Auditory Processing Disorders

An auditory processing disorder (APD) is a set of behaviors attributed to incorrectly processing simple and/or complex sound information. It is identified using tests that require a patient to listen and respond in a prescribed way to what is heard. When a patient does not respond in the same way as a group of normal-hearing listeners and no other reason(s) for the incorrect response is identified, the aberrant behaviors are thought to be associated with an APD, also known as a central auditory processing disorder (CAPD). APD is estimated to occur in 2 percent to 3 percent of children, with a 2-to-1 ratio between boys and girls; the prevalence of adult APD is estimated at 10 percent to 20 percent.

Parents, teachers and school psychologists associate a person’s diffi culty to recognize and accurately respond to spoken words, sentences and paragraphs as a possible APD. Sometimes, listening to sounds in quiet may produce normal responses but listening to sounds in a noisy environment may produce abnormal responses when compared to normal-hearing listeners. There may be plausible explanations for the abnormal response, such as a learning disability, but one possible explanation is an APD.

Listening and responding to beep tones while wearing a headset may not eff ectively detect an APD. Th erefore, a test for APD frequently includes more complex sounds, such as speech sounds, speech with noise sounds, sounds in one and both ears, or different sounds in both ears. These types of sounds emulate listening conditions a listener may experience in everyday life and can tax the listening system in ways that help to differentiate normal-hearing listeners from listeners with impaired sound processing.

The cause or causes for a patient’s abnormal performance on APD tests are not always easily identifi ed. Many times an APD does not show up until a patient/child begins to experience more complex language tasks, such as those encountered during academic school work. Academic tasks require an ever-increasing need to listen (auditory attention), differentiate complex words (auditory recognition and discrimination), retain strings of words (auditory memory), and subsequently process the information (auditory processing).

Audiologists and teachers of the deaf and hard of hearing are specialists that work cooperatively to recommend ways to help patients with APD. Recommendations are normally integrated into the patient’s life at home, school, work, or during recreation. Recommendations are targeted specifi cally toward the listening conditions most impacted by the patient’s APD. Frequently, APDs are associated with listening to speech in less than ideal conditions, in which case the patient is taught to use contextual, visual and linguistic cues, optimize the listening conditions and learn how to balance cues to extract the most information possible from the listening environment. It is critical for both the patient, family of the patient and people who associate with the patient, such as teachers or friends, to have realistic expectations for the patient’s changes over time.

While APDs oft en are suspected by parents/caregivers, professional educators recognize the impact of an APD on learning. Treatment is a coordinated eff ort between the patient’s physician, audiologist and teacher of the deaf and hard of hearing. The treatment team also may include other professionals, such as a speech language pathologist or counselor.

1. Atena, Clinical policy bulletin: Auditory Processing Disorder.

2. KidsHealth

3. American Speech Language Hearing Association.

4. Cincinnati Children’s Hospital.

5. University of Pittsburgh Medical Center (UPMC).

6. National Institute on Deafness and other Communication Disorders (NIDCD).

  Information sponsored by Starkey Laboratories, www.starkey.com