Need to know: Understanding auditory processing disorder

Auditory Processing Disorder (APD) is a complex condition that affects a child’s ability to process and make sense of auditory information. APD affects approximately 5% of school-aged children, with boys being more commonly affected than girls. 

Children with APD may have difficulty understanding speech in noisy environments, following verbal instructions, and distinguishing between similar sounds. APD is often misdiagnosed or overlooked, leading to frustration for both the child and their caregivers.

APD can impact a child’s academic performance, social skills, and self-esteem. Early diagnosis and intervention can help children with APD improve their communication skills and overall quality of life.

Why it’s Important

Children with ADP have normal hearing, the issue is how the ears and the brain work together to process the sounds they hear. This condition impacts a child’s understanding of speech and it can be misdiagnosed as hearing loss, an intellectual disorder, ADHD, or a language/learning difficulty. 

Signs that your child might have an Auditory Processing Disorder include your child:

• missing details or steps when given directions
• misunderstanding words with similar sounds
• having difficulty understanding speech in noisy environments
• struggling with reading and spelling
• having trouble following a conversation
• taking a long time to respond
• often responding with “huh?” “what?” or asks you to repeat
• having problems concentrating and paying attention
• difficulty identifying where a sound is coming from
• struggling to recognise sound patterns or rhythms and learning music

The overlap and comorbidity with other conditions require a thorough assessment for a correct diagnosis. In addition, there are various auditory processing deficits, and because every child is unique, APD can show up in different ways. If you have concerns, it is best to have your child checked by an audiologist to test their hearing, a psychologist to assess their cognitive processing, and/or a speech pathologist to evaluate their oral and written communication skills. In addition, it’s important to speak to your child’s teachers to get feedback on your child’s specific learning challenges. 

Children with APD often struggle to follow instructions, particularly in a classroom setting, which can affect their academic performance. Research has shown that children with APD may have difficulty with reading, writing, and spelling, as well as with other cognitive and language-based tasks.

In addition to academic difficulties, APD can also impact a child’s social skills and self-esteem. Children with APD may avoid social situations or feel anxious in noisy environments, which can affect their ability to form relationships and participate in activities.

Early identification and intervention are important for children with APD. Children who are diagnosed with APD before they become teenagers can “grow out” of the disorder because the brain areas responsible for processing auditory information are still developing until approximately the age of 13. Speech and language therapy, auditory training, and classroom accommodations can help children with APD improve their communication skills, academic performance, and social functioning.

Some of the approaches used to treat ADP include:

• Address sound discrimination – to help your child with difficulty hearing differences between sounds, they might be taught to tell apart sounds by hearing them in a quiet place and then hearing them in noisier places.
  
  
• Strengthen auditory memory – to improve your child’s memory for what they hear, they may be asked to practise remembering a list of numbers or instructions.
  
  
• Support language-processing difficulties – if your child struggles with understanding language, they will be given tools and strategies to help them ask someone to repeat or explain what they said and/or for your child to take notes in class.

Tips & Strategies

• Be present and at their level. Avoid giving instructions from another room, you need to be near your child for them to pay attention to what you are saying.
  
  
• Speak clearly and slowly. Children with APD may have difficulty understanding rapid or complex speech. Use keywords or short simple sentences to allow them to process what you say.
  
  
• Minimise background noise. Where possible, reduce noise distractions at home. The dog barking or TV blaring can make it difficult to listen and focus.
  
  
• Use visual aids. Routines are great for many reasons, use them to supplement verbal instructions and include visual cues, such as pictures or written instructions.
  
  
• Provide repetition and feedback. If necessary repeat instructions or information, and ask for feedback to ensure that your child has understood.
  
  
• Play games to increase auditory attention. Pick games that involve your child listening and taking action (Simon says, musical statues, etc), this can help strengthen their ability to pay attention to sounds.
  
  
• Advocate for accommodations. Work with your child’s teachers and other professionals to provide accommodations, such as preferential seating or extra time for assignments and tests, attention prompts, and visual aids.