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Central Auditory Processing Disorder (APD)

Auditory Processing, simply put, is how the Central Nervous System (CNS) processes or uses information obtained through hearing. Auditory Processing Disorder (APD) is the limitation within the CNS in the ongoing transmission, analysis, retention, retrieval and use of information contained in sounds that are heard. APD is not the result of disorders of higher-ordered cognition, language or intelligence. APD is an auditory deficit only.

There are many disorders and/or combinations of disorders that can cause a child to have difficulties understanding auditory information. APD is one of these disorders and is frequently and erroneously interchanged with Attention Deficit/Hyperactivity Disorder (ADHD). The behavior symptoms of APD and ADHD may seem similar, but the differences in treatment and outcomes are monumental.

Children with APD generally have normal hearing but will have difficulty understanding speech in noisy environments, have difficulty following directions when given verbally, and difficulty discriminating (hearing the difference) between similar sounding speech sounds. In the classroom settings, children with APD may have difficulty with reading, spelling and understanding information that has been presented verbally. More often than not, performance is noticeable better in classes that don’t relay heavily on verbal instructions. These children are able to complete tasks independently once they understand what is expected of them. Difficulties often become noticeable at the end of second grade or early third grade when classroom instruction becomes less directed and more complex.

One of the causes of APD in children is the delay in the maturation of the Central Nervous System (CNS). Studies have shown that the CNS maturation is generally slower in boys (Keith, 1995), making the prevalance of APD higher with boys than girls. Studies have shown the CNS maturation is slower in boys. (Keith, 1995). There could be difficulties in the auditory “timing” that may or may not be related to maturity. It’s in the “timing” that the brain is able to distinguish between similar speech sounds. Neurological problems such as brain injury resulting from head trauma or lesions on the brain or brainstem can result in APD.

Treatment varies depending on the severity of APD. Personal FM systems used for class room instruction have proven to be very successful in most cases.

Contact Preferred Audiology Services for an appointment to have your child tested if APD is suspected. The battery of tests will consist of a complete diagnostic audiologic evaluation including middle ear analysis, otoacoustic emissions testing and the SCAN 3-C.



Children with auditory processing difficulty typically have normal hearing and intelligence. They have also been observed to:

  • Have trouble paying attention to and remembering information presented orally
  • Have problems carrying out multistep directions when given orally
  • Have poor listening skills
  • Need more time to process information given orally
  • Have lower academic performance mainly in subjects that are more oral than written
  • Have behavior problems
  • Have language difficulty (e.g., they confuse syllable sequences and have problems developing vocabulary and understanding language)
  • Have difficulty with reading, comprehension, spelling, and vocabulary (again, these are oral tasks)
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