The Minnows, the Whale, and the Net Why So Many Struggling Kids Are Missed, and What We Can Do About It

Imagine your child is falling backward, like in a trust fall. But instead of one person catching them, there’s a net. That net is made up of professionals—an audiologist, a speech-language pathologist, a psychologist, an occupational therapist, a teacher, a reading specialist, and you.

Each person holds a different strand. Each one sees a part of your child. One sees speech. One sees behavior. One sees sensory overload. One sees listening. One sees academics. The idea is that together, they’ll catch what matters. But even when everyone is doing their job, sometimes the child still falls through.

That’s because the net isn’t broken. It’s just full of holes.

And those holes are not an accident. They’re built in.

Nets Are Supposed to Let Some Children Pass Through

Some children don’t need help. They hear clearly, tolerate background noise, process spoken language easily, and follow conversations without fatigue. They pass every test with room to spare. For them, the net works as intended. They are not the ones we worry about.

But what happens when a child who’s clearly struggling is told they’re fine?

What happens when they fall through?

Meet Jalen. A classic minnow.

He’s 8. His scores are all technically normal—word recognition in the 22nd percentile, speech-in-noise at 26th. His memory is borderline.

But Jalen mishears things constantly. He needs directions repeated. He confuses sound patterns in reading. He melts down after school. His day is filled with invisible effort.

Each problem on its own looks small. But taken together, they’re drowning him. He’s a school of minnows slipping through one by one. No one’s gluing the picture together.

Now meet Aria. A fatigue-based minnow.

Aria is 11. She’s bright, verbal, and often called “gifted.” Her parents say she’s brilliant. Her teachers say she’s inconsistent. Her auditory processing test was given in the morning, and she passed easily.

But by afternoon, she falls apart. Her working memory disappears. She refuses tasks that were easy earlier in the day. She only performs when she’s rested and engaged. But school doesn’t pause when she gets overwhelmed.

The test never saw the part of her that breaks.

Now meet Matt. The whale.

Matt is 10 and in a special education classroom. He scripts TV dialogue. He avoids eye contact. He pushes headphones away and hides when overwhelmed.

When his APD testing was attempted, he couldn’t finish it. The report said, “unable to complete.”

Matt didn’t slip through the net. He tore it.

And the system decided that because he couldn’t be tested, he couldn’t have APD. But just because a child has multiple diagnoses doesn’t mean auditory processing isn’t also part of the problem. It might even be the bottleneck making everything worse.

The Typical Child

Some children pass through the net because they should. Their hearing is stable. Their processing is fast. Their systems are clear and well-regulated. These children learn to read easily. They follow verbal instructions. They thrive in classrooms.

The net was designed for them.

Where Speech-Language Pathologists Place the Net

SLPs are often the ones who notice when a child is struggling to express ideas, form complete sentences, or understand classroom language. Their training tells them to place the net around language output and structure. That’s what they’re taught to measure.

But language doesn’t build itself.

Phonology, vocabulary, and syntax all depend on access to a clean, clear auditory signal. If that signal is distorted—even slightly—everything downstream suffers. Ear infections, background noise, sleep deprivation, and sensory overload all affect the input.

You can’t build strong language if the words never came in clearly.

This doesn’t mean speech therapy isn’t vital. It is. But if we only focus on the language, and never check the clarity of the signal underneath it, we’re treating the symptoms and ignoring the source.

A Brief History of the Testing Itself

Most auditory processing tests were designed decades ago. Originally, they weren’t made for kids at all—they were built to identify brain lesions and auditory cortex damage in adults recovering from stroke or trauma. They isolate subskills like dichotic listening and temporal processing, but they do it in artificial conditions: quiet rooms, headphones, artificial noise simulations, direct input.

They do not simulate real-world classrooms. They do not account for fatigue, sensory dysregulation, or sustained attention. Some have been updated in format, but many still run on old assumptions—and norms that don’t reflect today’s diverse learners.

These tests are useful. But they are incomplete.

Can’t We Just Use Brain-Based Testing Instead?

Parents often ask, “Can’t we just test the brain directly?”

In theory, yes. In practice, not yet.

Tools like pupillometry, advanced auditory brainstem response (ABR), and late-latency evoked potentials are being explored in research labs. They hold promise. But I’ve spoken with the researchers. And here’s the reality:

Pupillometry requires precise light control, tightly timed stimulus delivery, and consistent emotional state. Most clinics can’t guarantee that. Sleep, hunger, and stress all interfere.

ABR and late cortical responses offer a glimpse at auditory timing and processing, but are sensitive to head movement, alertness, and the child’s ability to remain still for extended periods. They’re better for group studies than for individual diagnosis—at least for now. Also, the equipment costs many tens of thousands of dollars, and it is not affordable for most clinics.

That doesn’t mean we give up on objectivity. It means we combine the best of what we can measure with what we can observe.

What We Might Do Differently

Perhaps, we could consider not treating one test score as the end of the story. Rather, let’s widen the lens. We could instead observe how a child functions, not just how they test. And maybe try supplementing existing testing methods?

Here’s what we could add:

• Fatigue testing—comparing performance when a child is fresh versus when they’re tired
• Listening effort reporting, not just once, but at different presentation levels. We could test at standard volume and again at louder or clearer levels to see how hard the child is working in each condition. We could ask them how it feels, then watch their accuracy and note how quickly or slowly they respond.
This helps us identify children who technically “pass” a test, but only by exerting extreme effort that is unsustainable in a classroom. Just because a child can repeat a sentence doesn’t mean it was easy to hear or process. We’d want to know how effort changes with conditions, not just whether the child got it right. • Low-gain hearing aid + FM treatment trials to test whether amplifying clarity improves comprehension, regulation, or speech
• Acceptable Noise Level (ANL) testing, to measure real-world background noise tolerance
• True collaboration with teachers, speech-language pathologists, occupational therapists, pediatricians, neuropsychologists, psychologists, and especially with families

But even more importantly, we might consider not insisting that every child rebuilds skills step by step. If a child is five years behind in language or reading, I personally don’t believe we should force them to crawl, then walk, then run.

Sometimes a child needs scaffolding. Sometimes they need to skip steps to stay motivated. Sometimes they need access to a higher-level task, writing with text-to-speech, reading with AI voice, or rehearsing complex vocabulary, because that’s what interests them and gives them a reason to generalize.

Access is not cheating. It’s how we keep the door open. Generalization happens when the work feels relevant. And relevance often happens upstream.

We Don’t Need to Throw Away the Net. We Just Need to Reinforce It.

We need to stop pretending these tests tell the whole story. We need to stop blaming children for falling through holes we built in. And we need to stop assuming that if something wasn’t caught, it must not exist.

If your child keeps being told they’re fine, but you know they’re not, trust your instincts. If they “pass” every test but fall apart by afternoon, you’re not imagining it. If they couldn’t even take the test, that doesn’t mean they don’t need help.

It just means the net didn’t fit.

Let’s fix it.

Dr. Rae Stout, CCC-A

Doctor of Audiology
drraestout.com

Looking for more information or related citations?

drraestout.com/blogThe Minnows, the Whale, and the Net Why So Many Struggling Kids Are Missed—and What We Can Do About It

Imagine your child is falling backward, like in a trust fall. But instead of one person catching them, there’s a net. That net is made up of professionals—an audiologist, a speech-language pathologist, a psychologist, an occupational therapist, a teacher, a reading specialist, and you.

Each person holds a different strand. Each one sees a part of your child. One sees speech. One sees behavior. One sees sensory overload. One sees listening. One sees academics. The idea is that together, they’ll catch what matters. But even when everyone is doing their job, sometimes the child still falls through.

That’s because the net isn’t broken. It’s just full of holes.

And those holes are not an accident. They’re built in.

Nets Are Supposed to Let Some Children Pass Through

Some children don’t need help. They hear clearly, tolerate background noise, process spoken language easily, and follow conversations without fatigue. They pass every test with room to spare. For them, the net works as intended. They are not the ones we worry about.

But what happens when a child who’s clearly struggling is told they’re fine?

What happens when they fall through?

Meet Jalen. A classic minnow.

He’s 8. His scores are all technically normal—word recognition in the 22nd percentile, speech-in-noise at 26th. His memory is borderline.

But Jalen mishears things constantly. He needs directions repeated. He confuses sound patterns in reading. He melts down after school. His day is filled with invisible effort.

Each problem on its own looks small. But taken together, they’re drowning him. He’s a school of minnows slipping through one by one. No one’s gluing the picture together.

Now meet Aria. A fatigue-based minnow.

Aria is 11. She’s bright, verbal, and often called “gifted.” Her parents say she’s brilliant. Her teachers say she’s inconsistent. Her auditory processing test was given in the morning, and she passed easily.

But by afternoon, she falls apart. Her working memory disappears. She refuses tasks that were easy earlier in the day. She only performs when she’s rested and engaged. But school doesn’t pause when she gets overwhelmed.

The test never saw the part of her that breaks.

Now meet Matt. The whale.

Matt is 10 and in a special education classroom. He scripts TV dialogue. He avoids eye contact. He pushes headphones away and hides when overwhelmed.

When his APD testing was attempted, he couldn’t finish it. The report said, “unable to complete.”

Matt didn’t slip through the net. He tore it.

And the system decided that because he couldn’t be tested, he couldn’t have APD. But just because a child has multiple diagnoses doesn’t mean auditory processing isn’t also part of the problem. It might even be the bottleneck making everything worse.

The Typical Child

Some children pass through the net because they should. Their hearing is stable. Their processing is fast. Their systems are clear and well-regulated. These children learn to read easily. They follow verbal instructions. They thrive in classrooms.

The net was designed for them.

Auditory Processing Isn’t Always the Cause—It’s the Bottleneck

Auditory processing disorder isn’t always the root cause of a child’s challenges. In many cases, it’s the place where deeper, upstream issues begin to show.

A child might have had early ear infections, fluctuating hearing, or subtle auditory neuropathy. They might be overtired, undernourished, or dealing with sensory overload. Maybe their brain simply processes sound timing differently. Any of these things can distort the incoming signal before it ever reaches the language system.

But here’s where it gets tricky. If a functional physician looked at the child, they might find inflammation. If a sleep expert looked, they might point to chronic fatigue. If a geneticist tested them, they might find a rare variant. Everyone has their own tributary—every professional sees a different part of the stream.

From their viewpoint, they’re upstream.

But here's what makes auditory processing different: even if it’s not the original cause, it often becomes the bottleneck that determines access. Because if a child isn’t hearing clearly, if the signal is degraded, distorted, or inconsistently processed, then nothing else can fully develop on top of it. Not speech. Not language. Not reading. Not self-regulation.

And while we can’t treat most genetic differences directly, and we may only be able to broadly support sleep or nutrition, auditory access is something we can assess and support with specificity. We can trial hearing aids. We can measure noise tolerance. We can monitor listening effort. We can adapt the environment. We can watch for change.

It’s not that speech-language therapy, sleep hygiene, or nutrition don’t matter. They do. But if we skip over the clarity of the incoming signal, we’re building interventions on a shaky foundation. And it won’t hold.

Auditory processing may not be the root cause for every child. But it affects everything. And it’s often the most addressable starting point we have.Where Speech-Language Pathologists Place the Net

SLPs are often the ones who notice when a child is struggling to express ideas, form complete sentences, or understand classroom language. Their training tells them to place the net around language output and structure. That’s what they’re taught to measure.

But language doesn’t build itself.

Phonology, vocabulary, and syntax all depend on access to a clean, clear auditory signal. If that signal is distorted—even slightly—everything downstream suffers. Ear infections, background noise, sleep deprivation, and sensory overload all affect the input.

You can’t build strong language if the words never came in clearly.

This doesn’t mean speech therapy isn’t vital. It is. But if we only focus on the language, and never check the clarity of the signal underneath it, we’re treating the symptoms and ignoring the source.

A Brief History of the Testing Itself

Most auditory processing tests were designed decades ago. Originally, they weren’t made for kids at all—they were built to identify brain lesions and auditory cortex damage in adults recovering from stroke or trauma. They isolate subskills like dichotic listening and temporal processing, but they do it in artificial conditions: quiet rooms, headphones, artificial noise simulations, direct input.

They do not simulate real-world classrooms. They do not account for fatigue, sensory dysregulation, or sustained attention. Some have been updated in format, but many still run on old assumptions—and norms that don’t reflect today’s diverse learners.

These tests are useful. But they are incomplete.

Can’t We Just Use Brain-Based Testing Instead?

Parents often ask, “Can’t we just test the brain directly?”

In theory, yes. In practice, not yet.

Tools like pupillometry, advanced auditory brainstem response (ABR), and late-latency evoked potentials are being explored in research labs. They hold promise. But I’ve spoken with the researchers. And here’s the reality:

Pupillometry requires precise light control, tightly timed stimulus delivery, and consistent emotional state. Most clinics can’t guarantee that. Sleep, hunger, and stress all interfere.

ABR and late cortical responses offer a glimpse at auditory timing and processing, but are sensitive to head movement, alertness, and the child’s ability to remain still for extended periods. They’re better for group studies than for individual diagnosis—at least for now. Also, the equipment costs many tens of thousands of dollars, and it is not affordable for most clinics.

That doesn’t mean we give up on objectivity. It means we combine the best of what we can measure with what we can observe.

What We Might Do Differently

Perhaps, we could consider not treating one test score as the end of the story. Rather, let’s widen the lens. We could instead observe how a child functions, not just how they test. And maybe try supplementing existing testing methods?

Here’s what we could add:

• Fatigue testing—comparing performance when a child is fresh versus when they’re tired • Listening effort reporting, not just once, but at different presentation levels. We could test at standard volume and again at louder or clearer levels to see how hard the child is working in each condition. We could ask them how it feels, then watch their accuracy and note how quickly or slowly they respond. This helps us identify children who technically “pass” a test, but only by exerting extreme effort that is unsustainable in a classroom. Just because a child can repeat a sentence doesn’t mean it was easy to hear or process. We’d want to know how effort changes with conditions, not just whether the child got it right. • Low-gain hearing aid + FM treatment trials to test whether amplifying clarity improves comprehension, regulation, or speech • Acceptable Noise Level (ANL) testing, to measure real-world background noise tolerance • True collaboration with teachers, speech-language pathologists, occupational therapists, pediatricians, neuropsychologists, psychologists, and especially with families

But even more importantly, we might consider not insisting that every child rebuilds skills step by step. If a child is five years behind in language or reading, I personally don’t believe we should force them to crawl, then walk, then run.

Sometimes a child needs scaffolding. Sometimes they need to skip steps to stay motivated. Sometimes they need access to a higher-level task, writing with text-to-speech, reading with AI voice, or rehearsing complex vocabulary, because that’s what interests them and gives them a reason to generalize.

Access is not cheating. It’s how we keep the door open. Generalization happens when the work feels relevant. And relevance often happens upstream.

We Don’t Need to Throw Away the Net. We Just Need to Reinforce It.

We need to stop pretending these tests tell the whole story. We need to stop blaming children for falling through holes we built in. And we need to stop assuming that if something wasn’t caught, it must not exist.

If your child keeps being told they’re fine, but you know they’re not, trust your instincts. If they “pass” every test but fall apart by afternoon, you’re not imagining it. If they couldn’t even take the test, that doesn’t mean they don’t need help.

It just means the net didn’t fit.

Let’s fix it.

Dr. Rae Stout, CCC-A

Doctor of Audiologydrraestout.com

Looking for more information or related citations?

drraestout.com/blog