Auditory Processing Awareness Day: 4 April

What is Auditory Processing Disorder?

Auditory Processing Disorder (APD), also known as Central Auditory Processing Disorder (CAPD), is where individuals face difficulties in understanding isolated sounds within social environments, affecting how the central nervous system interprets verbal information.

It is important to understand that APD isn’t like other hearing deficits; it is a processing error within people’s brains, rather than a problem with their ears. For instance, people with APD often mistake minor differences in words, such as misinterpreting “Please feed the dog” as “Please reach the log”. There was no deficit within their ears in hearing “Please feed the dog”, but the inability to isolate speech in noisy environments from APD led to a misconstrued auditory process and consequently left the person ‘hearing’ “Please reach the log” instead.

Memory capacity has been associated as significantly lower within children struggling with APD, and leads to difficulties in separating and grouping incoming information. ‘Phonemic awareness’ is a term used to describe a person’s ability to hear, identify and manipulate sounds.

A weakness in this is often associated with APD. Consequently, Auditory Processing Disorder Awareness Day was initiated to raise awareness towards the effects and challenges associated with APD for people affected by the condition.

Who is affected by APD?

While the causes of APD is often unknown, evidence has suggested that complications at birth or a faulty gene can be responsible. Subsequently, APD usually develops in childhood, with 3-5% of school-aged children unable to hear and understand in the same way as their peers, yet many adults develop the condition later in life too.

With difficulties in diagnosing and common misdiagnoses of ADHD and dyslexia, school children are often left struggling with their ability to read, spell and follow verbal instructions, restricting their academic progress and delaying skill progression.

External impactors such as head traumas can also contribute to the development of APD, with even minor injuries able to cause damage to the central auditory nervous system. Evidence has also associated Parkinson’s disease with APD, due to changes to the basal ganglia and brainstem, as well as a lack of dopamine able to help with sensory processing, resulting in auditory issues. Moreover, the implications of strokes have also been linked to APD, interlinked with aphasia which causes difficulty with language and speech.

The risk of developing APD has also been associated in people with seizure disorders, such as temporal lobe epilepsy (TLE), as well as children with a history of ear infections due to the muffled speech and sounds resulting in inaccurate coding. Peripheral hearing loss and changes to the central auditory nervous system as a result of ageing has also been found to instigate difficulties with recalling words and repeating short sentences, symptoms linking to APD.

Signs and Symptoms of APD

APD Awareness Day highlights how it is important children are diagnosed early to prevent falling behind at school. Key signs and symptoms of APD to look out for include:

• Difficulty understanding or responding to spoken words, with visual clues often needed.
• Overly and easily distracted by irrelevant or background noises and has trouble listening and paying attention in a group.
• Asking for/needing repetition of statements and instructions whilst struggling to remember things that have been said.
• Feeling like you are always speaking too loudly.
• Difficulty making out conversation in loud settings, interpreting loud noise much louder than other people.
• Difficulty spelling out loud and suffers from reading difficulties.

How is APD diagnosed?

Although difficult to diagnose, assessment with an audiologist is advised if you or a loved one is experiencing symptoms of APD for a more accurate diagnosis. The NHS states you should visit a GP if you or your child finds it hard to hear or understand speech, and the GP may refer you to a hearing specialist. Tests for APD include:

• Listening to speech with background noise.
• Spotting small changes in sounds.
• Filling in missing parts of words.
• Having electrodes on your head to measure how your brain reacts to sound.
• Speech and language tests.
• Memory, problem-solving and concentration tests.

How can it be treated?

While there is no cure for APD, there is help available to treat symptoms. This can include working with a speech-language pathologist (improving skills in distinguishing, remembering and sequencing sounds) or educational therapist (developing strategies to manage frustration and specific weaknesses), but usually involves auditory training to improve listening and concentration.

We thank Rosie for her contribution of this article for Auditory Processing Awareness Day.