We don't hear with our ears alone. Hearing also involves the brain.
Auditory processing disorder (APD), sometimes referred as central auditory processing disorder (CAPD), is a general term for hearing disorders in which the ears process sounds normally but the hearing centres and circuits of the brain don't always process incoming information sufficiently quickly or accurately.
Children with APD can hear but they sometimes have trouble with understanding what they hear.
It is estimated that 1 in 20 children have difficulties that affect processing of auditory information in the brain. APD can affect understanding, especially in challenging listening situations such as in the presence of other distracting sound, or when listening to complex information. APD is under-recognised hearing problem that is an underlying cause of learning difficulties in many children. APD is not detected in standard hearing tests but it can be diagnosed with special hearing tests. Most importantly, there are proven helpful treatments.
A number of factors can affect the normal development of auditory processing skills. Causes of APD include hereditary, developmental and birth-related factors, brain injury and neurological disorders. There is also research evidence that suggests that prolonged middle ear disease (e.g ., Glue ear) can result in APD, If hearing is disrupted during important developmental periods in infancy or early childhood.
APD frequently occurs in conjunction with other disorders including in particular dyslexia, autism spectrum disorder (ASD), and developmental language disorder (DLD). APD sometimes co-occurs with attention disorders (ADD and ADHD). Because APD can affect the correct and rapid recognition of phonemes, the sounds of speech, it can be an underlying cause of language, phonological awareness, spelling, and reading problems including dyslexia.
APD is frequently a barrier to meeting academic potential.
Many children with APD will struggle to progress with language and literacy skills, and overall academic progress. Some children with APD may be meeting expectation for their age and year level, yet are not meeting their own potential.
When listening is a challenge, learning is more difficult.
Children with APD may under-achieve in school despite great effort.
The extra effort required for listening often results in children with APD being exhausted at the end of the school day. Because listening is difficult they may also become less attentive, they may become more anxious and frustrated with their learning, or perhaps behaviour becomes a problem. Their communication problems can lead to low confidence and self-esteem, and difficulties with socialisation.
Children with APD often miss, or misunderstand, what is said. This can be because they miss parts of speech that are too fast or too complex, or because hearing against any background noise is especially difficult for them. Children need to develop hearing skills to separate important sounds from other surrounding sounds, such as the teacher’s voice against other children moving and talking. We also need to learn to rapidly and correctly identify all the sounds (phonemes) that make up our language, no matter the voice or speed or accent with which they are spoken, and be able to correctly distinguish between subtly different speech sounds. Children who grow up with APD often have difficulty in always rapidly and correctly identifying every phonemes in spoken language. Children with APD may also have poor skills at detecting nuances of speech denoted by changes in pitch or emphasis which, for example, may indicate emotion or humour or change a statement into a question. See our auditory processing disorder checklist for more information on APD symptoms.