APD and other Disorders or Difficulties

Auditory processing disorder (APD) can occur in isolation, but it frequently occurs alongside other difficulties or disorders. Sometimes APD turns out to be the underlying cause of undiagnosed learning disabilities. Irrespective of cause, treatment is warranted, though results may be affected by any co-occurring disorder.

APD commonly occurs with specific language impairment and reading disorders including dyslexia.

Auditory processing, language and reading are neurologically entwined. Difficulties with auditory processing can affect phonological processing, the ability to recognise and interpret phonemes, the elements of spoken language. Impairment of phonological processing in turn affects language and reading development.

Auditory processing difficulties are commonly seen in children with autism spectrum disorder (ASD).

Auditory processing difficulties in people with autism spectrum disorder (ASD) are a consequence of changes in the brain due to the ASD.

Children with global developmental delay may show difficulties with auditory processing as a consequence of the developmental delay.


APD can co-occur with attention problems, i.e., Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD).

According to one research study, speech pronunciation difficulties may be more common in children with APD than in typically developing children. Our clinical experience is that many children with APD also show signs of difficulties with visual processing.

When testing children at SoundSkills we take into account other areas of difficulty and factors such as attention, memory, language, and cognitive ability. Observations from parents, school teachers and other professionals involved with the child are important and are taken into consideration in our evaluation. We recognise that other difficulties and disorders do not preclude a child from also having auditory processing difficulties. At SoundSkills APD Clinic we endeavour to help all children, irrespective of their other difficulties. Our specialist team of audiologists, speech language therapist, Education Advisers, and Autisim Adviser evaluate individual needs and tailor treatment programmes to suit.

Traumatic Brain Injury (TBI)

Auditory processing disorder is a common consequence of brain injury.

Hearing related issues are not always forefront of concern following a head injury but may become especially noticeable once the person tries to resume their regular activities such as returning to work or school and socialising. There may also be the complication of hyperacusis, heightened sensitivity to sounds, with the result that sounds above moderate loudness are especially intolerable. Together with other effects of TBI, auditory processing difficulties can have severe effects on communication ability.

At SoundSkills APD Clinic we see children and adults with significant auditory difficulties as a result of head injury with TBI. Standard hearing test results may be normal, however the person will often have significant difficulties listening, processing information they have heard, and understanding when in groups or in noise. By identifying and understanding the auditory processing deficits, we can provide appropriate management, including treatment and intervention to help improve quality of life.

How does it sound to have APD?

Adults with APD, particularly if it arose in adulthood so they have prior experience of good hearing, can provide insight into the experience of hearing with APD.

Dr Louise Carroll QSO, JP, GDPPA , MPM, previously Chief Executive Officer of the National Foundation for Deaf and Hard of Hearing has Auditory Processing Disorder and uses hearing aids and a remote microphone (RM) system. She describes her hearing experience as follows.

“Without my hearing aids or RM system, speech seems fast, fragmented and confusing. Voices lack tonality. My directional hearing is poor and voices from behind are particularly difficult to hear. It’s very difficult to distinguish a voice from any other sound that is present. For example, if the refrigerator switches on (a sound barely noticeable to most people) it seems to me to swamp anyone speaking. With my hearing aids I hear much better, losing only perhaps 25% of speech. With both my hearing aids and RM system I can usually hear 100%. But I am still exhausted from listening at the end of the work day and want to take my hearing aids off as soon as I get home.”

One child with APD when first fitted with a remote microphone hearing aid system echoed the comment about lack of tonality in voices. He listened to the teacher and teacher aide for a moment then remarked with surprise that they had different voices. “I didn’t know people had different voices” he said.


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