Preschooler Can't Answer Questions

A mother is concerned that her three-year-old cannot answer even simple questions about a book that was just read.
Q
Hi. My three-year-three-month-old daughter seems to have no problem with learning new things. She knows ABC's and numbers, but the problem I notice is that she has a very hard time answering questions and reasoning. She cannot answer even the simplest question about a book that was just read. For example, "What animals are in the story?" (Even though she knows them all by name) or "What is that little boy in the picture doing?" She answers the question with an entirely different unrelated answer, as if she didn't even hear me. It seems she can only answer the question when you actually give her the answer. Everybody says that there is no problem, but she is my third child, and compared to her siblings there is a definite difference. Am I crazy or does she need some help?
A
The fact that your daughter has learned her numbers suggests that she has the ability to acquire information, which is good news. However, based on what you say, I wonder if her hearing is ok. Does she hear doors slam when people come into the house? Does she hear the phone ring? If there is any question about this, have her hearing tested right away. If her hearing is fine, then we have to wonder whether she can process information she hears. This means that she understands the information when it comes from her ears to her brain. Some children have a condition that affects listening comprehension which is called Central Auditory Processing Disorder (CAPD). This condition, which is a specific form of learning disability, cannot usually be diagnosed until a child is about eight years old. This doesn't mean that problems with auditory processing can't exist in a younger child, but the formal testing can't be done until the brain is more developed or mature. For now, this is a possibility that should be considered, but can't be easily confirmed. A speech and language pathologist diagnoses the condition, and the testing is usually done in a hospital speech and hearing clinic. The speech and language therapist in your local public school can give you more information about this condition. To enhance your daughter's listening skills, you can use props when you tell her stories. The story will come alive if you use puppets (which come with some books or which you can make) or real objects that represent elements of the story (toys, models, etc.). As you read the story, use these objects to tell parts of the story, or act it out. You can also play music on an instrument as you read parts of the story. It is easier to remember a part of a tale if a tune on a flute or a piano goes along with it. Materials that make sound effects (rattles, bells, sandpaper blocks, "footstep" sounds, etc.) can also add meaning to the text. In this way, you make the story more meaningful. When you ask your daughter to tell you the story, or parts of it, she can act out scenes or make sound effects that go with parts of the story. This technique will give more meaning to the story as it comes out, and make it easier for her to remember.
Jerome (Jerry) Schultz is the founding clinical director of the Learning Lab @ Lesley University, a program that provides assessment, tutoring, and case management services for children with learning challenges. Schultz holds a Ph.D. from Boston College, and has completed postdoctoral fellowships in both clinical psychology and pediatric neuropsychology.

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