Abby Barnes, M.S., CCC-SLP
Auditory processing disorder (APD) is a condition in which people can hear clearly, but their brain has trouble interpreting what they hear. This can make it tough to follow directions or join in conversations. APD can affect both children and adults. While there is no cure, there are ways to improve listening and communication skills, making it easier for people with APD to navigate their daily lives.
Key takeaways
Auditory processing disorder (APD) is a condition in which people can hear clearly, but their brain has difficulty making sense of what they hear.
Both children and adults can have APD. Many children with APD also have learning difficulties.
Some symptoms of APD include difficulty understanding speech, especially in noisy places; mishearing words and sounds; and difficulty following multistep directions.
Only an audiologist can diagnose auditory processing disorder, using special tests that measure how well a person processes sounds.
Speech therapy is a key part of treatment for APD. Treatment may involve making environmental changes at home or school, learning ways to cope with attention and communication challenges, and practicing specific listening skills.
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Find a speech therapistWhat is auditory processing disorder?
Have you ever heard someone say something to you, but at first you didn’t understand it? Then, a few seconds later, it’s as if what they said finally “clicks.” This is what auditory processing disorder is like, but on a much bigger scale.
Auditory processing disorder (APD) is different from hearing loss caused by damage to the ears. APD is a condition that affects how the brain processes sound. A person with APD can physically hear without problems. However, their brain has difficulty making sense of what they hear. This disorder can make it hard to follow conversations, especially in noisy places or when instructions are complex.
APD is sometimes called central auditory processing disorder (CAPD) or auditory perceptual disorder. Some people call it APD disorder.
Research suggests that boys may be diagnosed with auditory processing disorder more often than girls. The symptoms of auditory processing disorder can stand out in the classroom. Many children with APD have learning difficulties, especially in reading, spelling, and attention.
“Auditory processing disorder is also common in older adults, particularly those with other types of hearing loss,” says Laura Thorburn, M.S., CCC-SLP, a speech-language pathologist with Expressable.
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What causes auditory processing disorder?
The cause of auditory processing disorder isn’t specifically known. It can occur alongside conditions like ADHD or autism, but it is a separate diagnosis. It is different from receptive language problems, which make it hard to understand word meanings.
Auditory processing disorder in adults may develop after a stroke, brain injury, or neurological disease. In children, APD may be linked to:
Lyme disease
Lead poisoning
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Symptoms of auditory processing disorder
Some signs and symptoms of auditory processing disorder include:
Difficulty understanding speech, especially with background noise
Mishearing words and sounds
Asking people to repeat themselves often
Difficulty following directions, especially multistep directions
Problems distinguishing between sounds
Thorburn stresses that although someone with auditory processing disorder may appear to not be paying attention, this is because of their difficulty understanding or following through with directions. ADHD or attention problems may occur alongside auditory processing disorder, “but APD is not an attention-related issue itself,” she says.
What does auditory processing disorder look like in the classroom?
At school, children with auditory processing disorder may appear to have trouble with:
Paying attention
Understanding directions
Completing tasks appropriately
Understanding the teacher
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How is auditory processing disorder tested?
Only an audiologist can diagnose auditory processing disorder, using special tests that measure how well a person processes sounds. Other professionals may help with assessments as well, including a child’s teachers, a psychologist, and a speech therapist. Most of the tests needed to diagnose APD require that a child be at least 7 or 8 years old.
How is auditory processing disorder treated?
Auditory processing disorder can’t be cured, but there are treatments and strategies that improve listening and communication skills. According to the American Speech-Language-Hearing Association, there are three main types of treatment for APD:
1 Environmental modifications
You can modify, or change, the space around you to make listening easier. Examples might include reducing background noise or using sound amplification systems.
2 Compensatory strategies
You can learn ways to compensate for, or cope with, attention and communication challenges. Examples might include using memory tricks or taking notes.
3 Direct skills training
This involves practicing specific listening skills to improve how the brain processes sounds.
People with auditory processing disorder are typically treated by a multidisciplinary team in order to receive well-rounded support. This team might include audiologists, speech therapists, teachers, and/or psychologists.
Let’s take a closer look at how treatment and therapy work for auditory processing disorder.
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Screener for childrenEnvironmental modifications for auditory processing disorder
“One of the easiest ways to help someone with auditory processing disorder is to adjust the physical environment around them,” Thorburn says. Making changes at home, at work, or in the classroom can reduce the noise and distractions that make listening difficult. While you should always follow your therapist’s specific guidance, here are some ideas:
Turn off TVs, music, and loud appliances when you’re talking to your loved one.
Cover hard surfaces like floors and ceilings with carpets, rugs, or wall panels to reduce echoes.
Use curtains, bookshelves, or dividers to block outside noise.
Place soft pads under chairs and tables to lessen scraping sounds.
At school or work, seat the person closer to the teacher or speaker and away from windows, hallways, or noisy individuals.
These adjustments create a quieter space where people with APD can focus on speech.
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Compensatory strategies for auditory processing disorder
There are other strategies you can use at home, school, and work to support the person’s listening and learning:
Encourage face-to-face communication. Seeing a person’s face when they’re talking will help the person understand their speech.
Speak at a steady pace with a clear voice, instead of speaking more loudly.
Give simple, clear directions. Break up instructions into small steps.
Have your child or loved one repeat back directions you give them. This way you can confirm they understand.
Use written reminders and visual aids like chore charts, calendars, or checklists.
Turn on closed captions when watching TV or using computer programs.
“It’s also important to teach your child self-advocacy skills,” Thorburn says. “Encourage them to ask for help or use a signal when they are struggling to hear.”
If you have a child with special needs, these tips will help you communicate with teachers and therapists and start the new school year successfully.
Speech therapy for auditory processing disorder
Speech therapy is often part of treatment for auditory processing disorder. In speech therapy, the person receives training to help them understand speech more clearly.
There are several types of direct skills that someone may practice during treatment for auditory processing disorder:
Auditory discrimination is often part of APD therapy. The person practices telling one sound from another (for example, the /b/ sound vs. the /p/ sound). This helps people tune out background noise and focus on key sounds.
Phoneme discrimination helps people tell the differences between sounds and words, and the meaning that those sounds carry. They might learn to recognize speech sounds that change word meanings (e.g., “bat” vs. “pat”). This helps with speech clarity and reading.
Auditory pattern recognition relates to noticing patterns in sounds, like musical rhythms in songs or syllable patterns.
Sound localization and lateralization helps the person better understand where a sound comes from. Practice can involve playing games like identifying sound locations while their eyes are closed.
How to find treatment for auditory processing disorder
If you think that you, your child, or your loved one might have symptoms of auditory processing disorder, don’t hesitate to contact your doctor. You can also speak with an audiologist or speech therapist.
Expressable is here to help you navigate next steps. Click here to find a speech therapist who’s experienced in treating auditory processing disorder. The sooner therapy begins, the sooner you’ll start seeing progress!
Frequently asked questions (FAQs)
Is auditory processing disorder genetic?
APD can have a genetic component, but in many cases, the cause isn’t known. It can occur alongside conditions like ADHD or autism. In children, it may be linked to low birth weight or frequent ear infections. Auditory processing disorder in adults may develop after a stroke or brain injury.
Is auditory processing disorder a learning disability?
APD is not technically considered a learning disability. However, children with APD may be eligible for a school support plan such as an IEP or a 504 plan. Many children with APD have learning difficulties, especially in reading, spelling, and attention.
Who diagnoses auditory processing disorder?
An audiologist diagnoses APD using tests that measure how well a person processes sounds. Other professionals also may be part of the process, including a child’s teachers, a psychologist, and a speech therapist.
How do you test for auditory processing disorder?
Testing for APD includes auditory processing tests to measure your brain’s ability to process sounds. These tests may include tympanometry, acoustic reflex test, auditory brainstem response, and evoked potential test. The evaluation may also include hearing tests, language tests, and psychological tests to check for ADHD or similar conditions.
How do you treat auditory processing disorder?
Speech therapy is a key part of treatment for auditory processing disorder. There are three main types of treatments: environmental modifications (changing the space around you to make listening easier), compensatory strategies (learning ways to cope with attention and communication challenges), and direct skills training (practicing listening skills to improve how the brain processes sounds).
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech and occupational therapy practice serving children and adults. We treat all major areas of communication, feeding, and developmental skills, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 4,500 5-star reviews from our clients (4.83/5 average).
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