Auditory Processing Disorder: Signs, Testing and Treatment

Someone can pass a basic hearing screening and still have significant difficulty following conversations, especially when there is background noise. A child may seem distracted in the classroom. An adult may hear that someone is talking but struggle to understand the words in a busy restaurant. These difficulties may sometimes be associated with auditory processing disorder.

Auditory processing disorder, commonly shortened to APD, affects how efficiently the brain interprets and organizes auditory information. People with APD often have hearing sensitivity within normal limits, meaning they can detect the soft sounds measured during a traditional hearing test, but still struggle with complex listening tasks.

Flex Audiology provides auditory processing evaluations for children and adults in Lawrenceburg, Indiana, and Harrison, Ohio. Diagnostic testing is typically available beginning at age five after a comprehensive hearing evaluation confirms that hearing sensitivity is within normal limits.

What Are the Signs of Auditory Processing Disorder?

APD can look different from one person to another. A child may:

• Frequently ask for repetition

• Have difficulty following spoken directions

• Misunderstand words

• Struggle to hear the teacher in a noisy classroom

• Seem distracted or as though they are not listening

• Have difficulty with reading, spelling, or written language

• Become overwhelmed in group conversations

Adults commonly report difficulty understanding speech in restaurants, meetings, group settings, or telephone conversations. They may say, “I can hear people talking, but I cannot understand what they are saying.”

Passing a school hearing screening does not rule out APD. A basic screening primarily checks whether a child can detect certain sounds. It does not evaluate all the complex skills the brain uses to organize and interpret auditory information.

Is APD the Same as ADHD?

No. APD and attention-deficit/hyperactivity disorder are different conditions, but they can occur together and may look similar in everyday life.

If a child cannot clearly process what was said, they may appear not to be paying attention. Difficulty sustaining attention can also interfere with listening. Language and learning differences may cause similar concerns.

That is why APD should not be diagnosed from symptoms alone. Depending on the patient’s needs, an audiologist may collaborate with a speech-language pathologist, psychologist, physician, teacher, or school team.

What Happens During APD Testing?

The process begins with a comprehensive diagnostic hearing evaluation. This helps determine whether hearing loss or a problem involving the outer, middle, or inner ear could explain the symptoms.

When appropriate, Flex Audiology can complete a brief APD screening after the hearing evaluation. The screening takes approximately 10 to 15 minutes and samples several auditory processing abilities. If it identifies an area of concern, a separate comprehensive diagnostic APD evaluation may be recommended.

Diagnostic testing is completed in a sound-treated booth. The test battery is selected according to the patient’s age, history, and abilities. It may examine how the brain:

• Recognizes small differences in timing and pitch

• Understands speech when part of the message is unclear

• Combines different information presented to both ears

• Focuses on one message while ignoring competing information

No single test provides the entire answer. The audiologist interprets the pattern of results along with the hearing evaluation, symptoms, and relevant developmental or medical history.

Can Auditory Processing Difficulties Be Treated?

Management is individualized according to the skills affected and the patient’s everyday needs. Recommendations may include:

• Targeted auditory training

• Communication strategies

• Classroom or workplace accommodations

• Visual supports and written instructions

• Changes to the listening environment

• Remote microphone technology

• Collaboration with a speech-language pathologist or school team

At Flex Audiology, in-office auditory training may be recommended for approximately one hour per week over 12 weeks. Some patients may also receive structured practice activities to complete at home. The treatment plan depends on the evaluation findings and the patient’s individual goals.

Patients who have traditional hearing loss are not evaluated for APD at Flex Audiology because reduced hearing sensitivity can affect auditory processing test results. However, they may still benefit from appropriately fit hearing aids, remote microphone technology, communication strategies, or selected listening exercises.

When Should You Consider an APD Evaluation?

An evaluation may be appropriate when a child or adult has ongoing difficulty understanding spoken information that is not explained by a basic hearing screening. Common concerns include repeated difficulty with speech in noise, spoken directions, telephone conversations, or group communication.

The purpose is not simply to assign a label. A thorough evaluation can identify auditory strengths and weaknesses and guide practical recommendations for home, school, work, and social situations.

Schedule an Auditory Processing Evaluation

Flex Audiology provides auditory processing evaluations for children and adults at our Lawrenceburg, Indiana, and Harrison, Ohio locations. Diagnostic APD testing is generally available beginning at age five and starts with a comprehensive hearing evaluation.

If you or your child seems to hear normally but continues to struggle with understanding spoken information, contact Flex Audiology to discuss the appropriate first step.

Sources

• American Academy of Audiology: Clinical Practice Guidelines for the Diagnosis, Treatment, and Management of Children and Adults with Central Auditory Processing Disorder

• American Speech-Language-Hearing Association: Understanding Auditory Processing Disorders in Children