How to work with someone who may have an auditory processing disorder?

April 3, 2008 12:31 AM

I work with someone who I believe has an auditory processing disorder. Help me figure out how to work more efficiently and effectively with her.

(Anonymous because my username and workplace are connected, and I want to protect my coworker's privacy.)

My colleague works in a crucial capacity on our team; for as long as I've worked with her (5+ years) she has created a pattern of problems through more or less ongoing communication breakdowns. This has been noticed by virtually everyone who's worked with her for any length of time (supervisors, peers, and subordinates alike): she seemingly lacks the ability to communicate effectively, follow instructions, understand multi-step tasks (and the cause and effect of each step), and organize large amounts of information; all of this is coupled with a marked tendency to be very literal, highly sensitive, and an inclination for secrecy (which I've only recently realized is to cover up the work she says she's done, but often hasn't -- until the last minute, which inevitably creates a crisis, at which point we all pitch in to get the job done).

It suddenly hit me today that some of this was strikingly similar to a child in my family who has been diagnosed with dyslexia and an auditory processing disorder. In googling it a little, I found this description of the disorder; the integration and prosodic subtypes fit her to a T.

No one is interested in getting her fired or demoted (including her supervisors); she is a dear, lovely woman on a personal level and highly committed, hardworking, and knowledgeable within her specialty on a professional level. But it has reached the point where entire projects are breaking down (we're now having to hire freelancers to take on part of her workload in order to meet our deadlines), and all of us on the team are pretty much at our wits' end. How can we work with her more effectively and efficiently? Obviously, it seems that giving her written instructions is better than verbal; are there other things to be considered? Almost everything I've seen online so far has been along the lines of "how to help your child in school," which obviously isn't relevant under the circumstances.

posted by anonymous to human relations (6 comments total)

If she has a spouse or close friends or family that you've met and can talk to about this, that would be the best way to let her know she needs help.

Otherwise, have a supervisor or HR broach the subject carefully. It's still going to be ugly, I imagine, but unless you guys can shunt her off to non-critical tasks without her taking notice, you are going to have to bring this up to her. She needs to acknowledge the condition and take it on directly in order to get better and pull her weight at work.
posted by ignignokt at 1:07 AM on April 3, 2008

Hi there,

First let me state that, Wow, what a great (friend) colleague you must be to her. I think many people in your position would write her off. It would mean so much to her if she knew you were so deeply concerned about her.

The simplest answer to your question is, let her know you care for her and are available for her if she needs you. Your support and patience will make all the difference if she's struggling. Good luck to you both.

More Detailed Answer Follows:

Your colleague has a few similarities to myself. I haven't been diagnosed with a sensory integration disorder per se. I too have problems understanding or remembering spoken directions and processes requiring more than a couple steps. I have ADHD.

ADHD can display some similarities to what you call an auditory processing disorder. The fact is, ADHD is a profound inability to attend to information in the world around you. The frontal lobe is where several important attention tasks are monitored. If the frontal lobe is sluggish, the whole system can suffer.

Hearing vs. Listening:
I have been pleasantly surprised throughout my life that my hearing tests showed no dysfunction. However, for me there has always been a differential between hearing information and processing what the information meant. As an example, if you were to say, "Good afternoon to ya, mandab, are you taking muddy jr to the park?" I might catch, "Good afternoon, manda,..." but the rest would be a garbled mess to me. Or, I might hear it, but a second or two later, like this: "...What did you say? Oh, yeah, now I know what you said. We don't have him today, but hopefully this weekend..."

Math and Driving:
How is she at math? I was always terrible at math because I couldn't keep the order of operations straight.

When it comes to directions, I'm a mess. I have always had to delegate traveling to my fiance because I couldn't be trusted to follow the directions. "Left at Main Street, Right on Turner, Left on 15th, past the stop sign, third house down on the right." I could never be expected to remember so many steps.

And when it comes to driving, forget about it. I have historically driven because I have to, not because I want to. I don't like driving because I'm not a very good driver. I'm always coming thisclose to running into someone. I've gotten more tiny dings and insurance hikes than I care to mention. I wonder if your colleague has these problems too?

Sensitivity and Anxiety
You said your colleague is very sensitive to criticism about her work and tries to cover her tracks to hide the fact that she's fallen behind. I know for a fact that I developed several "compensatory strategies," e.g., cover stories or problems to divert the attention from my difficulty concentrating.

If you coworker is anything like me, she might be very high strung and anxious. Because my brain was trying to self-regulate, I developed an anxiety disorder to compensate for my difficulty paying attention. People with intense anxiety tend to be "Hyper-vigilant," which basically means, always ready for something bad to happen. My anxiety disorder covered for my ADHD very nicely. But it wasn't perfect.

Anxiety and hypervigilence can't keep you from blurting out information or statements or oversharing at inappropriate times. To the contrary: the level of urgency and impending doom with which anxious people live their lives can actually make them even more prone to impulsive words and behaviors.

Food and Eating:
Is she constantly moving away from her desk to get or make something to eat? Ask her if she ever eats just out of boredom and see what she says. If she says yes, ask her about some of these other items. Boredom eating is to ADHD what watching a movie is to reading a book.
I ate when I was bored, or failed to stop eating when I was full, for 2 reasons: (1) because I couldn't attend to my internal hunger and fullness cues, and (2) because eating as a physical act requires precious little concentration (How hard is it to cut something with your fork, stab it, and put it in your mouth? 'Cause that's all the attention I/we can afford to pay to that, or any other task for that matter.)

Also does she have trouble dieting and sticking to it because she has to "think too hard" about it? Does she seem to obsess about when her next meal will be?

Social Interactions:
I wonder if she also has a hard time connecting socially with coworkers that spend a great deal of time with her. People with ADHD are so distracted every moment that they can be very disconnected from relationships with peers. I had a hard time reading other people's nonverbal cues, which made it difficult to sense what they were feeling. (An interesting sidenote, I also had a terrible time trying to remember people's name after I met them. It was like the information was lost in a black hole, never to return.) It's hard to build rapport with people when you don't know that you might be bothering them with your words or actions.

Take a look at this checklist and see if you can answer of the questions by just observing.

My Solution:

I have suspected for a long time that I had this issue, but for a variety of reasons was never diagnosed. (If you are curious, please see this.) I don't necessarily believe that medication is the solution for all the troubles of the world, but after 26 years of life, 2 years of interpersonal psychotherapy, and countless behavioral attempts to remedy the situation, I was ready to try something else. A few weeks ago my psychiatrist and I started experimenting with medication, and the efect has been life-changing.
posted by mynameismandab at 1:52 AM on April 3, 2008 [11 favorites has favorites]

You say she's hard-working and committed but she can't cope with the workload - perhaps she would cope better with being assigned single tasks at a time, as well as the written instructions. Some people just aren't good at task prioritising and just get confused/overwhelmed with a large workload. It also sounds like she is very eager to please/fears getting in trouble so she says she's done things that she hasn't then has to try to get them done as well as looking like she's made progress in other areas. If you or her supervisor would take away that need to prioritise and only give her single tasks at a time, it would probably be a great help to her.

If you give her verbal instructions, email her a copy too.

I have a similar problem (I can pretty much check everything on the 'integration' list). But I only discovered this problem recently. The first place I worked was a very small company and we barely ever spoke (about work related stuff anyway) - if someone wanted you to do something, they'd send you a 'task' through outlook where they could set urgency and a deadline, so everything was in writing. The second place I worked the manager was very into lists and diagrams, occasionally I'd get a large project to work on my own and I'd find myself daydreaming a little and getting distracted but no-one seemed to care - it was a very low pressure job so I moved.

The last place I worked was very different, it was a new company so there was no established lines of communication, everything was all over the place and the boss would frequently come into the office and spout off some great new idea he'd had and I'd frantically try to scribble it down and at the same time try to understand what was being said because the boss in this case was a non-technical person and so frequently used words incorrectly - which really confuses and upsets me and makes it hard for me to understand what is wanted, equally, I had trouble communicating with him because I don't explain things well, I know what these technical words mean and I use them, I don't know how to explain it differently - so I don't work there anymore either ;)

Now I work freelance and all my work comes in by email, I'm much happier.

Lists are good too. Breaking tasks down into subtasks in a nice little checklist greatly helps my workflow - I find that with large tasks I tend to get distracted and jump from one thing to the next, having a list helps control that and helps me stay focused and organised.
posted by missmagenta at 1:54 AM on April 3, 2008 [1 favorite has favorites]

you might try following up with a written checklist for her, with due dates. do let her know that there's a problem--i know it will be uncomfortable, but it will give her the appropriate incentive to try a new system, rather than chalking it up to some inexplicable management whim.
posted by thinkingwoman at 4:34 AM on April 3, 2008

Read your final paragraph again substiituting "you" for "she", "your" for "her" at every point. Have you, or has anyone, tried saying that to her?

"How can we work with you more effectively and efficiently?", particularly if its linked to the sort of praise you've given her here, sounds like a good start. It's not as if she's totally unaware there's a problem - you've referred to her cover-ups - so this isn't going to be a complete surprise. Yes, it's going to be an awkward conversation, but if you show her in person a fraction of the sensitivity you've shown in your post here, you should be fine. Who knows - she might even be relieved it's finally out in the open.

You're at your wits end. This can't go on indefinitely. Involving her in the search for a solution has got to be a better (and kinder) way forward than trying out different suggestions from anonymous folks on the internet without broaching the subject with her. There is an "elephant in the room" already. Don't ignore it and don't aggravate it.
posted by genesta at 6:43 AM on April 3, 2008

I worked closely with someone much like your colleague. After several very frustrating episodes we sat down together and had a heart to heart. It turned out that she knew she had all of these difficiencies and worked terribly hard to compensate, which in turn made her level of anxiety even higher and it just created a viscious circle. She also would go to great lengths to cover up her mistakes, even lying on several occasions.

It was very much like missmagenta described. We began breaking her tasks up and putting instructions in writing. Did we still get frustrated with her at times? Sure. But it did help and it did get better. In the end, she admitted that the job really wasn't for her and went back to her old job which she had enjoyed much more.
posted by tamitang at 8:09 PM on April 3, 2008