Auditory processing disorder (APD), also known as central auditory processing disorder
(CAPD), is a hearing problem that affects about 5% of school-aged children.
Kids with this condition can't process what they hear in the same way other kids
do 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, because when 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.
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 these
Is your child easily distracted or unusually bothered by loud or sudden noises?
Are noisy environments upsetting to your child?
Does your child's behavior and performance improve in quieter settings?
Does your child have difficulty following directions, whether simple or complicated?
Does your child have reading, spelling, writing, or other speech-language difficulties?
Are verbal (word) math problems difficult for your child?
If you think your child is having trouble hearing or understanding when people
talk, have an audiologist (hearing specialist) exam 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 difficulty
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
Auditory discrimination problems: This is when a child has difficulty
hearing the difference between words or sounds that are similar (COAT/BOAT or CH/SH).
This can affect following directions and reading, spelling, and writing skills, among
Auditory attention problems: This is when a child can't stay
focused on listening long enough to complete a task or requirement (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 — require heightened
auditory processing and language levels. They develop best when all the other skills
(levels 1 through 4 above) are intact.
Since most of the 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.
Helping Your Child
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 crucial 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, so if your child has APD, be sure to ask school officials about
what may be 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 they
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. Be sure
to tell teachers and
other school officials 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
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
Keep in regular contact with school officials 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 just as successful as other classmates.
Coping strategies and techniques learned in speech therapy can help them go far.