What is APD?

Auditory processing disorder (APD), a neurological condition also known as central auditory processing disorder (CAPD), affects the brain’s ability to process auditory input, making it difficult to understand speech, follow oral instructions, or distinguish speech in noisy environments.

Anyone can have an auditory processing disorder. Research estimates that as many as 5 to 7 percent of school-age children will exhibit APD, according to the Auditory Processing Disorder Foundation, with boys diagnosed twice as often as girls. Adults can also have auditory processing disorders. These can be “left over” problems that never resolved in childhood, or they can appear secondary to having hearing loss, especially hearing loss that has been untreated or under-treated over time. Because having hearing loss so commonly causes auditory processing problems that hearing aids/cochlear implants alone cannot resolve, many people continue to be frustrated with their hearing function and performance. They do not realize that they could function better with proper intervention and treatment for the auditory processing problems caused by their hearing loss. The “dirty secret” in the hearing aid professional community is that hearing aids are enough to solve peoples’ communication problems that come along with hearing loss, and frequently they are not.

Though APD awareness has increased in recent years, confusion about the disorder abounds. APD can appear simultaneously with conditions such as attention deficit/hyperactivity disorder, so it’s important that those with APD symptoms get evaluated by an audiologist who has specialized training and a professional interest in APD for proper diagnosis. Unfortunately, even among professional audiologists, understanding, awareness, and ability to diagnose and treat APD varies widely. Many audiologists, especially mid-career or late-career audiologists, may mistakenly believe that there is no appropriate treatment for APD. People with APD have often experienced dreadful interactions with “experts” in hearing care who have told them there’s nothing that can be done to help them.

What Are the Symptoms of Auditory Processing Disorder?

The “classic” definition of APD is that a person has communication and learning challenges while their physical ability to hear soft sounds is technically within normal limits. For someone with APD, the issue is that their central nervous system has trouble accurately processing the information captured phsyically by the ears. Symptoms often appear at a very young age and can vary widely in severity. Research shows that people who have a history of middle-ear infections are particularly at risk for having APD. Because hearing loss deprives the central auditory system of sound, many people with hearing loss also will have symptoms of APD varying in severity. The fact that changes happen with central auditory processing over time with hearing loss present is not something generally discussed by hearing care professionals, but it is a well-documented neurological change that accompanies hearing loss, and typically a person’s symptoms are far worse with untreated or under-treated hearing loss.
 

Some signs and symptoms include the following:

  • Difficulty listening or learning auditorily
  • Problems following multistep directions
  • Difficulty with reading, spelling, or academics
  • Problems filtering out background noise
  • Hypersensitivity to or reduced tolerance for noise
  • Frequent mishearing or misunderstanding of speech
  • Difficulty understanding muffled, fast, or distorted speech
  • Problems remembering what was heard
  • Problems distinguishing between similar speech sounds
  • Difficulty organizing verbal information
  • Problems with oral and written expression

Girl reading with teacher

How Is Auditory Processing Disorder Diagnosed?

Unfortunately, a majority of audiologists do not have the training, clinical experience, or interest in diagnosing or treating APD. Thankfully though, there is a growing body of professionals, both speech-language pathologists and audiologists, who are actively involved and engaged in the diagnosis and treatment of APD. A wise health-care consumer will carefully research their diagnostic options before moving forward with a visit to a clinic if they are concerned about APD. Diagnosis of APD will typically involve more than one visit to the clinic, or one longer-than-typical visit. First, the audiologist must determine what an individuals’ hearing status is. The audiologist must interview the person to review their symptoms and history. Typically, the audiologist must also conduct additional testing that is not commonly part of a standard hearing evaluation to determine if an individual has auditory processing problems. The final step is developing a treatment plan for the individual. These services are not usually covered by health insurance.

Group of children laying in grass

How Is the Disorder Treated?

Just as every person is different, so are the treatments for APD. What may work for one person may not be the most effective approach for another.

Treatment starts with a careful diagnosis by an audiologist and is individualized to the patient and his or her auditory challenges.
 

Typically, APD management or treatment involves one or more of the following approaches:

  • Modifying the learning or communication environment to reduce barriers to listening
  • Using amplification devices to help improve the auditory signal
  • Strengthening language, problem solving, concentration, differentiation, and other skills to help directly address auditory deficits

 
If you or a loved one is experiencing symptoms of auditory processing disorder, contact us for an evaluation and customized treatment options for your individual needs.

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