Auditory Processing Disorder (APD), also known as Central Auditory Processing Disorder (CAPD), is a condition that affects how the brain processes auditory information. People with APD can hear sounds but have difficulty understanding and interpreting them, especially in environments with background noise or competing sounds.

The issue lies in how the brain processes the sounds, not in the ears’ function. This is because their ears and brain don’t fully coordinate. Something interferes with how the brain recognizes and interprets sounds, especially speech.

With the right strategies, kids with APD can be successful in school and life. Early diagnosis is important. If the condition is not identified and managed early, a child is at risk for listening and learning problems at home and school.

Auditory Processing Disorder Key Characteristics

• Difficulty distinguishing similar sounds or understanding speech in noisy environments.
• Problems following spoken directions, especially multi-step ones.
• Delays in processing spoken information, requiring more time to understand or respond.
• Difficulty with reading, spelling, and sometimes learning new languages, as these skills rely heavily on sound discrimination.

APD can impact learning and communication, especially in classroom settings or group discussions where clear auditory processing is crucial.

Trouble Understanding Speech

Kids with APD are thought to sense sound normally. They usually can hear sounds that are delivered one at a time in a very quiet environment (such as a sound-treated room). However, the problem is that they usually don’t easily recognize slight differences between sounds in words, even when the sounds are loud enough to be heard.

These problems usually happen in a poor listening situation — such as background noise or a reverberant room like an auditorium — often in social situations. Kids with APD can have trouble understanding what is said to them in noisier places like a classroom, playground, sports event, school cafeteria, or party.

What Are the Signs & Symptoms of Auditory Processing Disorder?

Symptoms of APD can range from mild to severe and can take many different forms. If you think your child might have a problem processing sounds, ask yourself:

• Does my child often mishear sounds and words?
• Are noisy environments overwhelming when my child is trying to listen?
• Does my child’s listening behaviors and performance improve in quieter settings?
• Does my child have trouble following verbal directions, whether simple or complicated?
• Does my child have trouble with spelling or phonics?
• Are verbal (word) math problems hard for my child?
• Are conversations hard for my child to follow?

Auditory Processing Disorder Audiologist Testing

The most common way to diagnose APD is to use a specific group of listening tests. Audiologists often look for these main problem areas in kids with APD:

• Auditory figure-ground: This is when a child has trouble understanding speech when there is speech babble or ambient noise in the background. Noisy, loosely structured, or open-air classrooms can frustrate a child with APD.
• Auditory closure: When a child can’t “fill in the gaps” of speech when it is more challenging. This can happen in a quieter situation but is more common when the speaker’s voice is too fast or is muffled. This makes it hard for the child to make sense of the sounds and words.
• Dichotic listening: This is when a child has trouble understanding competing, meaningful speech that happens simultaneously. For example, if a teacher is talking on one side of the child and another student is talking on the other, the child with APD cannot understand the speech of one or both speakers.
• Temporal processing: This is the timing of a child’s processing system, which helps them recognize differences in speech sounds (such as mat versus pat). It also helps them understand pitch and intonation (asking a question instead of giving a command), understand riddles and humor, and make inferences.
• Binaural interaction: This is the ability to know which side speech or sounds are coming from, and to localize sound in a room. Although less common, this problem happens in children with a history of brain trauma or seizure disorders.

Most traditional APD tests require a child to be at least seven years old. Children aren’t diagnosed until first grade or later. Newer electrophysiology tests (which use noninvasive electrodes to check the body’s response to speech) can give some early information about the central auditory system in kids younger than seven.