Auditory processing disorder
central; auditory; processing; disorder; ADD; language; ADHD; delay; hearing; CAPD; school; learning;
Auditory Processing Disorder (APD) means that the brain has difficulty making sense of the sounds that it hears. The child has a normal ability to hear sounds, but has difficulty understanding what the sounds mean.
APD is thought to affect approximately 5% of school age children. One of the characteristics of APD is that the child has a normal ability to hear sounds, meaning that their outer, middle and inner ear are all working well. However, even though the child may be able to hear sounds well, they may still have difficulty understanding what the sounds mean.
This may be more obvious when the child is in a challenging listening environment, such as when it is noisy or when they have been given a number of spoken instructions at once. This can make it very difficult for a child to access spoken information and understand what their teacher says in the classroom.
APD is a complex disorder as it can affect any or all of a number of listening skills, meaning that it can present differently in different children. Other common names for APD are: Central Auditory Processing Disorder (CAPD) and Central Auditory Dysfunction.
Signs that a child may have an Auditory Processing Disorder
Some of the things that children with APD find difficult are:
- Focussing on one voice when there are lots of people talking
- Remembering spoken instructions (they may ask for repetition or only complete the first step)
- Noticing the small differences between similar words (such as boat/coat, which/wish)
- Concentrating in a noisy place
- They may demonstrate sensitivity to noise and show a preference for quiet places
At school, most tasks depend on the child being able to understand what is said by the teacher or other children. This can be very difficult for a child with APD, and the child may become frustrated and less involved at school.
Causes of Auditory Processing Disorder
The causes of APD are still unknown.
- We know that APD involves changes in the way the brain processes sound, but we don't know why this happens.
- It is also not clear whether children are born with APD or whether it develops after birth.
- Children who have had a number of ear infections and associated hearing loss from a young age have been found to be more prone to developing APD.
What we do know is that an awareness of the disorder and a team approach can help to manage APD for your child. The type of management strategies recommended may differ from child to child, depending on the specific auditory skills they are having difficulty with and the severity of the disorder.
Auditory Processing Disorder Diagnosis
It is important to know if your child does have APD so that it can be managed.
Auditory Processing Disorder will not show up on a standard hearing test. An assessment for APD uses special tests that are specifically designed to test auditory processing skills in addition to hearing ability. These tests may involve your child repeating a series of words or numbers, listening to words coming to both ears at the same time, ignoring words from one side while listening to words on the other side or listening to target words while other noise is presented.
These tests may sound difficult, but each of them assesses one or more specific auditory skills and is age appropriate. Given that these tests can be quite challenging and time consuming even for children without Auditory Processing Disorder, the assessments can take up to three hours. For these reasons, APD assessments are generally only performed with children who are 7 years or older, even though the signs of APD may be present from a younger age.
APD assessments can only be performed by qualified audiologists who have undergone further training. Please see the list of clinics that perform APD assessments in South Australia further down this page.
Diagnosing APD can be difficult, because some of the signs of APD can also point to issues with attention, speech, language and learning in general. By working with other health professionals such as speech pathologists, psychologists and doctors, as well as your child's teacher we can ensure that your child receives the right diagnosis and care.
How to help a child with Auditory Processing Disorder
The main way we can assist a child who has APD is to make it easier for them to understand what they hear.
- Some forms of APD may be assisted by performing computer-based exercises
- The use of an Assistive Listening Device, such as an FM system, allows the child to hear the teacher's voice directly even if there is other noise or they are some distance away. The teacher wears a small microphone and their voice is transmitted wirelessly either to a small ear piece that the child is wearing or a speaker system within the classroom
- Breaking instructions into simple steps and giving the next instruction when the child has done the first one
- Sitting the child close to the teacher so that the teacher's voice is loud compared to the voices of other children.
- Giving the child other ways of ‘getting the message' such as written instructions
- Encouraging the child to ask the teacher to repeat what has been said if they have not understood, or having the teacher check that they have understood what was said.
- Reducing noise in the classroom as much as possible, particularly when the teacher is giving instructions
- Having quiet study places at home
- Recognising that the child has a difficulty and is not just being naughty
The audiologist who performs the APD assessment will be able to discuss what options are available to you and which ones may work best for your child
APD assessment clinics in South Australia
Note: We advise that you phone and discuss the cost of the assessment and management options prior to making an appointment as there are currently no publicly funded APD assessment clinics in South Australia
*Please note that some services may have additional visiting sites that are closer to your location. Please contact the service of your choice or visit their website for further information.
Other useful websites:
Information developed by:
Newborn and Children's Hearing Service
295 South Terrace
Telephone: 8303 1530
Non-English speaking: contact (08) 8364 5255 for information in languages other than English, call ABC International and ask them to call Flinders Medical Centre. This service is available at no cost to you.
© Department of Health, Government of South Australia.
Printed March 2013
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your child's sex.