"I've had her ears checked and her hearing is fine, but she just does not listen!"
As a Speech Pathologist I often heard this from parents. These children may have passed full audiology hearing assessments and have hearing within normal limits, but present as children who do not seem to hear properly in some ways.
Children can have hearing within normal limits but still not seem to be tuned in when people talk to them. Usually these children have difficulty following instructions when they have to remember several instructions at once. They do not memorize their address or phone number. Often they do not remember the names of objects. They can mispronounce words or make mistakes of grammar and sentence structure. When they are older they can not easily recite things like the months of the year.
Often they can be bright children who do not seem to achieve their potential, and this is frustrating for everyone. In the classroom they can appear to be watching what others do before they follow instructions. Or they tune out. They can have problems learning to read, write and spell.
Children with normal hearing can still have auditory processing difficulties. This means that the ears are receiving the signals but the brain is not making total sense of what they hear.
This can involve poor processing at a variety of levels.
Some children can not work out where a sound is coming from (sound location). Some children do not hear the differences between some of the speech sounds in words (auditory discrimination). For some, it is very effortful to break down what they are listening into meaningful chunks of words. And in real life, we often miss words or parts of words because of background noise or other interference, and our brain is supposed to be able to fill in the difference (auditory cloze) but children with auditory difficulties often can not do this – so they miss important information. Even worse, they come to expect to not be able to understand everything they hear.
Children with auditory processing difficulties will not be able to develop a good memory for what they hear (auditory memory). For some children this can mean that they do not have a clear idea of what each sound is like, and so they can not speak clearly or in accurate sentences. This will make it very difficult to develop phonological awareness skills (awareness of sounds) that are essential for reading. For other children, auditory processing difficulties mean that they will not be able to remember the exact words of rhymes or songs, or their address or date of birth.
Many children in this situation find it easier to 'tune out' because focusing on what they are listening is hard work. And, of course, they will have difficulty remembering exact instructions or other details that they are told.
This is frustrating for everyone, including parents and teachers.