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Auditory Processing Disorder


What Is Auditory Processing disorder (APD) , What Causes APD And Why Does It Undermine Learning?

Central auditory processing disorder (CAPD or APD as is now more common) is a disconnection between how an individual hears sound and how sound is processed. In most cases, there is no hearing loss or neurological disease involved. Because it impacts internal skills — listening, working memory, thinking — auditory processing disorder can be difficult to detect.

APD is not a condition or affliction, but rather an auditory deficit, where the cognitive makeup of the brain as a whole is unable to process sound accurately. Below certain thresholds in testing, the lack of auditory development or skill in sequencing and sound discrimination leads to an auditory processing disorder diagnosis.


What Causes Auditory Processing Disorder?

The primary auditory processing disorder causes have their roots in the amount of language your child is able to hear accurately in early life. Auditory processing skills develop naturally through daily language interaction and stimulation — listening and talking.

In most cases, there is sufficient stimulation around a child to develop fully formed language processing skills by the age of 6 or 7. At this age most children can comprehend spoken language at natural language speed and they can pick out phonemes, the sounds inside words, for reading. The most crucial time in this development of these crucial and complex skills in the central auditory nervous system is the first three years of life.

A famous study, the “Early Catastrophe” by Hart and Risley, found children in professional homes hear 30 million more words than their peers in lower income homes over their first three years of life. Researchers refer to it as the “30 million word gap.”  This cumulative language experience amounts to extra stimulation and practice for auditory processing skills that translate into a faster start in learning and reading.

Interruptions in Listening Can Cause APD

Therefore, the primary cause of auditory processing disorder in children is a lack of language stimulation in early life.  Or alternatively, it is an interruption in that language stimulation due to an unusual number of childhood viruses, recurring ear infections, degenerative disorders, glue ear and other hearing glitches. These interruptions deprive a child of language interaction practice in those crucial first three years of life. This early childhood form of auditory processing disorder is developmental APD.

Outside Trauma Can Cause APD

Acquired APD on the other hand refers to auditory processing disorder caused from an outside event. This might include head trauma, chemotherapy or a disease, such as viral meningitis. Acquired APD is less common, but similarly caused by a general lack of cognitive skill functioning that impacts language processing. About 40% of learning disabilities are hereditary. Auditory processing disorder fits into this pattern, it runs in families.

Finally, we should note that the most common cause of auditory processing disorder in children is “none of the above”.  It’s a tough skill to master, and many children simply require more time and stimulation than their surrounding environment provides.

How APD Undermines Learning

There is a correlation between auditory processing skill and learning outcomes.  Children with auditory processing deficits are slow to learn to read and to write.  And so yes, auditory processing is the most common learning skill you may have never heard of.

Auditory processing is a fundamental cognitive skill because it determines language mastery, the gateway to reading and learning. Children whose language processing skills do not mature and develop are at risk for difficulties in:

  • Learning — listening accuracy and comprehension
  • Reading — a language skill
  • Social interaction
  • Thinking — internal dialog uses language

Delays in auditory processing also impede development of working memory (related to IQ), attention skills and higher level thinking and learning. Furthermore, for children with auditory processing difficulties reading comprehension is almost always a challenge. If letter sounds are not clear, reading can’t be automatic. It will require constant concentration and extra effort.

A Child’s Day with Auditory Processing Disorder

Auditory processing disorder in children can be very challenging. When we are young, our day job is school. Our primary focus is getting an education. With auditory processing disorder, a child’s school day may be more challenging, frustrating and sometimes humiliating than anyone realizes.

  • He may be missing much of what the teacher is saying in class, particularly in noisy classrooms.
  • Homework can be frustrating and stressful.  This stems from not understanding the assignment, an inability to follow the lesson in class and/or reading problems.
  • Social conversations with peers are challenging, particularly in noisy playgrounds.
  • Sometimes she faces humiliation, having to answer in class before she understands the question.
  • Reading out loud in class or to a parent is often another daily struggle.

These daily frustrations erode confidence and self-esteem.  Furthermore, they create a negative connection to reading and learning that over time will be hard to reverse.  Consequently, many children with APD do eventually grow out of their processing delays, but they never do become enthusiastic readers.


How To Identify APD and What To Do Next

As you might expect, being aware of central auditory processing disorder causes and therefore recognizing auditory processing disorder in children early on is important. We recommend formal testing with one of our audiologists experienced in Auditory Processing Assessment.


APD Assessment at All Ears Hearing

Suitable for:

Children aged 6+ who seem to have normal hearing but still have problems understanding slightly complex conversations or directives. This should also be considered for kids who complain seem to get distracted by background noises very easily.


4 sessions at 1 hour each.

Prior to the appointment:

No referral necessary. However, with a referral from GP a medicare rebate of $300 is available. Please be prepared to describe the problem and its impacts.

During the appointment:

The first appointment consists of a standard hearing test.

The second and third appointments will focus on APD-specific tests, such as binaural processing tests and temporal processing tests.

The fourth appointment is used to provide a report, discuss the results and recommendations from the assessment. The child is not required to attend this appointment.

What you walk away with:

You - and your doctor if this was a referral - will be delivered a comprehensive report following the assessment. Management strategies would be discussed.

Home based auditory processing training program for eg: CAPDOTS might be recommended depending upon the results of the APD assessment.

Roger Focus ( FM system) might be recommended to assisst the child hear the speech clearly in classroom environment.