Auditory Processing Disorders (APD)

The teacher tells everybody to take out a pencil, a piece of paper, and turn to page 32 in the spelling workbook. Pretty straightforward and easily accomplished for most, except for the child with APD. Despite having normal hearing and intelligence, the child with an APD has trouble understanding and following the teacher’s verbal directions.

What is an Auditory Processing Disorder (APD)?

People with APD generally have normal hearing sensitivity, but find it difficult to process and make sense of what they hear. The disorder is most common among children, but it can also affect adults.

People with an auditory processing disorder or a central auditory processing disorder may have trouble receiving, analyzing, organizing, storing, and using auditory information. These symptoms may get worse in difficult listening situations, such as places with a lot of background noise or acoustic problems.

Major Challenges for Children

Children with APD may have difficulties with speech, language, and learning—especially in the areas of reading and spelling. They may also appear to be hearing impaired, inattentive, easily distracted, and have problems following oral directions.

Some children who have APD may also be diagnosed with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD).

Symptoms of APD

People with APD may have difficulty:

  • Hearing in places that are noisy or have poor acoustics, such as reverberant rooms
  • Following long conversations
  • Hearing conversations on the telephone
  • Performing academically with reading and/or spelling
  • Learning challenging vocabulary words or a foreign language
  • Remembering spoken information
  • Taking notes
  • Staying focused on an activity when other sounds are present
  • Developing organizational skills
  • Following multi-step directions
  • Directing, sustaining, or dividing their attention
  • Processing nonverbal auditory information, such as music

Causes of APD

APD is a neurological problem that interferes with the brain's ability to process speech and other sounds. It may be inherited, caused by a complication during pregnancy or birth, or a combination of causes, such as head trauma, disease, tumor, and lead poisoning, to name just a few. The cause usually can't be determined or attributed to one specific thing.

Diagnosing APD

The process of evaluating an APD is often a collaborative effort between a speech-language pathologist, a learning disabilities specialist, or a mental health professional. An evaluation usually includes a complete hearing test, standardized testing, questionnaires, and behavioral inventories administered by an audiologist.
Tests Simulate Different Listening Conditions

The audiologist first tests hearing sensitivity and middle ear function. More sophisticated tests follow to determine the patient's ability to understand speech in the presence of background noise, competing speech, and less-than-optimal listening conditions.

Treating Auditory Processing Disorders (APD)

A thorough APD evaluation can guide health professionals in developing individualized therapy and strategies to help patients deal with the disorder. Treatment options include:

  • Auditory Trainers or FM Systems—These electronic devices improve the loudness level of the speaker's voice, reducing background noise interference and allowing a person to focus attention on the speaker. They're often used in classrooms, where the teacher wears a microphone and transmits sound to the student, who wears a headset.
  • Environmental Modifications—An audiologist can suggest ways to improve the listening environment, such as improving a room's acoustics or changing seating arrangements.
  • Remedial Exercises—A range of exercises have been developed to help increase the patient’s language base and build on vocabulary.
  • Strategies—Practices such as writing down verbal instructions and checking them off as they are completed can prove helpful with school- and work-related tasks.


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