Auditory Processing Disorder
Auditory processing disorder, also called APD, is a type of hearing loss caused by something affecting the part of the brain that processes how you hear. Ear damage causes other types of hearing loss.
APD is also sometimes called central auditory processing disorder (CAPD). It can happen in anyone. But it most often happens in children and older adults.
Many conditions can affect how well a person understands what they hear, such as attention-deficit/hyperactivity disorder (ADHD) or autism. But these conditions are different from auditory processing disorder, although they can appear with APD. APD also can happen with other types of hearing loss.
Auditory processing disorder has no cure. But treatments can help you hear better.
Symptoms of auditory processing disorder (APD) can be subtle. Symptoms can include having trouble with:
- Telling where sound is coming from.
- Understanding words that are spoken quickly or in a noisy room.
- Paying attention.
- Reading and spelling.
- Following directions unless they are short and simple.
- Learning a new language.
- Singing or enjoying music.
- Understanding and remembering spoken information.
If you have APD, you also might:
- Take longer to reply to someone who is talking to you.
- Often need others to repeat themselves.
- Not understand sarcasm or jokes.
APD is often seen with attention, language and learning issues like those seen in attention-deficit/hyperactivity disorder, or ADHD.
When to see a doctor
If you have trouble hearing or understanding what you hear, talk to a health care professional.
The cause of auditory processing disorder (APD) is sometimes unknown. APD can be linked to many conditions. In older adults, conditions might include stroke and head trauma. In children, APD can be linked to issues at birth, such as low birth weight or early birth, or repeated ear infections.
In typical hearing, the brain’s auditory center takes the sound waves sent from the ears and turns them into sounds you know. But with auditory processing disorder (APD), the auditory part of the brain can’t do this.
Factors that increase your risk of auditory processing disorder (APD) include:
- Aging.
- Stroke.
- Head trauma.
- Lead poisoning.
- Seizure disorders.
- Issues linked to birth, such as an early birth, low birth weight or a pregnant person using alcohol, drugs or tobacco.
- Repeated ear infections, especially at a young age.
Auditory processing disorder (APD) complications include:
- Trouble understanding what people are saying.
- Trouble taking part in activities.
- Feeling isolated and lonely.
- Trouble reading and writing, in children.
- Trouble doing well in school.
- Feeling depressed.
To diagnose auditory processing disorder (APD), your health care team may ask questions about your symptoms and how long you have had them, as well as order tests.
Several specialists on your health care team might help diagnose you or your child with auditory processing disorder (APD). For children, the team might include teachers, who look at learning and attention issues. For children and adults, the team might include mental health professionals, called psychologists, who look at how the mind works. And speech-language pathologists can look at the use of language.
A hearing specialist called an audiologist may do tests to see what is happening when you or your child hear sounds. These tests might include:
- Tympanometry. This test can tell if the eardrum isn’t moving well. The eardrum needs to move for good hearing. For this test, the audiologist places a soft probe in the ear canal. Then they send small bits of air pressure toward the ear. The probe measures how much the eardrum moves in response to the air.
- Acoustic reflex test. This test shows what happens in the ear when it hears a loud sound.
Auditory brainstem response. This test shows how well the inner ear, called the cochlea, and the brain pathways for hearing are working. An audiologist places sensors around the ear and on the head. The sensors connect to a computer.
Short clicking sounds come through headphones worn during the test. The computer records how the nerves between the ears and the brain respond to the sounds.
Evoked potential test. This test shows how well sound travels along the nerves that connect the ears to the brain. For this test, an audiologist places sensors on the head. The sensors connect to a computer. Short clicking sounds come through headphones worn during the test.
This lets an audiologist see how well sound gets to different parts of the brain. It also shows if anything is blocking the nerves that link the ears to the brain.
Not everyone with auditory processing disorder (APD) needs treatment. If you or your child need treatment, there are many approaches. Every person with APD has different needs. Your health care team can work with you to help you. Your or your child’s treatment might include:
Hearing aids and listening devices. Your health care team may suggest that you use hearing aids with wireless listening devices. Listening devices help direct sound to you. They get sound from the source to your hearing aid.
Frequency modulated, or FM, systems send sounds to you so you can hear them better. They work with a hearing aid and direct sounds to it. These systems help make it easier to hear sounds in noisy environments.
Auditory training. Auditory training, also called hearing rehabilitation, helps you adjust to hearing loss. You may train with an audiologist, a speech-language pathologist or both. You may train one-on-one with a therapist or as part of a group.
During auditory training, you learn to tell one type of sound from another. You do this by listening to sounds that are louder and softer, given quickly and slowly. Sounds come from different directions. You also learn to tell the difference between speech sounds, which affects the meaning of the words you hear.
Auditory training helps the brain tell the difference between the many sounds you hear every day. The goal is to help you feel like you’re able to talk with others more.
- Computer-based training. Computer-based programs can help train the brain to recognize and understand sounds. These programs are like auditory training, but you do them online or with a computer program.
References
- Auditory processing disorders. American Academy of Audiology. https://www.audiology.org/consumers-and-patients/hearing-and-balance/auditory-processing-disorders/. Accessed June 22, 2023.
- Understanding auditory processing disorders in children. American Speech-Language-Hearing Association. https://www.asha.org/public/hearing/understanding-auditory-processing-disorders-in-children/. Accessed June 22, 2023.
- Cifu DX, et al., eds. Auditory, vestibular and visual impairments. In: Braddom’s Physical Medicine and Rehabilitation. 6th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed June 22, 2023.
- Liu P, et al. Electrophysiological screening for children with suspected auditory processing disorder: A systematic review. Frontiers in Neurology. 2021; doi:10.3389/fneur.2021.692840.
- Sardone R, et al. The age-related central auditory processing disorder: Silent impairment of the cognitive ear. Frontiers in Neuroscience. 2019; doi:10.3389/fnins.2019.00619.
- Central Auditory Processing Disorder. American Speech-Language-Hearing Association. https://www.asha.org/practice-portal/clinical-topics/central-auditory-processing-disorder/. Accessed June 22, 2023.
- Health Education & Content Services. Auditory processing disorder. Mayo Clinic; 2023.
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