Harmonizing Their Hearing

How Music Education May Help Children with APD

Dr. Susan Fulton

Assistant Professor of Communication Sciences & Disorders

University of South Florida, Sarasota-Manatee

Dr. Mary Ann Littrell

Pediatric Audiologist

Johns Hopkins All Children’s Hospital

Précis:  We too often take for granted our ability to process sounds efficiently, even in noisy surroundings. For children with Auditory Processing Disorder (APD), however, accurately sifting sounds from other noises can be an enormous challenge—especially in a classroom. A recent study indicates that music education can help children with APD hear with greater discernment.

Jimmy’s mother returned extremely frustrated from a conference with his 3rd grade teacher. Although very bright, Jimmy is failing in school. He has been tested for learning disabilities, hearing loss, and other problems that could explain his performance in school. All of the tests came back normal, yet Jimmy is not reading at his grade level and has difficulty understanding phonics. According to the teacher, Jimmy is often caught daydreaming, poking a fellow student, or shredding crayons at his desk. He rarely completes his classwork. It seems that the slightest sound grabs his attention. For example, Jimmy turns to look at the door whenever anyone walks down the hall or he runs to the window whenever a truck or siren goes by. Jimmy talks out of turn and disrupts class. Sharing his mother’s frustration, the teacher also realizes something is preventing this otherwise smart boy from reaching his potential.

This is the typical scenario with children who suffer from Auditory Processing Disorder (APD). They have normal hearing, but may act as if they have hearing loss. They may have trouble with reading and associating sounds with symbols (phonics). They find it difficult to concentrate on a speaker when other sounds are present and often will withdraw, appear to daydream, or act out. Because children with APD can struggle with auditory memory, they have trouble following instructions or forget them altogether. They become lost when classroom assignments are given and may partially complete the work or don’t do it at all. They are frequently labeled as problem students or criticized for not working to their potential. Since conditions like ADHD, autism, and dyslexia are more commonly known, they are frequently thought to be the source of the problem. Accurately diagnosing APD typically takes an audiologist, who can carry out a series of specifically designed tests.

Once identified from the test results, APD treatment can be as challenging as its diagnosis. Fortunately, audiologists like Dr. Susan Fulton Ph.D., an assistant professor at the University of South Florida, and her colleague, Dr. Mary Ann Littrell, Au.D, an audiologist with Johns Hopkins Medicine/All Children’s Hospital., are conducting research on ways to help children with APD.  Drs. Fulton and Littrell are studying the effects of music training on the ability of APD children to process auditory information. Two groups of children, diagnosed with APD, were given a battery of tests to establish a baseline. Leaving one group as a control group, the other group completed an eight-week period of music education, using the QuaverMusic.com curriculum. The children were taught:

  •  pitch training,
  •  interval identification,
  •  chord discrimination,
  •  composition,
  •  music theory, and
  •  music history.

Although the study is ongoing, preliminary results look promising. Participants in both groups have been retested with the same battery of tests used for the baseline. Results show no significant change in pre-test scores, as compared to post-test scores, for the control group. However, results for the music training group indicate promising benefit from eight weeks of training. The ability of children with APD who received music training to understand speech in noisy situations and to reduce the errors commonly made by them in situations with competing noise sources improved significantly. Drs. Fulton and Littrell presented the findings of the study at the 2016 meeting of the American Academy of Audiology to a large, appreciative audience, whom Dr. Fulton described as “hungry for alternative therapy ideas and methods” for treating APD.

Although encouraged by the results of the initial study, Drs. Fulton and Littrell are seeking additional evidence of the impact of music education on children with APD. For example, this summer they are holding a two-week camp for APD children, which will include daily sessions of music training. As she gathers more data supporting the benefits of music training on auditory processing, Dr. Fulton has begun developing a tool that others can use to incorporate music training in their treatment of APD.

QFAME greatly appreciates Drs. Fulton and Littrell for their dedication to improving the lives of these young people and we are proud to assist in their quest to standardize the use of music education in treating APD. We look forward to advancing their work and to developing the tool that others can employ. As a start, QFAME has agreed to subsidize the cost of the summer camp by purchasing the instruments and other materials needed for the campers.

We know that music can evoke every manner of mood. It can gladden and sadden. It can encourage and enrich, calm and compel. Perhaps it can also help young minds improve their ability to process sounds in an orderly way and bring harmony to their hearing. We look forward to partnering with Drs. Fulton and Littrell and to reporting progress on their work.

Dr. Susan Fulton is an Assistant Professor of Communication Sciences & Disorders at USF Sarasota-Manatee, where she teaches in the post-baccalaureate, online course sequence in Language, Speech, & Hearing Science. Dr. Fulton holds both a Florida license and national certification from the American Speech-Language Hearing Association (ASHA) in the field of Audiology.


Dr. Fulton earned the Master of Science in Communicology, with a concentration in Audiology, from the University of South Florida in 1987. She earned the Ph.D. in Communication Science and Disorders, with a concentration in Hearing Sciences, from the University of South Florida in 2010.


Dr. Fulton‘s research focuses in the area of psychoacoustics, specifically in the areas of temporal processing and speech-in-noise perception.

Dr. Mary Ann Littrell is a Pediatric Audiologist at Johns Hopkins All Children’s Hospital in St Petersburg, Florida, where she specializes in Central Auditory Processing Evaluations.  Dr. Littrell has worked in Pediatric Audiology for over 30 years and has performed processing evaluations for most of those years.

Dr. Littrell earned her Master of Science in Audiology at Case Western Reserve University in 1983.  She earned her Doctorate in Audiology in 2008 from Arizona School of Health Sciences.  Her present work at Johns Hopkins All Children’s is exclusive to evaluating school age children for processing disorders.

She has been involved in research with Dr. Fulton for several years


Quaver Foundation for Advancing Music Education, Inc.  is a 501(c)3 nonprofit organization incorporated under the laws of the state of Tennessee working to provide educational programs to the public.


Quaver Foundation for Advancing Music Education, Inc.  is located on historic Music Row in Nashville, TN.



1706 Grand Avenue

Nashville, TN  37212