What is an auditory processing disorder (APD)?

Auditory processing disorder (APD), a neurological condition also known as central auditory processing disorder (CAPD), affects the brain’s ability to process auditory input, making it difficult to understand speech, follow oral instructions, or distinguish speech in noisy environments.

The disorder can affect anyone but is estimated to appear in as many as 5 to 7 percent of school-age children, according to the Auditory Processing Disorder Foundation, with boys diagnosed twice as often as girls.

Though APD awareness has increased in recent years, confusion about the disorder abounds. It can appear simultaneously with conditions such as attention deficit/hyperactivity disorder, so it’s important that those with APD symptoms get evaluated by an audiologist for proper diagnosis.

Girl overcomes APD in the classroom

What Are the Symptoms of Auditory Processing Disorder?

In essence, APD is a learning and social-communication disability, not a hearing problem. In patients with APD, hearing thresholds are often normal, but the central nervous system has trouble processing what’s being heard. Symptoms typically appear at a young age and can range from mild to severe.


Some signs and symptoms include the following:

  • Difficulty listening or learning auditorily
  • Problems following multistep directions
  • Difficulty with reading, spelling, or academics
  • Problems filtering out background noise
  • Hypersensitivity to or reduced tolerance for noise
  • Frequent mishearing or misunderstanding of speech
  • Difficulty understanding muffled, fast, or distorted speech
  • Problems remembering what was heard
  • Problems distinguishing between similar speech sounds
  • Difficulty organizing verbal information
  • Problems with oral and written expression


How Is an Auditory Processing Disorder Evaluated and Diagnosed?

Group of children laying in grass

A trained audiologist is uniquely qualified to diagnose an auditory processing disorder or central auditory processing disorder. The sooner the condition is identified, the better, but it’s important for optimal accuracy that suspected cases be evaluated when a person is 8 years and older.

The first step in evaluating for APD involves an initial exam, including a case history, to ensure the ears are healthy and to rule out problems such as:

  • Hearing Loss
  • Literacy issues
  • Cognitive disorders
  • Speech-language disorders
  • Attention deficit/hyperactivity disorder (ADHD)

After ruling out other potential conditions, the audiologist performs special tests to assess the brain’s various auditory processing functions. The specific battery of testing for APD will depend on the patient’s age, symptoms, cognitive status, and other factors.

Testing focuses on a variety of metrics within two categories:

  • Behavioral, which measures the auditory system’s ability to differentiate sounds, recognize speech amid noise or other challenging circumstances, and otherwise process audio inputs
  • Electrophysiologic, which includes auditory brainstem response and other applicable measures of electrical activity in the auditory system


Once APD is confirmed, the audiologist — potentially in collaboration with other professionals such as a speech-language pathologist — can tailor a treatment plan to the patient’s specific needs.


How Is the Disorder Treated?

Just as every person is different, so are the treatments for APD. What may work for one person may not be the most effective approach for another.

Treatment starts with a careful diagnosis by an audiologist and is individualized to the patient and his or her auditory challenges.

Typically, APD management or treatment involves one or more of the following approaches:

  • Modifying the learning or communication environment to reduce barriers to listening
  • Using amplification devices to help improve the auditory signal
  • Strengthening language, problem solving, concentration, differentiation, and other skills to help directly address auditory deficits

If you or a loved one is experiencing symptoms of auditory processing disorder, contact us for an evaluation and customized treatment options for your individual needs.