Auditory processing disorder (APD) makes it hard to know what people are saying.
It isn’t related to hearing problems or intelligence.
APD can impact people of all ages, and in different ways.
Auditory processing disorder (APD) is a term that refers to problems in how the brain understands speech. The sounds may be loud and clear. But people with APD don’t pick up on the subtle differences between them.
For example, they may not recognize the difference between cat, that, and bat. The words seventy and seventeen may sound the same. Words can also get scrambled, so the question “how are the chair and couch alike” might sound like “how a cow and hair are like.”
There are four auditory processing skills that people may struggle with:
Auditory discrimination: noticing, comparing, and distinguishing between separate sounds
Auditory figure-ground discrimination: focusing on the important sounds in a noisy setting
Auditory memory: recalling what you’ve heard, either immediately or in the future
Auditory sequencing: understanding and recalling the order of sounds and words
APD can have an impact on learning and interacting with others. But it isn’t related to intelligence. People with APD are as smart as anyone else. They just struggle with a specific group of skills.
Dive deeper
It’s not clear what causes APD. But the difficulties impact people of all ages, and in different ways. Here are some common signs of APD:
Trouble following spoken directions, especially multi-step ones
Often asking people to repeat themselves or saying “Huh?” or “What?”
Trouble following a conversation, especially if there are multiple speakers or lots of background noise
Being easily distracted by background noise or sudden, loud noises
Trouble remembering details of things that are read or spoken
Trouble with reading or spelling, which require processing sounds
Taking longer to respond when someone speaks
Trouble knowing where sounds/speech is coming from
People with APD can have a hard time with conversation. They’re often slow to respond to what others say. And if they don’t understand, they may respond in ways that don’t make sense.
APD is controversial. Experts don’t all agree that it’s a disorder on its own, and there are multiple definitions of it. But the term is still used, and the difficulties are very real.
The first step in identifying APD is to rule out hearing loss. Health care professionals can usually do that. But testing for APD is done by audiologists.
These specialists do a series of advanced listening tests where kids listen and respond to different sounds. Kids aren’t usually tested until age 7 because their skills are still developing.
APD can look like other challenges. It’s often mistaken for and vice versa. ADHD can cause trouble with focus, which makes it hard to pay attention when others talk. Receptive language disorder can also make it hard to understand what people say, but for different reasons.
The main treatment for APD is speech therapy. Schools might provide therapy for free if the child has a language disorder. But there are also speech-language therapists who work in clinics or in private practice. The earlier treatment starts, the better.
There are many ways to support people with APD and make it easier for them to manage the challenges. These include:
Using simple, one-step directions
Speaking at a slower rate or slightly higher volume
Providing a quiet spot for doing work
Being patient and repeating things people miss
Schools may give students extra support in class under a special education plan called an IEP. For example, kids might get written instructions instead of spoken ones. They might also get assistive technology. Adults might get supports at work.
