Auditory Processing Disorder in Children

An Introduction to Auditory Processing Disorder (APD).

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Auditory processing disorder causes frustration and difficulty learning.

“Why can’t my child listen?”

“I feel like I have to repeat myself over and over all the time.”

“ If I tell him to go upstairs, get his jacket, and tell his brother it’s time to leave for school he’ll go upstairs and get lost up there and not even remember what he was supposed to do.”

“I don’t know if there’s a problem or he’s just lazy.”

Auditory processing disorder (also called “APD”) is invisible. For someone without this difficulty, it can be frustrating to understand how it affects everyday life.

The quotes above came from parents of children about to undergo testing for APD; for many, this was not their first experience in a medical office trying to figure out if there was a problem and what that problem could be.  They had been to other audiologists, ENT specialists, speech-language pathologists, and school psychologists without getting results explaining why their child continued to struggle in school, continued to have speech delays and continued to fall further behind their peers. 

Dr. Jack Katz was one of the early pioneers of auditory processing disorder testing and he defined auditory processing as, “What we do with what we hear.” While this is still correct decades later, when we look deeper at APD research a few points of agreement stand out:

  1. APD is not hearing loss. Children with APD will generally pass all standard tests of hearing.
  2. There is a breakdown in receiving, remembering, understanding, and using the information they hear.
  1. There is a neurological basis to their difficulties.
  2. The ability to listen is impaired.

True APD is isolated to how the brain uses auditory information. It is not the result of cognitive, language, or related disorders. Many disorders can cause symptoms that are consistent with APD. For example, a child with Attention Deficit Hyperactivity Disorder (ADHD) may exhibit poor listening and problems remembering what was said.

The attention issue is causing difficulty accessing and using information – the neural processing of auditory information may be completely intact. In that case, there is not an auditory processing disorder.

In addition to ADHD, other disorders that can mimic APD are autism spectrum disorder, sensory integration disorder, specific learning disability, and mental retardation.

In some cases, APD can co-exist with other disorders. A careful multidisciplinary approach is often needed to tease out what is APD and to make an accurate diagnosis. It is important to remember that APD can only be diagnosed by an audiologist. A team approach to diagnosis and management may include an audiologist, psychologist, speech-language therapist, occupational therapist, and neurologist. A child is more than just a pair of ears or a brain; looking at the whole child and the areas of difficulty will assist in diagnosis and allow for more meaningful treatment.

The bottom line: Find an audiologist who specialized in identification and treatment of APD.

There are treatments and accommodations to help your child achieve success. 

Sources:

Lucker, Jay. What is APD? 2014. <http://www.ncapd.org/What_is_APD_.html>

Bellis, Terry James. Understanding Auditory Processing Disorders in Children. May 19, 2014. <http://www.asha.org/public/hearing/disorders/understand-apd-child.htm>

Bellis, Teri. When the Brain Can’t Hear. New York: Atria Books, 2002.

Karp, Melissa. What is APD? Accessed 11/19/2015 from http://www.hearlistenlearn.com/patients-family/what-is-auditory-processing-disorder-apd.aspx

Updated by Melissa Karp, Au.D. 

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