What is Auditory Processing Disorder (APD)?

Contents

1. What is APD?
2. What causes APD?
3. What are the common signs and symptoms of APD?
4. How is APD diagnosed?
5. What are the different types of APD?
6. Is APD a disability?
7. How to help someone with APD

For parents, staying informed on how different conditions affect children is key. Whether you believe your child may have APD or whether you’d just like to know what signs and symptoms to look out for in your children, it’s a great idea to educate yourself on what auditory processing disorder (APD) is. In this article, we’ll give you an overview of what this disorder is and how it manifests in children.

What is APD? 

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is a term coined by experts to describe a condition in which the brain has problems interpreting sound, including speech. Sounds may be loud and clear, but a person with this disorder would not be able to pick up on the differences between them. People with APD experience delayed auditory processing – they have trouble registering and remembering the things they hear despite not having issues with their hearing. 🗣️

APD often starts in childhood, but it can also be developed later in life. An auditory sensory disorder like this can affect children in different ways and to varying degrees. Keep reading to find out the most common APD symptoms in children – but first, let’s take a look at possible causes of this disorder. 

What causes APD?

Auditory processing disorder doesn’t have any specific cause. However, studies suggest that the risk of development is higher in children who have or have suffered any of the following:

• Trauma to the head
• Lead poisoning
• Chronic ear infections
• A faulty gene
• Seizure disorders such as epilepsy
• Brain tumors
• Meningitis
• Complications at birth
• A family history of APD

There can be more than one cause of this disorder, and the cause may also be entirely unknown and not linked to any of the above scenarios.

What are the common signs and symptoms of APD?

The signs and symptoms of APD can range from mild to severe and can take many forms. 

Some of the common APD symptoms to look out for include: 

• Difficulty listening, especially when there is excessive background noise 
• Difficulty identifying where sounds are coming from
• Finding it hard to process too many words or sentences at any one time
• Trouble participating in conversations (misunderstanding or misinterpreting what other people say, not responding to questions, trouble following stories etc)
• Difficulty concentrating or maintaining focus
• A lack of appreciation for music and not being able to engage in musical activities (this is because it’s difficult for people with APD to process sounds, music may cause them to feel overwhelmed)
• Trouble with spelling or phonics (people with APD often have a hard time identifying letter sounds and syllables, which makes interpreting words difficult)

The auditory processing disorder symptoms listed above are the most common signs of APD. However, auditory processing disorder symptoms aren’t limited to this list, as the disorder could manifest in slightly different ways for everyone. 

APD is a learning disability, meaning it is in the same group as dyslexia, dyspraxia and dysgraphia among others.   

How is APD diagnosed?

Auditory processing disorder is diagnosed by an audiologist using a group of listening tests. If you think your child may be having issues understanding when people talk, your child’s doctor may refer you to an audiologist (a person who specialises in hearing). 👩‍⚕️

Only an audiologist can diagnose APD. The first thing they’ll do is eliminate possible hearing loss. A person with APD can usually hear well, but has trouble interpreting the sounds they hear. The most common method these specialists use is to administer a series of listening tests. Here are a few of the main problem areas they look for in kids:

• Auditory figure ground

This is when there’s trouble understanding speech when there is ambient noise or “babbling” in the background. An example of a similar situation would be a noisy classroom, which may be overwhelming for a child with APD. 

• Auditory closure 

This is when the child can’t “fill in the gaps” in a conversation. This usually happens in cases where a person’s voice is muffled or they’re talking too fast. This makes it hard for the child to make sense of or identify the words that are being spoken. 

• Temporal processing

This is the time it takes for the child to process sounds. This includes understanding differences in words such as “cat” and “bat” or “ring” and “ping”. It also involves them understanding pitch and intonations. For example, differentiating between a question versus a command, understanding jokes and riddles, and making inferences from statements. 

• Binaural interaction

This is the ability to figure out what direction a sound or speech is coming from. Another component of this is the ability of the child to localize a sound, that is, isolating a specific sound in a room with multiple sounds present. 

• Dichotic listening 

This is the inability for the child to understand competing speech happening at the same time. For example, a person talking on one side of the child and another talking on the other side. In this instance, a child with APD will have trouble understanding the speech of one or both people. 

After adequately assessing these different problem areas, and ruling out other things such as injury to the eardrum or inner ear, the audiologist can then make a concrete diagnosis of APD, or central auditory processing disorder as it is also known, if that’s what the results of the various tests indicate. 📝

What are the different types of auditory processing disorder?

APD will show up in different ways and vary from person to person. It may also present itself as a combination of different difficulties. There are five main types of auditory processing disorder in adults and kids, all of which are characterised based on varying symptoms. 

• Auditory Hypersensitivity

This is sometimes called “tolerance-fading memory”. This involves a person not being able to properly capture and process information due to an intolerance to background noise. Symptoms of this hypersensitivity include but are not limited to:

• Not hearing well in a busy or noisy environment. 
• Not grasping verbal directions well, particularly if they contain multiple steps.
• Forgetting memorized things such as multiplication tables, routines and correct spelling and pronunciation- even when they receive frequent reminders.

• Phonetic Decoding

Phonetic decoding is the inability to process language at a natural speed that is considered normal. It’s instead processed at a slower pace. Symptoms of this include:

• Difficulty with a phonics approach to reading (sounding out words).
• Confusing similar sounding words with each other. For example, “book” and “look”. 
• Phonetically incorrect spelling. For example, “littul” instead of “little”.
• Problems understanding grammar. 
• Issues with speech clarity and articulation.

• Auditory Integration

This is a delay in synchronising things heard with things that are seen. Because auditory processing disorders of any kind pull away from the brain’s capacity to understand things, integration may be present in the majority of APD cases. Symptoms include:

• Asking many questions before getting a task done because the child doesn’t understand what is being asked of them. 
• Difficulty reading or writing properly, regardless of their knowledge of phonics. They’ll have trouble matching sounds to the corresponding letters or syllables.

• Prosodic

This refers to a processing inefficiency where people find it hard to think while listening. Asking questions in conversation may throw them off because they are not able to think and listen at the same time. Symptoms include:

• Misjudging a speaker’s mood. 
• Unintentionally coming across as tactless (a lack of sensitivity when dealing with people, which may cause people with APD to come across as offensive and inconsiderate).  
• Absorbing details and facts from a conversation, but having trouble putting the thoughts together or “missing the bigger picture”. 
• Struggling with “cause and effect” reasoning. For example, “If you give me the money, I will give you the goods you want.”

• Organizational Deficit

This involves a difficulty with sequencing. You find that persons with this difficulty have problems with physical organization as well as planning ahead or planning any activities. A few things to look out for include:

• Difficulty understanding multi-step directions
• Trouble taking notes when in class
• Being unable to organize study material
• Inability to put plans together

Is Auditory Processing Disorder a disability?

There has been some confusion on whether auditory processing disorder is a disability. APD is in fact a type of learning disorder. A learning difficulty is one that affects the acquisition, organization, retention, understanding and use of verbal and/or non-verbal information.

People with this disorder don’t have hearing loss, and as a result, would not be considered “disabled” in the UK. Though auditory processing disorder generally isn’t considered a disability, there are special programmes and accommodations that are put in place to help people with APD. 

It is important to note that APD is a hearing disorder that affects how the brain processes sound. It is not caused by other conditions which affect cognition and attention such as autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD). 

How to help someone with APD

There are many practical ways in which you can help a person with APD:

• Talk with them face to face as much as possible
• Use pictures and written text to help them understand what is being said
• Repeat or rephrase things if it seems they are having trouble understanding
• Use carpets, curtains and soft furnishings to help eliminate background noise

If your child has been diagnosed with APD, your child’s school will be able to support their learning moving forward. It would be wise to maintain a great level of communication between you and your child’s educators. Some schools will provide a speech and language therapist to help your child devise strategies to help them succeed in school. ✔️

There is also evidence that learning a second language is more challenging to children with APD. There is therefore a correlation between auditory processing disorder and foreign language exemption in some schools for certain children. 

While APD may affect a person’s quality of life, with the right support, people with this disorder will be able to navigate their daily lives with more ease. As a parent, supporting your child with APD in the best way possible is crucial to their wellbeing, so we would recommend that you rely on the guidance of your child’s GP, the audiologist and any other specialists who can help your child thrive.