling between similar instruments (viola/violin, piccolo/flute) etc. This is not to mention all the non-music related hearing issues I’ve noticed everywhere else that were never present before, and how things simply sound “different” and noticeably less clear and much softer.
Despite the expense, I would highly recommend the evaluation - if nothing else, it provided vindication, and evidence for practitioners so there is less brush-off. Treatment, though, is unfortunately nebulous and a hard slog and so far has been largely a trial and error and looking for elusive long-term improvement, and seemingly largely in the realm of clinical trials.
Regarding your neurologist’s comments, I would agree that we have likely suffered cognitive impairment which may present as APD (and whether this is reversible is debatable), but certainly loss of compensation is very plausible and unfortunate. I’d be curious if they ever asked you to undergo a brain and the results. And if the neurologist ever made any formal diagnosis and/or recommended treatment.
I’m surprised the neuropsych documented the APD as my discussions with neuropsych simply said it was not their area and they could not comment.
If there is a way to discuss this with you in private, I would be happy to do so, since I’m sure you would prefer not to talk about sensitive medical issues on a public forum.
Also - how did you get into RECOVER-NEURO? Was BrainHQ simply just what the researchers for RECOVER-NEURO used, or was it that you sign up for brainHQ and then they identified users for study after signup etc. based on results?
You’re the first person I’ve heard that has said they have musical issues!
BrainHQ just happened to be what the clinical trial was using. They worked with BrainHQ to have different versions for the different branches of the trial - e.g. the therapy branch would have the difficulty adjusted based on your performance while the control did not. My phonetic discrimination was so bad I could not proceed through the app, which is why I need custom therapy. The doctor who I’ll be having the testing and therapy with claims that at most, people only need two rounds of therapy sessions.
I had a brain back in 2020 and they just dismissed the findings (several white matter intensities that doesn’t match my otherwise great cognitive functions pre-2020 and age), told me there was nothing wrong, and that I was crazy. My recent neuro visit did indicate that I need testing/therapy based on my reported issues and history, but again, my hospital does not test or provide therapy (which is illegal but that’s a different matter).
The hospital that conducted the clinical trial indicated that I should have an updated neuropsych (had one in 2021 in which I was testing at very bottom of the majority of cognitive domains). From what I gathered some neuropsych testing does differentiate visual from auditory domains. So I went into my updated neuropsych stressing the reason I wanted an updated neuropsych so they detailed that I expressed auditory difficulties despite the testing not differentiating.
I definitely have had musical issues, but I haven’t focused on describing them to audiologists, as they are much more interested in speech and “functional” hearing. Hard to describe to people that don’t experience it, but things all sounds different, less clear (and thus less recognisable), less loud, and musically, things sound overall “duller” and “less rich” and basically poorer quality, if that makes any sense at all. And beyond “hearing”, recognising music / instruments etc. has also been impaired. Similar functional deficits extend to beyond musical contexts.
In short, what you are describing all sounds very familiar. It will be interesting to see your visual v auditory testing once it is done…I don’t want to bias any results before the testing is done but lots of what you say overlaps and/or is identical to what I’ve been experiencing.
If you are willing, I would be highly interested in discussing this in more detail in private, and perhaps we can share information for our practitioners. Thankfully, after years of trying many, I have found practitioners that take me seriously now, but the more information they have (including similar cases) the more they might be able to help.
It would be also interesting to note if your symptoms started after COVID infection, since you mentioned long COVID, or whether it was after vaccination (or perhaps unclear if both occurs at around the same time.)
I’m not sure if there is a way to direct message on these forums or otherwise privately exchange contact details, if you are willing?
Another thing I forget to ask/mention - did you ever get done when doing audiologic testing? In your case, having had some hearing loss in the (prior to the ) might make this less useful, but changes to DPOAEs might be contributing to your APD.
It may be useful to see if there is a difference between your left and right ear for the DPOAEs (using the right as a baseline) but in your particular case with unilateral hearing loss prior to APD, interpretation could be more difficult. But could be an avenue to explore if you haven’t done so yet.
Also, I might not be able to reply anymore because I ran into an error regarding being a new user and cannot reply too many times to the same topic. Not sure what the limits are, but if I have trouble replying, that might be why.
. Now, along with massive deconditioning, I imagine I have a bit of “resulting damage” from all those years like how an organ gradually stop functioning and completely died last year. But, I can now slowly get better.