Many kids with ADHD struggle to block out background noise, have a hard time staying focused when someone is talking to them, or forget the details of a conversation. In fact, difficulty staying focused and blocking out distractions are hallmark symptoms of ADHD. But did you know that they are also primary symptoms of Auditory Processing Disorder or APD? APD isn’t as well-known as ADHD, and it isn’t included in the Diagnostic and Statistical Manual (DSM) of psychiatric disorders. However, it is widely recognized that many kids with ADHD or learning differences also struggle with auditory processing problems. APD can co-occur with ADHD or it can exist on its own. When ADHD and APD occur together, a child’s difficulties with concentration and memory are magnified.
What is Auditory Processing Disorder?
Kids with APD have difficulty processing information that is presented to them orally. They don’t have difficulty with hearing, although it may seem like they do at times. Instead, the problem lies in their brain’s ability to decipher and translate words and sentences into meaningful information. Kids with APD struggle to filter out background noise, focus on conversations (especially in noisy environments), remember the details of conversations, recall the order of instructions that are presented to them, correctly process sequences of numbers (e.g., 108 vs. 801), discriminate between similar sounding words (dig vs. big), and struggle to learn proper sentence structure and syntax. Since many aspects of language processing overlap in the brain, many kids with APD also struggle with components of reading and writing.
How is Auditory Processing Disorder Different from ADHD?
Many symptoms of APD overlap with symptoms of ADHD but there are significant differences between the two disorders as well. Kids with ADHD will have difficulty focusing or staying on task even when there are few distractions around them, and they will have difficulties in areas that are not related to attention and information processing (such as organizational skills, impulsivity, and/or hyperactivity). Kids with APD may be so sensitive to noisy environments that they have trouble tolerating them at all. They may even complain that the sound is “hurting their ears,” and become increasingly upset if they aren’t able to go to a quieter place. In contrast, many kids with ADHD enjoy noisy places. And while they may start having some behavior challenges if they become overstimulated, they usually aren’t distressed by the noise. When a child has ADHD as well as APD, their problems with focus and concentration become severely impairing in loud environments, and they are hypersensitive to sound.
How is Auditory Processing Disorder Diagnosed?
Unlike ADHD which can be diagnosed by a psychologist, psychiatrist, or pediatrician, APD can only be diagnosed by an audiologist. The audiologist administers a series of tests primarily designed to test a child’s ability to process information within the context of increasing levels of background noise. The child’s scores on the test are compared against the scores obtained from large samples of children without APD. If a child’s score falls well outside of the average range of the comparison sample’s scores, the audiologist will likely make an APD diagnosis.
How is Auditory Processing Disorder Treated?
There is very limited research on treatments for APD, so it is difficult to know what will be most effective for any one child. Generally, interventions are provided by speech and language pathologists who help a child improve their ability to discriminate between similar sounds and remember the details and the sequences of information that they hear. In addition, to speech and language interventions, many children benefit from accommodations that minimize the impairments related to APD. This may include preferential classroom seating, taking exams in quiet rooms, having teachers and parents ask the child to repeat information back to them to check for understanding, and having information and key concepts presented in multiple formats (e.g., orally, written, video, etc.). While there is no cure for APD, many children do see large improvements in their auditory processing abilities as their brain matures over time.
If you suspect that your child may have APD, talk to your child’s teacher or special education coordinator, or request an audiology referral from your pediatrician.
Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.
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