What is Auditory Processing Disorder (APD)?

Auditory processing (also known as central auditory processing) is how the central nervous system uses auditory information.  It is different than hearing, which generally refers to operation of the parts of the ear starting at the outer ear and ending at the auditory nerve.  People with auditory processing deficits typically have normal hearing sensitivity, but experience difficulty analyzing or making sense of what they hear.

Children with APD may demonstrate difficulties in speech, language, and/or learning, especially in the areas of reading and spelling. They may also appear to be hearing impaired, be inattentive, easily distractible, and have difficulty following oral directions.  It is for these reason that APD can also be misdiagnosed as Attention Deficit Disorder.

How is APD Diagnosed?

An audiologist first makes sure the person has normal hearing acuity, and normal middle ear function.  Middle ear condition is known to affect central auditory performance.  The ability to understand speech in the presence of background noise, competing speech, and optimal listening conditions can also be tested. A speech-language pathologist may also evaluate the linguistic characteristics of the disorder (i.e. difficulty listening and following directions).

How does APD affect speech and language?

Some children who have difficulty hearing the difference between speech sounds also have difficulty in their pronunciation. Receptive language development may also be delayed since these children have limitations in auditory memory and retrieval.

How does APD affect learning?

Classroom information is communicated auditorily. Taking notes and remembering assignments given verbally becomes difficult if listening requires all of a child’s attention.  Depending on the auditory processing difficulty, reading, comprehension, spelling, and vocabulary can also be affected.

What are some common difficulties experienced by people with APD?

Early Childhood School Age Teens and Adults
  • Unusual sensitivity to noise
  • Confusing similar sounding words
  • Difficulty understanding speech
  • Staying focused on a person’s voice
  • Remembering and following spoken directions
  • Sounding out new words
  • Understanding people who speak quickly
  • Talking louder than necessary
  • Poor ability to memorize information
  • Hearing clearly in noisy environments


How is APD treated?

  • Speech-language therapy to address speech articulation issues, as well as language and reading comprehension difficulties.
  • Auditory trainer – an electronic device that allows an individual to focus attention on a speaker and reduce the interference of background noise
  • Yoga and relaxation techniques to clear the mind before important conversations, presentations, etc.
  • Modification strategies for small children
    • Keep directions simple
    • Speak slowly
    • Limit background noise
    • Give directions both orally and visually
  • Classroom modifications for school age children
    • Seating in front of the class
    • Provide attention prompts and visual aids
    • Build in breaks
    • Rephrase and restate instructions
    • Use a microphone and headset. The teacher’s voice is amplified through a microphone connected to the student’s headset. This helps to focus attention on the teacher.
  • Modifications strategies for teens and adults
    • Find a quiet place to work
    • Request written instructions
    • Ask for directions to be given one at a time
    • Take notes or use a recording device

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