Auditory processing disorders: What they are, and are not

Today's guest blogger is Yell Inverso, Au.D., PhD., CCC-A a pediatric audiologist at Nemours/Alfred I duPont Hospital for Children.

As parents, we’ve all dealt with a situation where we feel like our kids are hearing us—but they are just not listening. But as a pediatric audiologist I have learned that as our understanding of Auditory Processing Disorders (APD)—also known as Central Auditory Processing Disorders—grows, there are times that we can’t always discount listening concerns.

Auditory Processing Disorders are broadly defined as neurological disorders or weaknesses that affect how the brain processes spoken language and other auditory information. At its core, Auditory Processing Disorders are just that—auditory. The result is that a child’s ability to listen and process is impaired. Children with APDs have normal hearing, but they have difficulty receiving verbal instructions or filtering out background noise. In essence, there is a breakdown in receiving, remembering, understanding, and using auditory information. Symptoms of APD can range from mild to severe and can take many different forms, such as:

  • A child that is easily distracted or unusually bothered by loud or sudden noises
  • Behavior and performance improve in quieter settings
  • There’s difficulty following a conversation or directions, whether simple or complicated
  • The child is disorganized and forgetful
  • A child asks for information to be repeated or clarified, as if hearing loss is present

Because outward signs and behaviors resulting from APD can appear in a wide variety of other conditions, particularly Autism Spectrum Disorder (ASD) and Attention Deficit Disorder (ADD), it often gets misdiagnosed. Children can also be improperly thought to have learning disabilities and behavioral problems.

To be clear, not all kids (especially teenagers) who say “huh?” a lot have an APD. But we should never ignore families who are desperately looking for answers that will help them understand what they experience, what the child’s teachers report, and what their gut is telling them…that something is wrong.  As parents and professionals, we need to know what to be looking for and where to go next.  

It is the audiologist’s primary responsibility to first rule out a peripheral hearing loss, meaning identifying if there is an actual problem with the hearing mechanism. Once peripheral hearing loss is ruled out, an audiologist can move forward with the full evaluation. However, a child must be at least 7 years old, because some of the skills a child needs to be evaluated for auditory processing disorder don't develop until that time.

Once a correct diagnosis of APD is made, it can be hard for families to accept that there is no cure. But a variety of treatments are available for APD that can be tailored for each child’s specific situation. There is no one approach that is appropriate for all children. But there are many strategies that can be applied at home and at school that can ease some of the difficulties associated with APD. The goal is to first determine the weakness and then develop a plan for helping the child.


Have a question for the Healthy Kids panel? Ask it here. Read more from the Healthy Kids blog »