Auditory processing disorder
An "auditory processing disorder" is a hearing or listening problem caused by the brain not processing sounds in the normal way.
It may affect your ability to:
pinpoint a sound
tell which sound comes before another
distinguish similar sounds from one another (such as "seventy" and "seventeen")
It may be difficult to understand speech when there is background noise, if more than one person is speaking at a time, if the person is speaking quickly, or if the sound quality is poor (if it's over a loudspeaker or in an echoey room, for example). Instructions can also be difficult to remember.
Most people find it becomes less of a problem over time, as they develop the skills to deal with it.
Who is affected?
According to Action on Hearing Loss, as many as one in 10 children could have some level of auditory processing disorder – see the box, left.
Adults may also be affected, as it can develop later in life.
What are the causes?
Causes in children
In children, auditory processing disorder may be caused by:
glue ear, a common childhood condition in which the middle ear becomes filled with fluid
a severe illness at birth, such as bacterial meningitis
a head injury
a genetic defect (it sometimes runs in families)
Causes in adults
Some adults may have had an auditory processing disorder since childhood, for one of the above reasons.
If it starts later in life, it may be because of:
age-related changes in the processing of sounds in the brain
a head injury
an infection such as Lyme disease (a bacterial infection spread to humans by infected ticks found in woodlands)
a demyelinating disease (any disease of the nervous system in which the myelin sheath of nerve cells is damaged)
How can my GP help?
If your GP suspects a hearing problem, you may be referred to an audiologist (hearing specialist) for tests.
The tests used will depend on the suspected underlying cause, and may include:
hearing tests – you or your child will be asked to listen to a variety of sounds and respond to them
questionnaires – you or your child may be asked questions such as: "If a friend or family member shouts your name, do you know who is calling without looking to see?"
electrode tests – an eartip or headphones are placed in your ear and electrodes on your head to measure your brain's response to sound
speech and language assessments
cognitive (thinking) assessments
Once auditory processing disorder is diagnosed, the cause can be then determined and, if necessary, treated.
How is APD managed?
You can learn to live with auditory processing disorder by:
Practising special exercises to train your brain to analyse sound better (auditory training). It's important to do this consistently – either on your own, with a professional, or with the help of a CD.
Making changes to the environment. Be aware of room acoustics and how they affect you. Rooms with hard surfaces will cause echoes, so rooms with carpets and soft furnishings are best. Switch off any radios or televisions and move away from any noisy devices such as fans.
Asking others to help. For example, they can:
– get your attention before they talk
– speak clearly and a little more slowly
– emphasise their speech to highlight the key points of the message
– repeat or rephrase the message if necessary
For more information on what you can do to help yourself, and how others can help you, read this guide to help your auditory perception (PDF, 136kb).
Does my child have it?
Children with auditory processing disorder may have difficulty:
responding to sounds
understanding when listening
concentrating (this may be mistaken for ADHD)
learning songs and remembering instructions
expressing themselves clearly using speech
reading and spelling
Problems may start to become apparent when they start school, or when they transfer to a more challenging educational environment – but note that children with auditory processing disorder can be just as successful at school as their classmates.