Auditory processing disorder (APD) is a hearing condition in which your brain has a problem processing sounds. This can affect how you understand speech and other sounds in your environment. For example, the question, “What color is the couch?” may be heard as “What color is the cow?”

Although APD can occur at any age, symptoms typically begin in childhood. A child may seem to hear “normally” when in fact, they’re having difficulty interpreting and using sounds correctly.

Continue reading to find out more about APD, its symptoms, and how it’s diagnosed and treated.

Hearing is a complex process. Sound waves from our environment travel into our ears where they’re converted to vibrations in the middle ear.

When vibrations reach the inner ear, various sensory cells create an electrical signal that travels via the auditory nerve to the brain. In the brain, this signal is analyzed and processed to turn it into a sound that you can recognize.

People with APD have a problem with this processing step. Because of this, they have trouble understanding and responding to sounds in their environment.

It’s important to note that APD is a hearing disorder.

It isn’t the result of other conditions that may affect understanding or attention, such as autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD).

However, in some cases, APD can occur along with these conditions.

Symptoms of APD can include:

  • difficulty understanding speech, particularly in noisy environments or when more than one person is speaking
  • frequently asking people to repeat what they’ve said or responding with words like “huh” or “what”
  • misunderstanding what’s been said
  • needing a longer response time during conversation
  • trouble telling where a sound is coming from
  • problems distinguishing between similar sounds
  • difficulty concentrating or paying attention
  • problems following or comprehending rapid speech or complex directions
  • trouble with learning or enjoying music

Due to these symptoms, those with APD may appear to have difficulty hearing. However, because the problem involves processing sounds, testing often shows that their ability to hear is normal.

Because they have problems processing and understanding sounds, people with APD often have trouble with learning activities, especially those that are presented verbally.

There’s no standard process for diagnosing APD. The first part of the process involves taking a thorough history.

This can include evaluating your symptoms and when they started as well as checking to figure out if you have any risk factors for APD.

Multidisciplinary approach

Because multiple conditions can be similar to or occur along with APD, a multidisciplinary approach is typically used to make a diagnosis.

This can help your healthcare provider rule out any other potential causes for your condition.

Here are some examples:

  • An audiologist can perform a variety of hearing tests.
  • A psychologist can assess cognitive functioning.
  • A speech-language therapist can evaluate your oral and written communication skills.
  • Teachers can offer feedback on any learning challenges.

Assessment tests

Using the information the multidisciplinary team provides from the tests that they’ve performed, the audiologist will make a diagnosis.

Some examples of the types of tests that they may use include those that:

  • evaluate whether or not your condition is due to hearing loss or APD
  • assess your ability to hear and understand speech in a variety of scenarios, including with background noise, competing speech, and rapid speech
  • determine if you can pick up on subtle changes in sounds, such as changes in intensity or pitch
  • gauge your ability to recognize patterns in sounds
  • use electrodes to monitor your brain’s activities when using headphones to listen to sounds

It’s not completely understood what exactly causes APD. However, there are some potential causes or risk factors that have been identified.

These can include:

  • delays or problems with the development of the area of the brain that processes sounds
  • genetics
  • neurological changes related to aging
  • neurological damage that occurs due to things such as degenerative diseases like multiple sclerosis, an infection like meningitis, or a head injury
  • recurring ear infections (otitis media)
  • problems during or shortly after birth, including lack of oxygen to the brain, low birth weight, and jaundice

Treatment for APD is tailored to your individual needs based on evaluations made during the diagnostic process.

Treatment focuses on:

  • helping you to learn how to better process sounds
  • teaching you skills to help compensate for your APD
  • helping you to make changes to your learning or working environment to better manage your condition

Auditory training

Auditory training is a primary component of APD treatment. It can help you to better analyze sounds.

Auditory training can be done via an in-person, one-on-one session with a therapist or online.

Some examples of exercises include:

  • identifying differences in sounds or sound patterns
  • determining where a sound is coming from
  • focusing on specific sounds in the presence of background noise

Compensatory strategies

Compensatory strategies aim to strengthen things like memory, attention, and problem-solving skills in order to help you manage your APD. Examples of compensatory strategies that are taught include:

  • predicting potential elements of a conversation or message
  • using visual aids to help organize information
  • incorporating memory techniques like mnemonic devices
  • learning active listening techniques

Changes to your environment

Making changes to your surroundings may also help you to manage your APD. Some examples of environmental changes include:

  • adjusting the furnishings of a room to help make it less noisy, such as using carpet instead of hard floors
  • avoiding things that generate background noise, such as fans, radios, or TVs
  • sitting close to the sound source in situations where communication is necessary, such as in a business meeting or classroom
  • using visual aids in a classroom instead of just speaking
  • incorporating assistive technology like a personal frequency-modulated (FM) system, which uses a microphone and receiver to deliver sounds directly from a sound source to your ears

Dyslexia is a type of learning disorder that’s characterized by having trouble with reading.

This trouble includes difficulty with such things as:

  • identifying words
  • matching speech sounds with letters and words
  • understanding what you’ve read
  • translating written words into speech

Dyslexia is similar to APD in that people with dyslexia have trouble processing information.

However, instead of affecting the part of the brain that processes sounds, dyslexia affects the part of the brain that processes language.

Like with APD, individuals with dyslexia can also have trouble with learning activities, particularly those activities that involve reading, writing, or spelling.

ASD is a type of developmental disorder that affects both a person’s behavior and ability to communicate.

Symptoms of ASD fall into two categories:

  • trouble communicating or interacting with others
  • performing repetitive behaviors and having very restricted, specific interests

ASD can vary greatly between individuals — both in the specific symptoms that are present as well as their severity. The condition can affect a variety of different processes, including responding to sounds or spoken language.

However, a person with ASD who has trouble processing or understanding sounds from their environment doesn’t necessarily have APD.

This symptom can instead be due to the global effects of ASD as opposed to a hearing condition like APD.

APD is a hearing disorder in which your brain has trouble processing sounds.

People with APD often have trouble:

  • understanding speech
  • telling the difference between sounds
  • determining where a sound is coming from

It’s unknown what causes APD. However, various factors have been identified that may play a role, including:

  • developmental issues
  • neurological damage
  • genetics

Diagnosing APD involves a team of several different professionals.

APD treatment is determined on a case-by-case basis.

Your healthcare provider will work closely with you or your child to develop an appropriate treatment plan based on your individual needs.