Children and adults with APD, short for Auditory Processing Disorder, have normal hearing but difficulties recognising and understanding speech and other sounds they hear. Early diagnosis can help get the right support. Learn more about APD, it’s symptoms, diagnosis and treatment options!
Auditory Processing is a term used to describe how the brain recognises and understands sound. APD, also known as central auditory processing disorder (CAPD), is an umbrella term for a variety of disorders that produce a failure in the hearing and listening process. It is a complicated problem thought to affect more than 5 per cent of school-aged children.
The affected children and adults do not correctly process auditory information which results in difficulty detecting subtle differences between sounds in words. One of the biggest problems reported by individuals with APD is difficulty listening in noisy environments, however, it is frequently the presence of academic deficits that will trigger a referral for APD assessment.
There are four auditory processing skills that people with APD may struggle with:
As a parent or teacher, common signs of APD in children to look out for are:
These symptoms are often present without hearing loss.
APD can often be confused with other conditions such as language disorders or higher-order cognitive disorders such as:
This is because the symptoms and behaviours displayed by the child can be similar. In some people, APD can co-occur with these disorders and therefore a careful and accurate assessment is required for correct diagnosis.
Click here to learn more about the signs of hearing loss in children that parents should look out for.
The exact cause of APD is unknown, but it involves the neural pathways of the central auditory nervous system. There is growing evidence that for many children it is probably a developmental delay. Children still need to improve and strengthen the neural connections and pathways required for auditory processing.
APD may also be linked to:
Diagnosis of APD will be made by an audiologist. An audiologist is a university-trained health professional with specialist skills and knowledge about the ears and hearing. The first step in diagnosing APD is to rule out hearing loss. The audiologist will perform a hearing test, tympanometry and acoustic reflex testing.
In children, the hearing test can rule out any medical causes or temporary hearing loss such as middle ear problems. Often children will also be tested by bone conduction, which allows the audiologist to distinguish between the middle ear and inner ear problems (conductive hearing loss or sensorineural hearing loss). If a hearing loss or other abnormality is found by the audiologist, a report will be supplied to the GP and a recommendation to refer to an ENT will be made.
Then the audiologist will perform the APD assessment. It can be performed on adults and on children over 7 years of age who do not have a hearing loss but cannot process sound information accurately. It is more common to assess children, many (but not all) of these children experience significant learning difficulties because they are unable to make sense of what they are hearing.
Auditory processing and memory testing consist of a series of tests designed to test specific auditory skills. Tests for children may vary depending on individual difficulties. An audiologist will do the testing and interpret the pattern of results.
This provides the audiologist with a profile of strengths and weaknesses for the individual. This is vital because the degree and type of auditory processing deficit, combined with individual experiences will determine the best therapy for each person.
The tests include:
At the end of the assessment, the audiologist will be able to explain the test results, discuss recommendations and answer any questions. They will supply a formal written report (at a later date) and include any recommendations for further investigations and management or intervention as appropriate. The audiologist will be available to call you should you have any questions about the report.
The nature and degree of the disorder are determined during the assessment process. This allows the audiologist to recommend a management and treatment plan to address the specific needs of children individually.
Children with APD can improve their ability to listen in the classroom and other noisy environments with the right intervention and support. In some people, the intervention can improve the listening ability to almost normal.
The audiologist might suggest strategies or training programs which can be used to improve listening in background noise. The audiologist may also recommend using a personal remote microphone or sound field amplification system. This will help children hear the teacher’s voice more clearly, even when it’s noisy.
Children might be referred to a speech pathologist to work on their language skills. A referral to see a special education teacher for extra help at school, especially with reading and writing may also be warranted. Sometimes an educational psychologist might also be able to help.
Treatment and intervention for APD are personalised to each individual child. It’s a good idea to ask your audiologist or speech pathologist about the treatment options that might work best for your child.
If you have concerns that your child may have APD, do not delay booking a children’s hearing test with your trusted, local Audiologist at Attune Hearing.