About auditory processing disorder

Auditory processing disorder (APD) is a problem with the way the ears and brain work together to understand sound. Children with APD have normal hearing, but difficulty recognising and interpreting the sounds they hear.

These difficulties make it hard for children to work out what a sound is, where the sound came from and when the sound happened. And this means it’s hard for children to listen properly when there’s background noise or the sound is muffled.

APD can look like hearing impairment, an intellectual disorder, a language problem, a learning difficulty or attention deficit hyperactivity disorder. But it isn’t any of these conditions.

Because APD looks like other conditions and often happens alongside other conditions like language and reading difficulties, it can be hard to diagnose.

APD is also referred to as central auditory processing disorder (CAPD).

APD affects around 3-5% of school-age children.

Signs and symptoms of auditory processing disorder

If a child has auditory processing disorder (APD), you might notice that they have difficulties with:

• listening and hearing, especially if there’s a lot of background noise and distractions
• following instructions
• staying focused – for example, they might be easily distracted
• remembering spoken instructions
• telling the difference between letters that sound similar, like ‘k’ and ‘g’, or ‘t’ and ‘d’
• remembering to say the beginning or end sounds of words when they're reading.

This means that APD can appear as problems with learning, listening and communication, as well as reading and writing.

Causes of auditory processing disorder

We don’t know what causes auditory processing disorder (APD). Some experts think having lots of ear infections or glue ear might increase a child’s risk of developing some types of APD. Some types of APD might be because of a delay in the development of the body’s nervous system.

Diagnosis of auditory processing disorder

Auditory processing disorder (APD) is usually diagnosed once children start school. Diagnosis is important so that children can get support for classroom learning.

It’s a good idea to see your GP or paediatrician for advice if you’ve noticed any of the signs or symptoms of APD, or if your child’s teacher has noticed your child is having trouble listening at school. The GP or paediatrician might refer your child to an audiologist to test your child’s hearing.

If the audiologist thinks the problem might be APD, the audiologist will do an auditory processing assessment. This includes diagnostic hearing tests for hearing loss and auditory processing tests.

An auditory processing test involves several short tests like listening to and repeating words and sounds back to the audiologist. The audiologist uses equipment to change the words and sounds so they’re harder to understand – for example, the equipment might add background noise or play words or sounds at the same time.

You can ask your audiologist for more information about the tests before your child has them.

Audiologists diagnose APD in consultation with a range of professionals including speech pathologists, psychologists and your child’s teachers.

Support and treatment for auditory processing disorder

With the right intervention and support, children with auditory processing disorder (APD) can improve their ability to listen in the classroom and other noisy environments. In some cases, intervention can improve listening ability to almost normal.

Your audiologist might suggest strategies or training programs your child can use to improve their listening in noisy environments. The audiologist might also recommend that your child uses a personal remote microphone or sound field amplification system. This will help your child hear the teacher’s voice more clearly, even when there’s lots of background noise.

Your child might be referred to a speech pathologist to work on their language skills. Your child might also see a special education teacher for extra help at school, especially with reading and writing. An educational psychologist might also be able to help.

Treatment for APD is tailored to each child. It’s a good idea to talk with your audiologist or speech pathologist about the treatment options that might work best for your child.