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Case Study: Auditory Processing, Reading and Attention Difficulties

🕑 5 minutes read
Posted February 26, 2016

Author: Patrice Whiting, MA. Ed., Elementary Learning Support Specialist,Oakland Christian School, Auburn Hills, MI 

Case: “B” is an 8-year-old girl with auditory processing, reading, attention and social challenges. 

Summary: “B” began exhibiting difficulties in preschool with auditory processing and motor skills, as well as increasing difficulties with peer interactions. As she began 2nd grade school, she tested below grade level
(1 year below norm RIT) in all subject areas. A comprehensive intervention program was developed to address her difficulties, including Integrated Listening Systems (iLs) in conjunction with Orton-Gillingham and Fast ForWord.

By January, B’s auditory processing, decoding, literacy, fluency, and comprehension skills had all improved significantly. By the end of the school year, her NWEA Reading RIT scores had improved from the 19th to 85th percentile. In addition to academic changes, this case includes comments from parents and teachers which capture the emotional and confidence-related changes occurring during the course of the year.

Pre/Post Assessments:  SCAN3-C (auditory processing); CRI (Comprehensive Reading Inventory);NWEA Reading RIT; Lexia Core 5 Reading; iLs Measure of Foundational Abilities (symptoms in 5 categories);
teacher and parent comments 

“B” had difficulties in preschool retaining the names of letters and learning the sounds associated with those letters. She also showed a general clumsiness and hand-eye coordination difficulties.  Though interventions were established, gains were not seen, and before second grade, she was given an auditory processing evaluation and an educational plan was developed. She is now in 3rd grade.

Presenting Problems: 

  • Auditory processing difficulties, memory, phonics, comprehension and literacy skills
  • Dyslexia tendencies
  • Limited attention span, especially in classroom or group settings
  • Poor engagement in the classroom and with other children
  • Poor sleep, bedtime procrastination, waking up at night, sleeping with siblings 

Therapeutic Goals: 

  • Improve body organization through sensory-motor integration
  • Improve basic focused attention to tasks through attention-concentration integration
  • Strengthen left and right ability through physical activity
  • Build decoding and literacy skills
  • Improve and develop short- term memory, build upon body posture, enhance listening skills, and literacy
  • Enhance and improve both left and right ear proper processing
  • Improve sleep and sleep habits

iLs Programs Used: 

  • Total Focus programs (Sensory Motor and Concentration & Attention) were implemented 60 min/day for the first nine sessions. Thereafter, sessions were 40 min/day, 5 days/week.
  • The Interactive Language Program (ILP) was added after Session 21 for 10 – 15 min of the 40-min sessions.
  • The iLs Dreampad was used nightly to help with sleep

Other Interventions Used:

  • Orton-Gillingham three times a week
  • Critical Reading Instruction Intervention once a week
  • Fast ForWord 50min/day, five times a week

Results & Discussion

The MFA tracks progress in five key categories with an optional sixth category, sleep, and is available through the iLs Portal.

The MFA tracks progress in five key categories with an optional sixth category, sleep, and is available through the iLs Portal.

Classroom and special subjects’ teachers/staff observations:
Student B’s second grade teachers reported she is “an engaging participant in our classes. She enters into dialogue quite well.” Her PE teacher noticed improved control of her body, coordination and cooperative play with her peers. “Student B is so eager and participatory in our Art and Music classes. She is displaying a very creative side, artistically and verbally.”

Student B is physically, verbally, and academically developing in leaps and bounds! She is becoming a very confident reader. . . Self-confidence and a great sense of humor are beginning to exude from Student B.”

CRI assessment

Student B maintained and even made greater gains in her reading over the summer.

Parental observations and comments:
Student B is exhibiting a positive attitude towards school. She is reading each day at home with more ease and fluency as well as comprehending well. She even tells us that sometimes her literacy group activities are quite easy. We are seeing no more reversals in her writing and number use, a real feat for her. It seems the dyslexic habits are fading.  Overall, her whole being and school attitude are positive.”

Student B was able to get up to grade level within one school-year.

Student B was able to get up to grade level within one school-year.

Summary of Changes, Conclusions, And Recommendations:  
Student B has most assuredly improved in her body organization, balance, coordination and control. She has also succeeded in improving her fine motor skills, especially her handwriting.

The Dreampad has positively affected the student’s energy level and overall health; she comes to school less tired and more awake. Her family has consistently supported her use of the Dreampad at home. This year she has had fewer absences due to illness or tiredness, and she is also less lethargic and slow in response or movement. She is sitting up more often than not and is very attentive in all class, group, or individual situations.

Student B no longer cuddles a stuffed animal everywhere she goes at school, she talks to whomever she is with and has steady, confident eye contact. She is more agile and physically toned thus, more willing to try new things. She went through cheer training and then performed a cheer with the middle school cheer squad at a major event last week.


Auditory Processing Difficulties are no longer seen, and student B falls well within the normal range of hearing and processing.

Student B is more focused on tasks and needs less repetition with directions. She is able to work better in the classroom or group with other noises or voices in the background. She has learned some tactics and tools to keep her eyes on those talking or directing.

The auditory processing functions have improved remarkably. Decoding, literacy skills, fluency, and comprehension have shocked all of her support team. The improvements have also generated impressive writing of jokes, riddles, and poems.

Fall 2015 Update:

Student B had dramatic gains between September and January, and continued to progress through the year.

Student B had dramatic gains between September and January, and continued to progress through the year.

Student B is now in 3rd grade. Her teacher reports vibrant conversation and engagement in classroom activities. Her attention is on target. I have also observed Student B totally engrossed in her school environment. Her fall, third grade, NWEA scores ranged at third grade end/spring levels in reading, comprehension, and language (above the national norms and school norm).

For me, the icing on the cake was when I saw Student B this fall and she told me, “I convinced my mom to buy all of these twelve books for me at the book fair!” Her attendance is perfect thus far into the year; she does not want to miss a day of school. She has also developed wonderful peer bonds and a few close friendships as well.

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