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Beth Ciavarella
ciave@iu29.org
570-544-9131 x1282

Cindy Studlack
studc@iu29.org
570-544-9131 x2379

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What is auditory processing disorder?

Your child passes a hearing test, but is diagnosed with auditory processing disorder (APD). How is it possible to have an auditory disorder when you don't have a hearing impairment?

Children with APD typically have normal hearing. But they struggle to process and make meaning of sounds. This is especially true when there are background noises.

Researchers don't fully understand where things break down between what the ear hears and what the brain processes. But the result is clear: Kids with APD can have trouble making sense of what other people say.[1]

Typically the brain processes sounds seamlessly and almost instantly. Most people can quickly interpret what they hear. But with APD, some kind of glitch delays or "scrambles" that process. To a child with APD, "Tell me how the chair and the couch are alike" might sound like "Tell me how a cow and hair are like."

Many conditions, including ADHD and autism, can affect a child's ability to listen and understand what they hear. What makes APD different is that the problem lies with understanding the sounds of spoken language, not the meaning of what's being said.[2]

Some educators and other professionals question or doubt a diagnosis of APD. Not all professionals see it as a specific disorder. The medical profession didn't start seriously studying APD in children until 1977.[3] Three decades later, there's still confusion about APD.

How common is auditory processing disorder?

The number of children with APD is estimated to be 2 to 7 percent.[4] Some experts estimate that boys are twice as likely as girls to have auditory processing disorder, but there's no solid research to prove that.[5]

What causes auditory processing disorder?

The exact causes of APD are still unknown. Research suggests possible links to several factors. These include premature birth or low birth weight, head trauma, chronic ear infections and lead poisoning.

What are the symptoms of auditory processing disorder?

There are several kinds of auditory processing issues. The symptoms can range from mild to severe. Children with APD can have weaknesses in one, some or all of these areas:

Auditory discrimination: The ability to notice, compare and distinguish between distinct and separate sounds. The words seventy and seventeen may sound alike, for instance.

Auditory figure-ground discrimination: The ability to focus on the important sounds in a noisy setting. It would be like sitting at a party and not being able to hear the person next to you because there's so much background chatter.

Auditory memory: The ability to recall what you've heard, either immediately or when you need it later.

Auditory sequencing: The ability to understand and recall the order of sounds and words. A child might say or write "ephelant" instead of "elephant," or hear the number 357 but write 735.

Children with APD usually have at least some of the following symptoms:

Find it hard to follow spoken directions, especially multi-step instructions

Ask speakers to repeat what they've said, or saying, "huh?" or "what?"

Be easily distracted, especially by background noise or loud and sudden noises

Have trouble with reading and spelling, which require the ability to process and interpret sounds

Struggle with oral (word) math problems

Find it hard to follow conversations

Have poor musical ability

Find it hard to learn songs or nursery rhymes

Have trouble remembering details of what was read or heard

It's difficult to diagnose children with APD before age 7 or 8. Some of these auditory skills don't develop until then.[6] Getting a diagnosis requires finding a trained audiologist who can run electrophysiological tests. These tests record how the brain responds to sounds.

What skills are affected by auditory processing disorder?

Experts agree that children can learn to work around challenges they face when dealing with APD. But APD can present lifelong difficulties if it isn't diagnosed and managed. Here are some skills that are commonly affected:

Communication: Children with APD may not speak clearly. They may drop the ends of words and syllables that aren't emphasized. They might confuse similar sounds (free instead of three) long after their peers have learned to correct themselves.

Academics: Kids with APD often have trouble developing reading, spelling and writing skills. Learning vowels and developing phonemic awareness-the building blocks for reading-can be especially difficult.[7] Understanding spoken instructions is challenging. Kids with APD tend to perform better in classes that don't rely heavily on listening.

Social skills: Kids with APD have trouble telling stories or jokes. They may avoid conversations with peers because it's hard for them to process what's being said and think of an appropriate response.

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How is auditory processing disorder diagnosed?

The first step is to have a pediatrician rule out other possibilities such as hearing loss related to an ear infection. A speech-language pathologist or school psychologist may also give your child tests that measure receptive language or listening comprehension skills as well as cognitive abilities. But only a trained audiologist can conduct the tests needed to make a diagnosis of APD.

What conditions are related to auditory processing disorder?

Many children with APD also have dyslexia, ADHD and other conditions. Recent research suggests that auditory processing issues may be a contributing factor to dyslexia.[8]

Experts also suspect that some children are misdiagnosed with ADHD when they actually have APD.[9] Both conditions can cause attention issues, but with APD the cause is an inability to process what people are saying. With ADHD, on the other hand, there's an underlying issue with focus.

How can professionals help with auditory processing disorder?

There's more than one method for helping kids with APD. If your child has been diagnosed and is eligible for special education services, the school will come up with a plan of supports. These can include:

Accommodations (such as changes in timing, formatting, setting or presentation of assignments)

Modifications (altering assignments to minimize the area of weakness)

Remediation (training and therapy to build skills)

Among the therapies and treatments that may help:

Reading instruction: Your child could have one-on-one or group instruction in reading skills, targeting any areas of weakness.

Speech therapy: Speech therapists can provide exercises and training to build kids' ability to identify sounds and develop conversational and listening skills.

Accommodations you and the school may want to consider include:

Preferential seating: Seating kids with APD in the front of the room and away from distractions can help them focus.

Improved acoustics: Closing doors and windows minimizes outside noise.

Assistive technology: An amplification system, such as a wireless FM system, reduces background noise and poor acoustics. The child wears a headset and the teacher wears a clip-on microphone.[10]

Classroom visuals: The teacher uses images and gestures to reinforce the child's understanding and memory.

Quiet rooms for taking tests.

Special instruction: Research funded by the NIDCD found that some computer programs helped improve children's language-processing skills when the programs were used intensively.[11]

Note: Many of the services and accommodations listed here require that the student have an Individualized Education Program ( IEP) or a 504 plan. But even without a diagnosis, the school may be willing to offer informal supports (such as providing copies of classroom notes) to help your child succeed.

What can be done at home for auditory processing disorder?

Even small steps can have a big impact on how your child functions at home. Here are some suggestions you may want to try:

Provide a quiet spot for studying, with background noise kept to a minimum.

Have your child look at you when you're speaking.

Use simple, one-step directions.

Speak at a slightly slower rate and at a slightly higher volume.

Ask your child to repeat directions back to you. If he'll need to act on the directions later, ask him to write notes to remind himself.

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What can make the journey easier?

Whether your child has been diagnosed with APD or you suspect he might have it, Understood can help you find helpful tools, strategies and support.

Assistive technology can help kids with reading and listening challenges. You can explore Tech Finder for ideas on apps for your child.

Connect with other parents. Other parents of kids with APD may give you more information and strategies-as well as the support you need to help your child. They know what you're going through and can share tips to help propel you forward.

Get behavior advice from the experts. Parenting Coach has strategies that can help with the social and emotional issues that can come along with APD.

There's a lot you can do to help your child-and you don't have to do it alone. Teachers, doctors and other professionals can help guide you, along with other parents who have been there.

Continue to explore information on APD, including common questions parents have. If you can, carve out some extra bonding time with your child. And remember to take care of yourself.

[9] "Scrambled Sounds."

About the Author

The Understood Team is composed of writers, editors and community moderators, many of whom have children with learning and attention issues.

Reviewed by

Kelli Johnson, M.A., is an educational speech-language pathologist, working with students from early childhood through 12th grade.

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Your child passes a hearing test, but is diagnosed with auditory processing disorder (APD). How is it possible to have an auditory disorder when you don't have a hearing impairment? Children with APD typically have normal hearing. But they struggle to process and make meaning of sounds.

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Auditory Processing: How our ears process sound.

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How is education like bowling?

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Shelley Moore: Transforming Inclusive Education

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Teaching Students with Processing Disorders

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Teaching Students with Processing Disorders

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horizons auditory processing - Bing video

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Auditory Processing Dyslexia Auditory Lesions Auditory Processing Super Auditory Processing Structures Auditory Processing Strategies Auditory Processing Test Auditory Processing Evaluation Auditory Processing Interventions Auditory Processing Activities Processing Auditory Contraletal Auditory Processing Treatment Auditory Learning Style

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No Technology strategies

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Ciocci APD Classroom Intervention Strategies.pdf

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Skills that can be affected by auditory processing disorder

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About the Author

The Understood Team is composed of writers, editors and community moderators, many of whom have children with learning and attention issues.

Reviewed by

Joanne Restivo, Au.D., is an audiologist in Newport, California, and a former assistant professor at Columbia University Medical Center.

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Skills That Can Be Affected by Auditory Processing Disorder

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About the Author The Understood Team is composed of writers, editors and community moderators, many of whom have children with learning and attention issues. Reviewed by Joanne Restivo, Au.D., is an audiologist in Newport, California, and a former assistant professor at Columbia University Medical Center.

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Classroom accommodations for auditory processing disorders

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Classroom accommodations for auditory processing disorders

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At a Glance: Classroom Accommodations for Auditory Processing Disorder

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What classroom accommodations can help students with auditory processing disorder? Here are some options you can discuss with your child's teaching team.

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AP. A Breakdown of Skills Super Duper Handy Handouts.pdf

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APD in Children. Symptoms and Treatments Super Duper Handy Handouts.pdf

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Myth #3: Kids with auditory processing disorder are less intelligent than their peers.

Fact: APD is not connected to a child's intelligence. In fact, most kids with learning and attention issues have average to above-average intelligence. It's true, though, that children with APD may score lower on verbal IQ

tests than their peers do. They also can appear to be "slow"-taking longer to respond to questions and pick up new concepts. But this isn't because they're less intelligent. It's because they have difficulty processing and interpreting new sounds.

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5 Common Myths About Auditory Processing Disorder

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Fact: APD is not connected to a child's intelligence. In fact, most kids with learning and attention issues have average to above-average intelligence. It's true, though, that children with APD may score lower on verbal IQ tests than their peers do. They also can appear to be "slow"-taking longer to respond to questions and pick up new concepts.

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Debra John AudD

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Oticon Ear Level FM System for students with APD.  How to replace the dome and slim tube.

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Oticon Ear Level FM System for students with APD.  How to replace the dome and slim tube.

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How to place the Oticon hearing aid with dome on the ear

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High tech option

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FM Systems Super Duper Handy Hand-outs.pdf