An auditory processing disorder (APD or CAPD) is a disorder in “how” auditory information is processed in the brain. It can be thought of as a “listening disorder” not a hearing disorder. The problem is in the brain – not in the ear.
The symptoms of APD are extremely varied, however, some of the most common are:
- Children who say “huh” or “what” frequently
Children who don’t look or respond when their name is called
Children who give slow or delayed responses to people talking to them
Children who mispronounce typical word sounds
Children who have difficulty following oral directions
Children who misunderstand what is asked or said to them …these children usually answer off topic or don’t answer at all.
Children who are easily distracted or become confused especially when there is background noise
Children who avoid loud noises (cover their ears) even around common household noises
Children who show delays in acquiring language
Children who evidence difficulty learning phonics, reading and spelling
Symptoms of APD can actually be seen in infancy, however, they usually become noticed at about age 18-24 months.
APD can not be formally diagnosed by an audiologist until age 7 years, when the auditory system has maturated (fully developed). However, by age 5 speech-language pathologists, audiologists and/or psychologists can administer a sound based screening test along with auditory based language tests and determine if the child is “at risk” or “showing signs of APD.”
Most often auditory processing disorder is misdiagnosed as attention deficit. The is because most APD children have a difficulty time staying focused because they can’t understand what is being said around them or they are bothered by sounds in the environment that most individuals can block out. APD can also be misdiagnosed as simply a language delay/ disorder or a reading-spelling delay or disorder. Unfortunately, APD can also be diagnosed as the “child is lazy”, or “non-compliant”, “rude” etc.
The extreme forms of APD (hyperacoustics and hypoacoustics) are obvious early, but from my experience, the milder deficits are overlooked. Children who have had significant educational difficulties often have a more general diagnosis of a “learning disorder” or “attention deficit” and APD was not even considered. Currently, it is suspected that APD affects about 10% of children, which is quite significant. Boys are twice as likely to have APD as girls.
Auditory Processing is best diagnosed by a team of professionals: the audiologist will test to make sure hearing is normal and will administer sound tests to determine the type and degree of severity of APD. The speech-language pathologist will administer language based tests to determine the child’s strengths and weaknesses in receptive/expressive language and will often test phonics, reading and spelling. The educational psychologist may also test phonics, reading and spelling and will also look at auditory versus visual memory along with the child’s learning strengths and weaknesses. In some cases an occupational therapist will test how the APD affects the child’s sensory processing system.
There are sound-based intervention programs now available that provide the largest boost to actually changing “how” the brain processes sounds; these are programs using filtered music; computer sound based programs that exercise processing skills through intensive, adaptive games; and traditional auditory based therapy provided by a speech-language pathologist.
Helping a Child with APD
If a parent or caregiver is at all concerned that their child might have APD, they should seek professional advice. If the child is over the age of three, they can contact the speech-language pathologist in their local public school or contact a speech-language pathologist or audiologist who specializes in APD in private practice. Parents or caregivers should also provide an auditory enriched environment for the child.