Is it ADHD or APD?

Is it an attention problem or difficulty processing?. Hero Images/ Getty Images

ADD, ADHD, CAPD, APD…these are enough acronyms to confuse anyone! Let’s break them down and take a look at what all of these letters mean and how to differentiate between attention issues and processing disorders.


Attention Deficit Disorder (ADD) is no longer a diagnosis. Instead, Attention Deficit Hyperactivity Disorder (ADHD) is the diagnosis used, and there are three types of ADHD: Predominantly Hyperactive, predominantly inattentive, and mixed.

ADHD will affect processing across different modalities and will typically respond to behavioral management and medication.


Central Auditory Processing Disorder (CAPD) and Auditory Processing Disorder (APD) are the same thing. It is more accurate to use the term “APD” as the auditory system we are discussing involves much more than just the central auditory pathways. APD is a single modality issue and behavioral management and medication are ineffective.

Separate Disorders

It is important to note that people with ADHD will often have a coexisting learning disorder and may have APD as well. ADHD and APD are not treated the same, so the disorders need to be evaluated with ADHD being treated first in order to accurately diagnose the presence of an APD. A multidisciplinary team consisting of at least a psychologist/psychiatrist and audiologist are necessary for this dual diagnosis.

Evaluations and Behaviors

Prior to an APD evaluation, a cognitive evaluation with a psychologist should be completed.

This evaluation needs to look at attention differences and ideally rule out ADHD. If the psychological evaluation has not been completed first, or if the results did not address ADHD, the audiologist should test for auditory vigilance. This screening should be done before the APD test battery to ensure the child has appropriate attention to obtain accurate testing for APD.

A child with ADHD is usually described as having inattentive, distracted, or hyperactive behaviors. In contrast, a child with APD is usually described as having difficulty in background noise, difficulty following oral directions, and having poor listening skills. The child with APD will not have trouble focusing and paying attention in quiet environments.

There may be overlap in how children with ADHD and APD behave. For example, in ADHD and APD, there is often difficulty with following directions. However, the child with ADHD is not following the directions because their attention issues are preventing the entire message from being delivered or used properly by the brain, while the child with APD is getting all the information but the information is being distorted by problems with higher level processing in the brain.

Some different behaviors that may be present in ADHD that are not seen in APD-only include aggressive behavior, decreased visual attention, difficulty with transitions, decreased motor coordination, excessive motor activity, impulsivity, and impaired peer relationships. Diminished verbal abstraction and decreased verbal IQ are more typical of APD and not ADHD.

Final Thoughts

It can be a frustrating journey when your child has difficulty learning, no matter the cause.

Proceeding in a methodical manner with the assistance of the right multidisciplinary team members is essential for accurate diagnosis and effective treatment.


Bellis, Teri. Assessment and Management of Central Auditory Processing Disorders in the Educational Setting From Science to Practice (2nd Ed). Delmar Learning, Clifton Park NY (2003).

Nowell, David (28 March 2012). Managing Supramodal Influences: Distinguishing (C) APD from ADHD. Presented at Audiology Now! 2012 Conference in Boston MA.

Spielvogle, Keri (2009). What is the Difference Between CAPD and ADHD? Central Auditory Processing Disorder (CAPD). Super Duper Publications. Accessed 06/29/2015 from

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