Auditory processing disorder (APD) or central auditory processing disorder (CAPD) is most common in school-aged children, though it also affects about three to five percent of adults.

A person with APD does not hear things the same way others do because something interferes with the coordination between the ears and the brain.

An Auditory Deficit

Auditory processing disorder is not a hearing issue; it's an auditory deficit in which the brain cannot recognize how words sound. The brain disorder is specific to the auditory complex.

Children with APB usually hear normally but have a difficult time recognizing words, especially in environments with significant background noise.

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What APD Is Not

Because auditory processing disorder affects a person's ability to understand information, it is often confused with other conditions. For example, some children with ADHD or autism may be poor listeners and have difficulty processing words, but if their brains are processing auditory input appropriately, then they should not receive an APD diagnosis.

While APD can co-exist with these and other disorders, such a diagnosis requires careful evaluation.

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Causes and Risk Factors

Doctors often cannot determine the cause of auditory processing disorder in their patient. Risk factors include premature or traumatic birth, chronic ear infections, head trauma, seizure disorders, stroke, lead poisoning, and meningitis.

Determining the prevalence of APD is challenging, but some research indicates that it affects twice as many boys as girls.

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Signs of APD

Signs of auditory processing disorder include difficulty following directions, paying attention, determining the source of a sound, and following rapid speech, especially when there is a lot of background noise.

Children with APD will often ask their teacher or parents to repeat things and may have trouble in classes where the material is presented orally, such as reading and spelling. These symptoms can also indicate various other disorders, so again, careful evaluation and diagnosis are critical.

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A Multidisciplinary Approach

To fully and accurately assess children with auditory processing disorder, a multidisciplinary approach is necessary.

The evaluation may include teachers to cover academic problems, psychologists to evaluate cognitive functioning, and a speech-language pathologist to investigate speech and oral language. The information obtained from these individuals is valuable for understanding the child and developing a treatment plan.

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Although many professionals are involved in assessing children with auditory processing disorder, only an audiologist can make a definitive diagnosis.

Testing is done in a sound-treated room; the child must be at least six or seven. Younger children have a lot of variability in brain function, making it difficult to interpret the test results appropriately.

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Problem Areas

Children with auditory processing disorder can have a variety of problem areas, including auditory figure-ground, which is when the child has a hard time understanding speech when there is ambient chatter or noise.

They may also experience dichotic listening—the inability to understand meaningful competing speech from two or more speakers happening simultaneously—and auditory closure, which makes it challenging to process speech that is too fast or muffled.

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Disqualifying Testing Conditions

Unfortunately, not all children qualify for auditory processing disorder testing.

In addition to having to be at least six or seven, children with autism spectrum disorder, developmental delay, Down syndrome, hearing loss, intellectual disability, below average IQ, or a significant speech or language disorder do not qualify for APD testing.

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Treatment for auditory processing disorder focuses on environmental changes, compensating for the condition with other skills, and correcting the auditory deficit.

Interventions may include using electronic devices to assist with listening and strengthening problem-solving, memory, and attention skills. Treatment to correct the deficiency may include hearing aid amplification, auditory training, and assistive listening devices.

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Children diagnosed with auditory processing disorder before 13 may grow out of it as the auditory system develops and matures. Children diagnosed with APD should be retested every two years until their 13th birthday to determine if there are any changes or improvements.

Still, some children may have lifelong residual effects of the disorder. Early diagnosis and treatment are crucial to navigating this diagnosis throughout childhood and beyond.

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