Auditory processing disorder (APD) is a hearing problem that affects about 5% of
Kids with this condition, also known as central auditory processing disorder (CAPD),
can't process what they hear in the same way other kids do. This is because their
ears and brain don't fully coordinate. Something interferes with the way the brain
recognizes and interprets sounds, especially speech.
With the right therapy, kids with APD can be successful in school and life. Early
diagnosis is important. If the condition isn't caught and treated early, a child
can have speech and language delays or problems learning in school.
Trouble Understanding Speech
Kids with APD are thought to hear normally because they can usually hear sounds
that are delivered one at a time in a very quiet environment (such as a sound-treated
room). The problem is that they usually don't recognize slight differences between
sounds in words, even when the sounds are loud and clear enough to be heard.
These kinds of problems usually happen when there is background noise, which is
often the case in social situations. So kids with APD can have trouble understanding
what is being said to them when they're in noisy places like a playground, sports
events, the school cafeteria, and parties.
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:
Is my child easily distracted or unusually bothered by loud or sudden noises?
Are noisy environments upsetting to my child?
Does my child's behavior and performance improve in quieter settings?
Does my child have trouble following directions, whether simple or complicated?
Does my child have reading, spelling, writing, or other speech-language difficulties?
Are verbal (word) math problems hard for my child?
If you think your child is having trouble hearing or understanding when people
talk, have an audiologist (hearing specialist) examine your child. Only audiologists
can diagnose auditory processing disorder.
Audiologists look for five main problem areas in kids with APD:
Auditory figure-ground problems: This is when a child can't pay
attention if there's noise in the background. Noisy, loosely structured classrooms
could be very frustrating.
Auditory memory problems: This is when a child has trouble remembering
information such as directions, lists, or study materials. It can be immediate ("I
can't remember it now") and/or delayed ("I can't remember it when I need it for later").
Auditory discrimination problems: This is when a child has trouble
hearing the difference between similar words or sounds (COAT/BOAT or CH/SH). This
can affect following directions and reading, spelling, and writing skills, among others.
Auditory attention problems: This is when a child can't stay
focused on listening long enough to complete a task (such as listening to a lecture
in school). Kids with CAPD often have trouble maintaining attention, although health,
motivation, and attitude also can play a role.
Auditory cohesion problems: This is when higher-level listening
tasks are difficult. Auditory cohesion skills — drawing inferences from conversations,
understanding riddles, or comprehending verbal math problems — need heightened
auditory processing and language levels. They develop best when all the other skills
(levels 1 through 4 above) are intact.
Because most tests done to check for APD require a child to be at least 7 or 8
years old, many kids aren't diagnosed until then or later.
How Can Parents Help?
A child's auditory system isn't fully developed until age 15. So, many kids
diagnosed with APD can develop better skills over time as their auditory system matures.
While there is no known cure, speech-language
therapy and assistive listening devices can help kids make sense of sounds and
develop good communication skills.
A frequency modulation (FM) system is a type of assistive listening device that
reduces background noise and makes a speaker's voice louder so a child can understand
it. The speaker wears a tiny microphone and a transmitter, which sends an electrical
signal to a wireless receiver that the child wears either on the ear or elsewhere
on the body. It's portable and can be helpful in classroom settings.
A key part of making the FM system effective is ongoing therapy with a speech-language
pathologist, who will help the child develop speaking and hearing skills. The
speech-language pathologist or audiologist also may recommend tutoring programs.
Several computer-assisted programs are geared toward children with APD. They mainly
help the brain do a better job of processing sounds in a noisy environment. Some schools
offer these programs. If your child has APD, ask school officials about what's available.
Strategies applied at home and school can ease some of the problem behaviors associated
Kids with APD often have trouble following directions, so these suggestions may
Reduce background noise whenever possible at home and at school.
Have your child look at you when you're speaking.
Use simple, expressive sentences.
Speak at a slightly slower rate and at a mildly increased volume.
Ask your child to repeat the directions back to you and to keep repeating them
aloud (to you or to himself or herself) until the directions are completed.
For directions that are to be completed later, writing notes, wearing a watch,
or maintaining a household routine can help. So can general organization
It can be frustrating for kids with APD when they're in a noisy setting and need
to listen. Teach your child to notice noisy environments and move to quieter places
when listening is necessary.
Other tips that might help:
Provide your child with a quiet study place (not the kitchen table).
Maintain a peaceful, organized lifestyle.
Encourage good eating and sleeping habits.
Assign regular and realistic chores, including keeping a neat room and desk.
It's important for the people caring for your child to know about APD. Tell teachers and other school
staff about the APD and how it may affect learning. Kids with APD aren't typically
put in special education programs, but you may find that your child is eligible for
a 504 plan through the
school district that would outline any special needs for the classroom.
Some things that may help:
changing seating plans so your child can sit in the front of the classroom or
with his or her back to the window
study aids, like a tape recorder or notes that can be viewed online
computer-assisted programs designed for kids with APD
Stay in touch with school staff about your child's progress. One of the most important
things that both parents and teachers can do is to acknowledge that APD is real. Its
symptoms and behaviors are not something that a child can control. What the child
can control is recognizing the problems associated with APD and using the strategies
recommended both at home and school.
A positive, realistic attitude and healthy self-esteem in a child with APD can
work wonders. And kids with APD can go on to be as successful as their classmates.
Coping strategies and techniques learned in speech therapy can help them go far.