Auditory processing disorder

Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), affects a child’s ability to process and filter sounds and words. It’s caused by an abnormality in the central auditory nervous system, making it difficult for sufferers to process what they hear. 

There are three different types of APD:

• Developmental APD: children who experience hearing difficulties despite having normal hearing. 

• Acquired APD: children with a known medical or environmental event (e.g. brain lesion, trauma, illness).

• Secondary APD:  children who have APD that occurs together with, or as a result of, hearing impairment (e.g. glue ear).

Generally, auditory processing disorder begins during childhood. While some adults can develop the condition, it’s much rarer. 

Common symptoms of APD include: 

• difficulty focusing

• commonly mishearing similar sounds and words

• difficulty hearing speech, or becoming overwhelmed or ‘zoning out’ in noisy environments

• sensitivity to loud noises

• easily distracted by background noise

• difficulty processing and understanding spoken instructions or directions, or constantly asking for information to be repeated

• difficulty memorising numbers or facts

• difficulty understanding fast talkers or strong accents

• fatigue from efforts to process speech and information

It’s important to note that the condition isn’t a hearing-related issue and isn’t caused by issues relating directly to the ears, but affects how speech and noises are perceived and processed.

The underlying cause of APD still isn’t known, but the disorder can be caused by:

• brain damage from a head injury, trauma, stroke or brain tumour 

• birth complications

• chronic ear infections

• lead poisoning

As APD symptoms can differ from patient to patient, it can be difficult to diagnose the condition. Similarly, as many of the symptoms of APD are similar to other disorders such as ADHD or learning difficulties, it’s often misdiagnosed and misunderstood. 

To diagnose auditory processing disorder, your child will need to see an audiologist (even though children with APD don’t normally have a hearing impairment).

Before APD can be treated, your child will need to have a hearing test to check for any other forms of hearing loss. If none is present, while there’s no cure for APD, there are some treatment options that can help to improve concentration and listening skills, and help people learn to hear more effectively. These include:

• Speech-language therapy: a type of auditory training focusing on helping children to differentiate sounds and improve their ability to both understand and make them. 

• ​​Assistive listening technology: to help with background noise, you can ask speakers, such as parents or teachers, to wear wireless microphones that directly transmit to hearing aid receivers worn by the person with APD. This helps to remove any background noise, which can be distracting and make it hard to focus.

• Environmental changes: while there’s no cure for APD, there are several things that both parents and teachers can do to assist those with the condition:

  • speaking more slowly and clearly

  • using written rather than verbal instructions, which can ease frustration

  • using visual aids and cues to support learning