Hearing Matters Podcast

Central Auditory Processing Disorder with Dr. Angela Alexander

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The mysterious disconnect between hearing and understanding affects millions worldwide, yet remains largely undiagnosed and untreated. Dr. Angela Alexander pulls back the curtain on auditory processing disorder (APD), revealing why so many people struggle to understand speech despite normal hearing tests.

"One in five adults who report hearing loss actually have normal hearing test results," explains Dr. Alexander, highlighting a staggering statistic from the Framingham cohort study. These individuals aren't imagining their difficulties – they're experiencing a processing problem in the brain rather than the ears. The mismatch between audiogram results and real-world experience leaves many frustrated, bouncing between providers who tell them their hearing is "fine" when their daily struggles suggest otherwise.

Dr. Alexander offers practical screening tools for hearing professionals, particularly recommending the Hearing Handicap Inventory for Adults (HHIA) to identify potential processing challenges. She also shares remarkable success stories, including her work with Matt Hay, who has an auditory brainstem implant. Through targeted auditory training – what she calls "physical therapy for the ears and brain" – Matt improved his word recognition from 60% to nearly 90% in just three months, demonstrating the brain's remarkable adaptability.

For parents of children diagnosed with APD, Dr. Alexander offers hope: "Auditory processing disorder is a hopeful diagnosis because there's so much we can do about it." She explains how APD can overlap with conditions like ADHD and dyslexia, but unlike those conditions, auditory processing is often easier to improve with the right intervention. Through her Auditory Processing Institute, she's trained 170 specialists worldwide and created a searchable map to help individuals find qualified providers.

Ready to understand why you or your loved ones struggle to process speech despite "normal" hearing? This episode might just change how you think about hearing forever. Subscribe, share your experiences, and join us in spreading awareness about this hidden hearing challenge.

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Blaise M. Delfino, M.S. - HIS:

Thank you to our partners. Cycle built for the entire hearing care practice. Caption call by Sorenson. Life is calling CareCredit. Here today to help more people hear tomorrow. Faderplugs the world's first custom adjustable earplug. Welcome back to another episode of the Hearing Matters podcast. I'm founder and host Blaise Delfino and, as a friendly reminder, this podcast is separate from my work at Starkey and joining us today. This is a guest we have been so anxiously awaiting to have on the show. We have Dr Angela Alexander. Angela, welcome to the Hearing Matters podcast.

Dr. Angela Alexander:

Hello, hello. It's wonderful to see you and hear you here today.

Blaise M. Delfino, M.S. - HIS:

It is so awesome having you on the show. We have been following your success but also your passion number one for central auditory processing disorder. This is your second love, your husband being number one, capd being number two. There's a lot of people out there today that say I can hear you, but I can't quite understand you. So for those listening, can you explain what central auditory processing disorder is, the age detection and how you got started in the field of audiology?

Dr. Angela Alexander:

Fantastic. So auditory processing, just in general, is what our brains do with what our ears hear. So once we receive sound, what does our brain do with it? So when there's a problem with auditory processing, we call it an auditory processing disorder. Now this is kind of crazy, but there was a study done in 1980. It's the Framingham cohort and they found that one in five adults who report hearing loss actually have normal hearing test results. So 20% of the population say, oh my goodness, I have so much hearing loss. And then they go to an audiologist, have a hearing test done and find that their results are within normal limits. But that doesn't make sense and that doesn't match their life experience. Maybe they say, okay, I can't hear in background noise, I can't remember what people say to me. These people are at risk for something we call auditory processing disorder or APD. But here's one thing that I think is really interesting. We used to think about auditory processing in terms of people who had no hearing loss whatsoever, but it is also possible to have hearing loss and processing problems. I kind of wonder if people who have hearing aids but aren't getting the improvements they would like to see. I wonder how much of that is within the brain and how much we can change. So I'm really looking forward to our conversation today to unpack all of that with you.

Dr. Angela Alexander:

I was really interested in audiology from a young age. My mom noticed that I wasn't really responding to sound as much as a baby and so, as a nurse, she was concerned that I might have hearing loss. Our next door neighbor was an audiologist and he did some tests and he thought that my hearing sensitivity was probably within normal limits. But he decided to track me and he was doing audiograms quite regularly for me through fourth or fifth grade. There were some interesting results from like tympanometry. I had shallow temps, but other than that everything was within normal limits. So when I was in college I was at the University of Kansas and I was pursuing my audiology and speech language pathology degrees, and in undergraduate I was late to a class, and because I was bowling, if I'm honest like it was a class that I had right beforehand.

Dr. Angela Alexander:

So I walk into this classroom and I see that there's a speaker at the front who is not my professor. I'm like, oh no, oh no, I did not realize there was a guest today and there was only one seat left and it was at the front and center of this classroom. So I sheepishly walked in late, sat at the desk and proceeded to have my mind blown by Dr Jack Katz. So Dr Jack Katz is a well-known audiologist who has done a lot of work, not just in auditory processing, but he wrote the Handbook of Clinical Audiology which is sometimes known as the.

Dr. Angela Alexander:

Audiology Bible, but I honestly believe that Jack Katz is a little bit of a Picasso of audiology, and the major work that will be attributed to him throughout the rest of time is what he has learned about how to assess auditory processing issues in people across the lifespan and across the audiogram, and also how we treat what we see, and I think that's the real richness that he will add to this world for the rest of time.

Blaise M. Delfino, M.S. - HIS:

Having been in private practice for a little over five years and working side by side with my father who, as I said, is an audiologist as well, there would be so many times and I'm not exaggerating when I say so many times and we've seen so many patients who say you know, blaze, I can hear, I just can't understand. And I have been to two other hearing care providers. I have normal hearing sensitivity and they tell me I'm fine, but I'm still struggling. Then we have the conversation of going beyond the audiogram, going beyond peripheral hearing, because central auditory processing happens in the brain. What can hearing healthcare professionals do today to raise awareness of CAPD and why is it so important that hearing care professionals add the CAPD test battery to their clinic menu, if you will?

Dr. Angela Alexander:

I love it. I love it. Okay, so hearing healthcare providers listen in. I'm going to give you the most fire tip I could possibly give in the next couple of minutes. All right, so for adults these are people age 18 and older I would suggest using something called the Hearing Handicap Inventory for Adults.

Dr. Angela Alexander:

This questionnaire has questions like does a hearing problem cause you to feel embarrassed when meeting new people? And a person answers these questions with yes sometimes, or no. If they say yes, that gets four points, sometimes two points, and no is zero points. You ask them 25 questions and ask them to go with their first thought. Like don't overthink any questions, just come up with your first response to each one of those questions. Let me try one with you. Does a hearing problem cause you difficulty when talking to members of your family? No, no, good. So there are lots of people who may have a normal audiogram but say yes to that question.

Dr. Angela Alexander:

We want to look at the audiogram and then we want to look at the HHIA and see how they match up. The HHIA has 25 questions. So if a person answers yes and gets four points to all 25 questions, you do the math for me, blaze. How much would that be oh, that's 100%, 100%, right. So if a person gets a score of 100, it's awful, and a score of zero is awesome, all right, got it. So we can almost think about this gradient with the same gradient as an audiogram. So where we have zero is awesome, 100 is awful. We want to look at these same scores in the same way.

Dr. Angela Alexander:

Does a person come to your clinic and they have an audiogram where, on average, their hearing sensitivity is around 15, which is either a slight loss or within normal limits and then look at their HHIA score? Is that 50? There is a mismatch. So we could almost put the HHIA score into the same thought process as the audiometric gradients. And so a 50 is moderate, right, moderate and slight. Those don't match up. That is a red flag. Refer that client on to a person near you who does auditory processing testing, or become that provider yourself if you're an audiologist, yes. So I think that, honestly, the HHIA is amazing. It looks at a person's social and emotional impacts of hearing problems and I get worried because if we see an HHIA score that's close to 100, with essentially normal hearing sensitivity, I get worried that those people are a red flag for mental well-being issues and potentially suicide. We talk a lot about suicide when it comes to tinnitus but honestly we have really been underserving and underhelping a group of individuals who really need our help.

Blaise M. Delfino, M.S. - HIS:

I absolutely wholeheartedly agree with you, especially with the mental health aspect, angela, not only with patients that have severe hearing loss, but you're absolutely right normal hearing thresholds, peripheral hearing and struggling to understand speech in noisy situations. Really, we are in this loneliness epidemic and these individuals may start to withdraw. They have normal hearing and there are providers out there that can help them, but maybe they're not educated on what CAPD is, or the hearing healthcare providers they visited don't know what CAPD is either. And that's what I love most about the work you're doing is you're using the gifts that you've been blessed with to spread awareness of central auditory processing disorder, and you've helped so many individuals, and I'd love to know more about the work that you've been doing with the Auditory Processing Institute. When did you found this organization? How does your training model look like for SLPs and audiologists?

Dr. Angela Alexander:

Oh, my goodness, okay. One other thing I want to fly in and just say what do we say not to do with tinnitus clients?

Dr. Angela Alexander:

We say don't tell a tinnitus client, a person who has ringing in the ears. We should never say to them that it doesn't exist, that it doesn't bother them, that it can't be treated. But what do we continuously say to these people with normal audiograms? That it doesn't exist, that it shouldn't bother them and that it can't be treated, which I'm going to go ahead and say right now? Auditory processing difficulties are absolutely treatable.

Dr. Angela Alexander:

Back in 2017, I was massively pregnant with my daughter. I mean like gigantic, you know, I was really excited to be pregnant. I really wanted to be a mom. I mean, lots of people thought I was having triplets. I was not. I was having one child with lots of room. I was kind of embarrassed when she was born slightly, you know, like lower than average weight, because I had been blaming it on a chunky baby this whole time.

Dr. Angela Alexander:

When I was marinating that kiddo in my innards, I started realizing that the clients that I was doing auditory training with, where I was doing ear exercises to improve their auditory processing, were suddenly not going to have a clinician walking them through auditory processing treatment, because we usually do 12 to 14 weeks one hour sessions of doing actual ear workouts to help a person understand what they're hearing, to understand speech sounds, hearing background noise, remember what they hear, organize what they hear. And it's not just telling a person you need to try harder. It's like actually doing kind of like physical therapy for the ears and the brain more importantly, the brain. But I thought, okay, what am I going to do if, like, once, I give birth, to help these clients continue to move forward? So I made a series of videos where a client could take themselves through the therapy and I released that online and I'm like, yeah, this is going to be like the biggest thing ever, it's going to be so awesome, it's going to be so sick. And then, you know, a few weeks later I'm like, yeah, that's the worst thing I've ever done. It's terrible, it's horrific, I should just erase it.

Dr. Angela Alexander:

And then I had a client who came in and she had the testing done, found out she had auditory processing disorder, went and did the video exercises and came back and her retest results looked like what it looked like. When I was doing the work with her I was like, okay, maybe there's something to this, but there wasn't really necessarily a big market out there Cause not a lot of people knew about auditory processing, but there were clinicians who said to me hey, could I learn how to do this treatment for clients? And so I started out on that journey in 2017. And I thought, okay, here we go, I will teach audiologists and speech language pathologists how to do the treatment. And then I got an email. I got messages from Dr Tom Goyne and Dr Megan Thomas on the same day, within 24 hours, and it said hey, you, and they're just Facebook messages. Hey, you teach people how to treat auditory processing, will you train us how to evaluate it?

Dr. Angela Alexander:

And I was really overwhelmed by this, because there's a lot of things I don't know. There's a lot of things I don't necessarily understand, but I also am glad that I went ahead and said I will try, because I've learned more in the last two years than I had previously. Clinically and together as a group, I'm now trained 170 audiologists and speech language pathologists how to do central testing and treatment. For people who are the youngest, I really test is three and a half and you know I had a client who was 99, who signed up for therapy, but then she decided to do it the next year and I didn't hear from her since that was like seven years ago. So I can only assume that she has matured out of auditory processing disorder.

Blaise M. Delfino, M.S. - HIS:

One hundred and seventy. Wow, For lack of a better term that has to fill your cup.

Dr. Angela Alexander:

It does because Because you're paying it forward. I mean well, okay, but these people have added as much to my life as I have added to theirs. Back in 2008, I realized that it was really hard for clients with auditory processing to find clinicians in their area who were doing this work, and so I created an online searchable map where people could go on and find someone close to them. I'll go ahead and plug that here. It's APDSupportcom forward slash APD map. Once again, apd like auditory processing disorder supportcom forward slash APD map. On this map, you can enter your location and find the clinician nearest to you. Who's doing this.

Dr. Angela Alexander:

And when I first started the map in 2008, there were 250 providers worldwide. So then I did an update of the map in 2018. I was like, okay, here we go, let's see how many people are there. Like some people had retired, some people had added their practice. Guess how many people there were? Blaise, 250 still Hadn't changed, won some, lost some, but the net difference was nothing. So it was my goal to double that number in the next four years. So as many as 300 million people worldwide who have auditory processing issues.

Dr. Angela Alexander:

We say one out of every thousand children is born with permanent childhood hearing loss and we say that between five to 6% of the child population may have auditory processing issues. So that's 50 to 60 times the rate of permanent childhood hearing loss, and there's only 200, well, now there's 400 of us worldwide doing auditory processing services. But the great thing is that more people are testing younger. They're not just testing at seven years of age. There was this terrible bit of information which got misconstrued a long time ago and then taken for fact that we couldn't test before seven years of age. It's total BS. It's not true. Most of the clinicians are testing earlier than seven. They're testing and treating, and a majority of them are doing work over telepractice as well. So a hundred percent of my work is over telepractice and let me tell you, march of 2020 was a total game changer. I went from seeing almost all children with normal hearing sensitivity to seeing mostly adults with severe hearing loss. So here we go.

Blaise M. Delfino, M.S. - HIS:

The statistics are alarming, to say the least. You had said that that would equate to about 300 million individuals who present with central auditory processing disorder. So there's about what is it like? 315 million individuals in the United States, that's almost everyone in this country in the United States like presents with CAPD. That is insane and we're not saying disclaimer. It's not all 300 million in the United States that present with CAPD.

Dr. Angela Alexander:

There's only 15 million normal people wandering the streets understanding what they hear. All the rest of them are just eh, what Huh.

Blaise M. Delfino, M.S. - HIS:

When I was in graduate school, one of my first clients presented with CAPD and I used some of Jack Katz's tools, thankful that my father had those, because they really did help me. Because I'm, you know, mid-20s I'm like CAPD. I've heard about this during dinner conversations but I don't know how to like treat this and you know I'll shout out Dr Susan Dillmuth-Miller. She's the audiologist at East Stroudsburg University. Shout out Dr Susan Dillmuth-Miller. She's the audiologist at East Stroudsburg University. She is so passionate not only about audiology but also CAPD and she taught us so much about it. But to have the CATS tools really did help with this client and it was so amazing to see the improvement throughout the semester.

Blaise M. Delfino, M.S. - HIS:

Angela, you have quite the voice in the hearing healthcare industry and the space in and of itself, and I've been following you on social media for a few years now and I saw that you recently met with Matt Hay, nina Krause, judy Hutch and a few other thought leaders in the hearing healthcare space, and whenever thought leaders like yourself get together, some amazing industry breakthroughs are often the result. What can you share with us about this retreat slash get together, or is that confidential?

Dr. Angela Alexander:

Let me just tell you there's going to be more to come. However, let me give you a tasty little nugget, a little tidbit of information. So first of all, matt Hay, who you've had on your podcast, loved that episode. I listened to it in an airport once. It was quite good. So Matt Hay is a phenomenal person.

Dr. Angela Alexander:

He was in college and had a hard time hearing on the phone, went and found out that his hearing was asymmetrical and as a result of that hearing test, he went and had an MRI done which just made him discover that he has neurofibromatosis type 2. He gets these benign tumors on any nerve of his body and unfortunately, those tumors often like the auditory nerve. So he had acoustic neuromas and he found out that, okay, he was going to lose his hearing. It was kind of a slow process, so he taught himself he actually he didn't realize that he was creating the tools to help himself in the future, but he took 67 of his favorite songs and he played them on repeat to himself his little soundtrack of silence and kept listening to these songs over and over because he said if in the future he heard nothing, he wanted these songs stuck in his head.

Dr. Angela Alexander:

One day he lost his hearing and they said we could do an auditory brainstem implant. So they opened up his brainstem and implanted 12 electrodes where basically anytime sound is in his environment, it shocks his brainstem, which is perceived in his brain as sound. Now they didn't expect that he was really going to understand what he was hearing. They said you just will know that life noises exist. And he said that when you're used to not hearing anything, even hearing an oven timer sounds like a choir of angels. So basically we didn't expect him to understand what he heard.

Dr. Angela Alexander:

But he started listening to that music, that soundtrack of silence, over and over again and pairing what he was hearing with what his brain remembered and he was able to, over 16 years, get up to 60% correct on hearing in noise sentences. These were in quiet, though at a comfortable level. So that is mind blowing. First of all, we do not expect someone with an auditory brainstem implant to have that good of word recognition and at the point where he was implanted there were only 200 in the world. That is just mind-blowing.

Blaise M. Delfino, M.S. - HIS:

That's incredible, isn't it cool? Matt Hay is amazing.

Dr. Angela Alexander:

He is a legend, and that is the reason why Channing Tatum reached out to Matt and bought his life story to make a movie with Paramount Pictures about Matt Hayes' story. He's just absolutely incredible. So then last year he reached out to me on LinkedIn and he was like hey, angela, I see you're an audiologist in Australia. You want a Redux Wink, wink. And I'm like Hi, matt, my name is Angela and, yeah, I'm not really into that, but that's because I'm not dispensing. Know, hi, matt, my name is Angela and, yeah, I'm not really into that, but that's because I'm not dispensing hearing aids in my practice. I'm doing 100% auditory processing and 100% on telepractice. And he was like well, could we still get together? I have an auditory brainstem implant and I'm like let's do this, I would love to hear you. So I met with him and I said can I do some of these tests that I would do on a child with normal hearing sensitivity? And based on the results of that test, I said to Matt yo, I think there are some things we could do to optimize what you've got going on. And he was like all right, I guess. So we met once a week for 12 weeks we did auditory training and after that, for 12 weeks, we did auditory training and after that his word recognition score went up to 87% and 92% correct in quiet. So he said, over 16 years he taught himself how to get 60% of the way. And then in three months we worked together in kind of a coach-like way in an auditory training format and got him another 30%. Wow, now that's in quiet, and we all know noise is. Wow, now that's in quiet, and we all know noise is everywhere. So that's more important.

Dr. Angela Alexander:

But Matt reached out to Nina Krause, who is a world famous researcher at university of Northwestern, and he said hey, I know you love music.

Dr. Angela Alexander:

I love music. I taught myself how to understand with music and, as Nina Krauss and Carol Flexer say, we don't hear with our ears, we hear with our brains. So Nina said Matt, you don't hear with your ears at all, you only hear with your brain. She didn't actually say that, cause that would be like here explaining, but she was like I want to understand, I want to study your brain and I want to see how your brain is understanding what you hear. And he was like yo, nina, I'd love to come to your lab, but I'm going to bring my friend Angela, is that okay? And so I got looped into this conversation and on my birthday morning I woke up to a conversation between Matt Hay and Nina Krause over online and I started ugly crying. I have never ugly cried before. My tears were spraying out of my eyes because Nina was like you know what? What you and Matt have done together is going to change the course of the hearing care industry.

Blaise M. Delfino, M.S. - HIS:

That gives me goosebumps, angela, it's really exciting, I know. Yo.

Dr. Angela Alexander:

Oh my gosh, I'm not going to spray my eye water at you. My, my husband was pretty sure my mom had passed away, but I was like no, that's incredible.

Blaise M. Delfino, M.S. - HIS:

All right, I'm excited Then we went to Chicago.

Dr. Angela Alexander:

Yeah, so we went to Chicago and we met up and we studied Matt's brain and to, to be continued, to be continued.

Blaise M. Delfino, M.S. - HIS:

Oh, I'm so excited to hear, no pun intended, about what the results of that trip are going to be. Matt Hay, incredible human being, puts family and friends number one, and then to link up with you, for you to use your gifts, help him, and then Nina Krause and the rest of the team. This is like the audiology all-stars.

Dr. Angela Alexander:

I think this is the issue is that a lot of people think that APD is only this one little thing. Yes, but auditory processing is huge. Let's say a person has hearing aids. Hearing aids are like a bike. Right, they're like a bike, but if you don't know how to ride a bike, you're not going to do very well. Auditory processing is like the ability to ride a bike. Do you think that a person who gets like a performance bike is going to do better than a person who gets a walmart bike? If the person with the walmart bike actually has like an olympic level trainer, yeah, helping them with their walmart exactly ring, ring little bells with you there.

Blaise M. Delfino, M.S. - HIS:

Angela. Parents looking for answers. What does treatment look like? My child was just diagnosed with CAPD. Now what I want? An FM system in their classroom. The school doesn't want to do that, so what does remediation and treatment look like for those with CAPD?

Dr. Angela Alexander:

Yep, okay. So there are both technical and non-technical options and I will be very honest with you that I have a bias toward using low-gain hearing aids for adults more than kids. So let's say, in particular, you have a client who comes to your office and they have a high HHIA, but their audiogram is normal. You can try hearing aids with them and look at the ROOP et al 2018 study to get the settings for the hearing aids, but it's basically 10 dB of gain from one to four for soft and medium inputs and nothing for loud sounds. Just throwing that out there.

Dr. Angela Alexander:

If you put these hearing aids on them, have them come back in a week's time and check their HHIA again. Has it dropped? Let's say, like I said before, the patient has an audiogram that's 15 across the board and an HHIA of 50. There's a mismatch which is a red flag. They need more help. So let's say, you fit low gain hearing aids on them. Boom, it's like up to 20 or something like that, where it's a lot closer together. Then you've done your job and that's good enough. If not, have them come back the next week. Try a better level product, like a higher level product, or maybe add like a remote mic yes, then have them come back into the clinic again check again.

Dr. Angela Alexander:

Has their HHIA dropped? If it hasn't, you need to refer them on for APD testing. You need to refer them on for treatment. I would like for every single person in the world who has APD to have auditory training given by an individual audiologist. I know that is not realistic, especially with only 500 audiologists eventually online doing this work. However, I think we have to start measuring what the impacts are of our interventions. Have we done enough? And I don't think we've been doing that.

Blaise M. Delfino, M.S. - HIS:

We've had adults come into the practice and they've only had pure tones bone conduction but no otoacoustic emissions, no tympanometry and no speech and noise testing. And, to your point, patients can have normal hearing and then if you test their speech and noise, it's severe speech and noise scores. So something's definitely not matching up. Let's change gears to children specifically. Parent is not sure what CAPD is. Their child was just diagnosed with CAPD. This news to a parent, number one, is scary. What's going on with my child? So I know this is sort of a loaded question. How would you, with the 10,000-foot view, counsel these parents assist these children to ensure that they're better able to comprehend the world around them?

Dr. Angela Alexander:

Ooh, I love it. Okay, first of all, auditory processing disorder is a hopeful diagnosis because there's so much we can do about it as long as you work with the right people. I'm not seeing clients myself, other than case studies right now. So on that map clients myself other than case studies right now. So on that map you can find people to help you with your child.

Dr. Angela Alexander:

But auditory processing can co-occur with dyslexia, adhd, autism, brain injury. There are a lot of different reasons why a person might have auditory processing and it can also co-occur with all these other things. But unlike those other things, auditory processing is easier to change. It's easier to improve. So for me, I almost feel like everyone who gets a diagnosis of ADHD should also have an auditory processing test just to see how much of this is sensory and what can we improve from a sensory side. That will also help with a behavior, and you know on that side of things.

Dr. Angela Alexander:

Number one if you realize that your child might have auditory processing disorder, go get an auditory processing evaluation done. Find a clinician who also does therapy, because those clinicians have a really clear understanding of what things can change and what the potential for improvement might be. I also am a big fan of not putting a glass ceiling on top of children. I have worked with children who have congenital brain anomalies, children with severe speech, children who are nonverbal, and the results that we have from auditory training training just really basic understanding of speech sounds can have huge, huge improvements throughout everything in the child's life. It's amazing I sound like a crazy person talking like that.

Blaise M. Delfino, M.S. - HIS:

Oh, I love it, it's passion.

Dr. Angela Alexander:

It really is actually kind of miraculous For me. If it's my kid, I would rather look into auditory training than devices. But if you don't have the luxury of having someone near you who can do the auditory training or who is knowledgeable about this, then looking into devices can also be helpful, and there is some good research behind that as well.

Blaise M. Delfino, M.S. - HIS:

I love it, angela. I love the passion I so appreciate. On behalf of the entire hearing healthcare industry, thank you for all that you're doing.

Dr. Angela Alexander:

I'm nothing, man.

Blaise M. Delfino, M.S. - HIS:

No, no, this is. We love the Hearing Matters podcast because all of the guests that we have on it's like we've established such great professional relationships with and we're raising awareness of these best practices. That's number one. Because you go on Google and it's like whoa, there's a lot of misinformation out there. And when you were saying to team up with an audiologist who treats CAPD, my hope one day is that the majority of hearing healthcare clinics, because hearing healthcare is more than just a hearing aid.

Dr. Angela Alexander:

Yeah.

Blaise M. Delfino, M.S. - HIS:

Just you know, throwing that out there, that there is an SLP speech language pathologist on staff who can assist with some of these services that are being administered. The last question that we have for you this is a big question. The last question that we have for you this is a big question. Share with us the experience that you had with TEDx, because your TEDx video is absolutely incredible 13 steps in one click. You are an inspiration to so many, so thank you for your strength and sharing your story and being vulnerable.

Dr. Angela Alexander:

Thank you oh, my goodness, tedx. So I've been on the TEDx journey for a very long time. You get nominated or you are a total winker and you nominate yourself, which is what I did. I nominated myself many years ago and I started down a journey and interviewed with one TEDx group and they said everyone in the world needs to hear this. I'm like I know. And then they ghosted me. Oh, no, because, let's be honest, I wasn't ready. I was not ready. Everything I was sending to them they're like no, this is crap.

Dr. Angela Alexander:

Any TEDx journey, if you're doing it right, is just completely full of rejection. So I was rejected heaps and applied to other TEDxs in the area. Ted talks are like they're like the unicorn, like Bill Gates and Oprah and whatnot and Brene Brown get. Those TEDx are independently organized with much lower quality, thank God. So I went for another TEDx and I applied to them two years ago and literally last year I wrote down in the next three to five years, I want to do a TEDx in my goal setting. And four hours later I got an email asking if I would be interested in doing a TEDx. That was in May. Would I be ready to go in July? Wow. So I interviewed with them. I threw it out there. They did not ghost me. I was not rejected that time. Very surprising Actually. I went into that interview. I'm like you are not.

Dr. Angela Alexander:

You are not rejecting me, I refuse, I am you are going to give me this opportunity now it is going to be at least okay, but my goal was to get between 4,000 and 5,000 views over the lifetime of that talk. I was watching talks that had about those numbers, so I don't know if you Were we connected when my TEDx finally went up Because I was like it was almost like I was in labor. It was climbing. It was climbing the crazy thing was because I was like it was almost like I was in labor.

Blaise M. Delfino, M.S. - HIS:

It was climbing Well it was climbing.

Dr. Angela Alexander:

The crazy thing was I was like, okay, I know it's going to hit YouTube soon, it's going to hit YouTube soon. I want to get you know like it would be cool to get a couple hundred views in the first day. That would be sick. And then I it's up and it had been up for 17 minutes and had 1700 views already and I almost fell on my chair. And then now it's at like a little over a million.

Blaise M. Delfino, M.S. - HIS:

Yeah, over a million.

Dr. Angela Alexander:

I mean a million people know my daddy issues 2 million years.

Blaise M. Delfino, M.S. - HIS:

That's wild 2 million years.

Dr. Angela Alexander:

Oh, this just in 2 million years, and at least one auditory brainstem implant. Cause Matt Hay also helped me write that speech.

Blaise M. Delfino, M.S. - HIS:

Reading the comments and I love the fact that you submitted a comment from the speaker and so many people connected with you. Thank you, this is one of the best talks that I've heard. She speaks so clear and precise. I'm like, yes, that's Dr Angela Alexander Mic drop.

Dr. Angela Alexander:

Thank you so much, my friend.

Blaise M. Delfino, M.S. - HIS:

Dr Angela, thank you so much for joining us on the Hearing Matters podcast. For our listeners tuned in, where can they connect with you? And please share the APD Institute website with us again. We're also going to put that information in the show notes.

Dr. Angela Alexander:

Fantastic. So audiologists and speech language pathologists can be trained to do evaluation, if you're an AUD, or treatment, if you're an AUD or SLP. Auditoryprocessinginstitutecom and then APDSupportcom is where you can find the APD map if you are a parent of an individual, or if you are an individual themselves who has auditory processing issues, with or without hearing loss. Let's see what we can do to get your processing better.

Blaise M. Delfino, M.S. - HIS:

You're tuned in to the Hearing Matters podcast. Today we had Dr Angela Alexander join us talking all things central auditory processing disorder. And until next time, hear life's story.

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Blaise M. Delfino, M.S. - HIS

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