Auditory processing disorder (APD) is a condition in which people can hear clearly, but their brain has trouble interpreting and making sense of what they hear.
Have you ever heard someone say something to you, not understood it, and then a few seconds later, it’s as if what they said finally “clicks?” This is what APD is like, but on a much bigger scale.
Speech therapists often work with children and adults who have auditory processing disorder. These clients may have a co-occurring diagnosis, or APD might be the reason they are in speech therapy. Read on to learn the causes and symptoms of APD, along with how treatment and therapy work for auditory processing disorder.
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What is auditory processing disorder?
Auditory processing disorder (APD) is different from hearing loss caused by damage to the ears. APD is a condition that affects how the brain processes sound. This disorder can make it hard to follow conversations, especially in noisy places or when instructions are complex.
APD is sometimes called central auditory processing disorder (CAPD) or auditory perceptual disorder. Some people call it APD disorder.
Research suggests that boys may be diagnosed with auditory processing disorder more often than girls. The symptoms of auditory processing disorder can stand out in the classroom. Many children with APD have learning difficulties, especially in reading, spelling, and attention.
Auditory processing disorder is also common in older adults, particularly those with other types of hearing loss.
Only an audiologist can diagnose auditory processing disorder, using special tests that measure how well a person processes sounds. While there is no cure, there are treatments and strategies that can help improve listening and communication skills. This makes it easier for people with APD to navigate their daily lives.


What causes auditory processing disorder?
The cause of auditory processing disorder isn’t specifically known. It can occur alongside conditions like ADHD or autism, but it is a separate diagnosis. It is different from receptive language problems, which make it hard to understand word meanings.
Auditory processing disorder in adults may develop after a stroke, brain injury, or neurological disease. In children, APD may be linked to:
Lyme disease
Lead poisoning


Symptoms of auditory processing disorder
Some signs and symptoms of auditory processing disorder include:
Difficulty understanding speech, especially with background noise
Mishearing words and sounds
Asking people to repeat themselves often
Difficulty following directions, especially multistep directions
Problems distinguishing between sounds
It’s important to note that although someone with auditory processing disorder may appear to not be paying attention, this is because of their difficulty understanding or following through with directions. ADHD or attention problems may occur alongside auditory processing disorder, but it is not an attention-related issue itself.
What does auditory processing disorder look like in the classroom?
At school, children with auditory processing disorder may appear to have trouble with:
Paying attention
Understanding directions
Completing tasks appropriately
Understanding the teacher


How is auditory processing disorder treated?
According to the American Speech-Language-Hearing Association, there are three main types of treatment for APD:
1 Environmental modifications
You can change the space around you to make listening easier. Examples might include reducing background noise or using sound amplification systems.
2 Compensatory strategies
You can learn how to cope with attention and communication challenges, such as by using memory tricks or taking notes.
3 Direct skills training
This involves practicing specific listening skills to improve how the brain processes sounds.
People with auditory processing disorder are typically treated by a multidisciplinary team in order to receive well-rounded support. This team might include audiologists, speech therapists, teachers, and/or psychologists.
Let’s take a closer look at how treatment and therapy work for auditory processing disorder.
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Environmental modifications for auditory processing disorder
Some of the easiest ways to help someone with auditory processing disorder is to adjust the physical environment around them, whether it’s the classroom, workplace, or home. These changes can reduce the noise and distractions that make listening difficult. While you should always follow the guidance of a professional, here are some ideas:
Turn off TVs, music, and loud appliances when you’re talking to your loved one.
Cover hard surfaces like floors and ceilings with carpets, rugs, or wall panels to reduce echoes.
Use curtains, bookshelves, or dividers to block outside noise.
Place soft pads under chairs and tables to lessen scraping sounds.
At school or work, seat the person closer to the teacher or speaker and away from windows, hallways, or noisy individuals.
These adjustments create a quieter space where people with APD can focus on speech.


Compensatory strategies for auditory processing disorder
There are other strategies you can use at home, school, and work to support the person’s listening and learning:
Encourage face-to-face communication. Seeing a person’s face when they’re talking will help the person understand their speech.
Speak at a steady pace with a clear voice, instead of speaking more loudly.
Give simple, clear directions. Break up instructions into small steps.
Have your child or loved one repeat back directions you give them. This way you can confirm they understand.
Use written reminders and visual aids like chore charts, calendars, or checklists.
Turn on closed captions when watching TV or using computer programs.
Teach your child self-advocacy skills. Encourage them to ask for help or use a signal when they are struggling to hear.


Speech therapy for auditory processing disorder
Speech therapy can be an incredible support for people with auditory processing disorder. In therapy, they can receive training to help them understand speech more clearly.
There are several types of direct skills that someone may practice during treatment for auditory processing disorder:
Auditory discrimination is often part of auditory processing disorder therapy. The person practices telling one sound from another (for example, the /b/ sound vs. the /p/ sound). This helps people tune out background noise and focus on key sounds.
Phoneme discrimination helps people identify the differences between sounds and words, and the meaning that those sounds carry. They might learn to recognize speech sounds that change word meanings (e.g., “bat” vs. “pat”). This helps with speech clarity and reading.
Auditory pattern recognition relates to noticing patterns in sounds, like musical rhythms in songs or syllable patterns.
Sound localization and lateralization helps the person better understand where a sound comes from. Practice can involve playing games like identifying sound locations while their eyes are closed.
How to find treatment for auditory processing disorder
If you think that you, your child, or your loved one might have symptoms of auditory processing disorder, don’t hesitate to contact your doctor. You can also speak with an audiologist or speech therapist.
Expressable is here to help you navigate next steps. Click here to find a speech therapist who’s experienced in treating auditory processing disorder. The sooner therapy begins, the sooner you’ll start seeing progress!