Auditory Processing Disorders

Children and adults with APD often report difficulty hearing in background noise, in rooms that reverberate (echo) and/or other less-than-ideal listening situations.

Individuals often need more time to process auditory instructions, they “mishear” information and look for visual cues to help fill in the missing auditory information.

Auditory processing disorders (APDs) are referred to by many names: central auditory processing disorders, auditory perceptual disorders, and central auditory disorders. APDs affect the auditory areas of the brain.

An auditory processing disorder is a broad term used to describe a variety of different auditory challenges rather than a single event. Broadly, auditory processing disorders negatively impact the brain’s interpretation of sounds. Individuals with auditory processing disorders may not perceive subtle differences in sounds of words even though the sounds are loud enough. This difficulty becomes more noticeable in noisy or challenging listening environments or when listening to complex information.

APD is often associated with various learning disabilities. Children with APD experience difficulties in less-than-ideal (noisy) listening situations and may have difficulties with reading, spelling, attention, and language problems.

APD is common in older adults, particularly when hearing loss is present. It is likely that many processes and problems contribute to APD in children.

In adults, neurological disorders such as stroke, tumors, degenerative disease (such as multiple sclerosis), and head trauma can contribute to APD. (Musiek, 2009)

The exact prevalence of auditory processing disorder is variable given the wide definitions of auditory processing and how it is measured in different areas.

Some research has suggested a prevalence of 2-3 percent in the pediatric population (Chermak and Musiek, 1997), with other estimates at 3-5 percent (Santucci cited in Matson, 2005). Up to 5 percent in school-aged children according to the National Institutes of Health.

A 2:1 ratio of boys to girls has also been cited.

There is no single cause of auditory processing disorder; however, it is linked to risk factors such as (Musiek and Chermak, 2009):

• Chronic ear infections
• Premature and/or traumatic birth history
• Seizure disorder/epilepsy
• Head trauma
• Lead poisoning
• Stroke
• Meningitis

Auditory processing disorders make communication more challenging overall. For children, this often leads to learning difficulties in school and perceived behavioral challenges due to miscommunication. For adults, auditory processing disorders may lead to decreased communication due to frustration. The social isolation of hearing loss is a tragic outcome of this untreated disorder.

APD is an audiological diagnosis, and therefore, the audiologist is the professional who generally makes the diagnosis.

To properly diagnose APD, special tests need to be administered by an audiologist. Individuals with APD usually pass standard hearing tests because standard hearing tests are designed to test the quietest sounds one can hear. APD may be present with or without hearing loss.

APD in children and adults often is best managed by a multidisciplinary team of professionals that may include audiologists, speech-language pathologists, psychologists, and teachers, to evaluate and treat hearing, language, cognition, and academic issues.

Although APD treatment is usually determined based on the likely cause of APD, a variety of treatment approaches may be recommended. These approaches can include medical treatment, hearing aid amplification, assistive listening devices, auditory training, and special listening strategies. Treatment strategies are usually provided by audiologists, although physicians, speech-language pathologists, psychologists, teachers, and other professionals may be involved.

Whenever a concern for hearing is present, educators should refer for a comprehensive hearing assessment first. If hearing sensitivity is normal an auditory processing screening should then be performed. Children with medical histories that include frequent middle-ear infections, lead poisoning, seizure disorder, extreme prematurity all present with greater risk factors associated with auditory processing disorders.