Auditory Processing Disorder

Auditory processing disorder (APD) is a condition that adversely affects an individual’s ability to effectively recognize sound. Unlike deafness or being hard of hearing, auditory processing difficulties do not affect what is heard, but rather affects how auditory information is retrieved and processed by the brain. Children affected by this disorder can usually hear fine. They simply fail to process what they hear in the same way as others because of an aberration in the way their brains process sounds, particularly those that comprise speech.

Auditory Processing Disorder can be difficult to detect because most kids with APD have no noticeable hearing impairment. These children do not have a “hearing problem” as it relates to detecting sound, but do have a “hearing problem” based on their inability to process auditory information in a normal fashion. APD often co-exists with learning disabilities such as dyslexia, ADHD, or autism which can pose an additional complicating factor in recognizing the disorder. Symptoms of APD may be manifested in a variety of ways:

• Inability to concentrate in noisy environments
• Difficulty following multi-step verbal directions
• Problems paying attention to and remembering information presented orally
• Poor listening skills
• Speech difficulty with pronunciation or using the correct order of syllables in a word
• Academic difficulty with spelling, reading, and comprehension

The impact of APD varies based on the extent to which a child is impacted by the disorder. However, there are common difficulties each of which can have a negative impact on a child's academic performance.

Phonological Awareness – the ability to recognize and identify the individual sounds in a word. This skill is essential for reading, and weakness in this area can result in difficulties with reading, comprehension, and spelling for children with APD.

Auditory Discrimination – the ability to distinguish the difference in similar sounding words (i.e. being able to hear the difference between “ask” and “act”)

Auditory Memory – the ability to hold in memory and later retrieve information that was verbally presented. This can result in a child struggling to follow multi-step instructions.

Auditory Sequencing – The ability to sequentially recall the order of items that were conveyed verbally. An example is confusing the sounds or order of syllables in a word such as saying or writing “am-i-nal” instead of “an-i-mal”.

Auditory Blending – the process of blending individual sounds to make a word.The phonemes /sh/ /r/ /i/ /m/ /p/ are blended to make the word “shrimp”. Problems with auditory blending can make it difficult to accurately spell words phonetically.

Audiologists are qualified to officially diagnose APD. They employ auditory testing to assess the ability to hear a range of sounds as well as the extent to which sounds are recognized in spoken words and sentences. It can be difficult to formally diagnose APD before the age of 8 or 9 because many of the requisite skills needed for accurate evaluation aren't fully developed before that time.

Once diagnosed by an audiologist, children are usually referred to a speech pathologist who develops a course of therapy to remediate the problem. Remediation techniques vary and may include speech therapy, use of electronic auditory devices, classroom modifications, memory enhancement training, or a combination of several of these techniques.