Auditory Processing Disorder


APD is often missed because it can occur alongside or mimic symptoms of other disorders such as dyslexia, autism, ADD, ADHD, and other behavioral disorders.

What is Auditory Processing Disorder (APD)? 

Auditory processing is how your brain interprets the sounds you hear every day into something that makes sense to your mind. It involves 4 major steps: detection, discrimination, identification, and comprehension. Auditory Processing Disorder (also known as Central Auditory Processing Disorder or CAPD) is a difficulty with one or more of these steps making it more difficult to “hear” or understand sound and speech. For many children and adults with APD, hearing test results are within normal limits and there is no diagnosis of hearing loss. This disorder affects approximately 20% of school-aged children as well as adults of all ages. It is common for younger and middle-aged adults to notice symptoms of APD in specific listening situations such as the college classroom, work, and social environments, and realize later in life the struggles they had growing up. 

APD is often missed because it can occur alongside or mimic other disorders such as dyslexia, autism, ADD, ADHD, behavioral disorders or symptoms like poor attention, not following directions, and general learning disabilities. In more challenging environments like a dynamic classroom, the playground, or other social settings, children are less likely to “hear” what is being said and may miss some words or instructions altogether. It can be difficult for children to recognize that they have an issue. Therefore, it is important for parents, teachers and others to know how to spot symptoms of APD.

Auditory Processing Evaluation

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Symptoms and Diagnosing

Signs of APD

Auditory Processing Disorder (APD) cases can range from mild to severe. Symptoms include difficulties with: 

  • Following directions
  • Learning to spell, read, reading comprehension, and/or write
  • Remembering auditory information
  • Organization of numbers
  • Knowing where sound is coming from
  • Following or understanding telephone conversations
  • Following long conversations
  • Taking notes
  • Understanding accents
  • Technical information where language is novel or unfamiliar
  • Social issues—difficulty "reading" others/pragmatic communication issues
  • Consistent delay in responses

Symptoms of APD in Children 

If you believe that a child may have APD, there are a few questions to consider

  • Is the child easily distracted? 
  • Are noisy environments distracting or upsetting?
  • Does the child's behavior improve in quieter settings?
  • Does the child have trouble following directions, whether simple or complicated?
  • Does the child have reading, spelling, or writing difficulties?
  • Is the child disorganized or forgetful?
  • Are conversations difficult for the child to follow?

If you recognize any of the behaviors listed above to be true in your child, yourself, a loved one, a student, or a client, it is important to request an appointment. 

Think you or your child could have APD. Click the links below to download the Child or Adult Checklists

Child Checklist Adult Checklist

Diagnosis of APD

We are currently equipped to test and treat children cognitively 5 years of age or older.

  1. A parent or adult interview is conducted as to understand the difficulties that the individual is having.
  2. A hearing evaluation including middle ear assessment is first required in order to confirm hearing status.
  3. APD Assessment includes Words in Quiet, Words in Noise, Staggered Spondaic Words, and Phonemic Synthesis. Additional tests are performed based on individual's performance. (A different screening/test battery is performed for children 6.5 and younger)
  4. Scoring comparing scores with normative data for patient's age.
  5. Thorough report writing based on the individual's needs. For school children, classroom recommendations and school letters are also provided.

APD Deficit Categories

Decoding– the ability to detect sound of speech (phonemes)
Tolerance Fading Memory– the ability to understand speech in noise along with short-term memory
Organization– the ability to retrain auditory information in the brain in the correct order
Integration– the ability for each side of  the brain (right and left hemisphere) to talk to one another

Treatment of APD

Yes, there is treatment! Many individuals with APD are diagnosed and given classroom recommendations yet they are not provided therapy options. We are changing that! 
The sooner treatment starts, the better. These difficulties may greatly affect an individual’s educational, social, and job performance. At Elevate Audiology, we not only make recommendations but we offer in-office and online therapy programs as well as low-gain hearing aids, when appropriate.
For in-person therapy, we perform the Phonemic Training Program which includes phonemic (speech sound) training, speech in noise training, phonemic synthesis practice (blending of sounds), and auditory training.
The goal of all therapy and recommendations is to develop the skills within each deficit to reduce the effect on the person’s quality of life. Treatment lengths vary based on the individual’s specific needs.

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