What is an auditory processing disorder (APD)?

Auditory Process Disorder Testing ExpertsIn the very broadest sense, APD (auditory process disorder) refers to how the central nervous system (CNS) uses auditory information.  In other words, what the brain does with what it hears.  In recent years, many misconceptions have developed in regard to APD. It is important to emphasize that APD is an auditory deficit that is not the result of other higher-order cognitive, language, or related disorder.

There are many disorders that can affect a person's ability to understand auditory information. For example, individuals with Attention Deficit/Hyperactivity Disorder (ADHD) may well be poor listeners and have difficulty understanding or remembering verbal information; however, their actual neural processing of auditory input in the CNS is intact. Instead, it is the attention deficit that is impeding their ability to access or use the auditory information that is coming in. Similarly, children with autism may have great difficulty with spoken language comprehension. However, it is the higher-order, global deficit known as autism that is the cause of their difficulties, not a specific auditory dysfunction. Finally, although the terms language processing and auditory processing sometimes are used interchangeably, it is critical to understand that they are not the same thing at all.

 

Children with APD may exhibit a variety of listening and related complaints.

  • Difficulty understanding speech in noisy environments
  • Following directions
  • Discriminating (or telling the difference between) similar-sounding speech sounds
  • Sometimes they may behave as if a hearing loss is present, often asking for repetition or clarification.
  • In school, children with APD may have difficulty with spelling, reading, and understanding information presented verbally in the classroom.
  • Often their performance in classes that don't rely heavily on listening is much better
  • They typically are able to complete a task independently once they know what is expected of them
  • However, it is critical to understand that these same types of symptoms may be apparent in children who do not exhibit APD. Therefore, we should always keep in mind that not all language and learning problems are due to APD, and all cases of APD do not lead to language and learning problems. APD cannot be diagnosed from a symptoms checklist. No matter how many symptoms of APD a child may have, only careful and accurate diagnostics can determine the underlying cause.

A multidisciplinary team approach is critical to fully assess and understand the cluster of problems exhibited by children with APD. Thus, a teacher or educational diagnostician may shed light on academic difficulties; a psychologist may evaluate cognitive functioning in a variety of different areas; a speech-language pathologist may investigate written and oral language, speech, and related capabilities; and so forth. Some of these professionals may actually use test tools that incorporate the terms "auditory processing" or "auditory perception" in their evaluation, and may even suggest that a child exhibits an "auditory processing disorder." Yet it is important to know that, however valuable the information from the multidisciplinary team is in understanding the child's overall areas of strength and weakness, none of the test tools used by these professionals are diagnostic tools for APD, and the actual diagnosis of APD must be made by an audiologist.

How do you diagnose APD?

To diagnose APD, the audiologist will administer a series of tests in a sound-treated room. These tests require listeners to attend to a variety of signals and to respond to them via repetition, pushing a button, or in some other way. Other tests that measure the auditory system's physiologic responses to sound may also be administered. Most of the tests of APD require that a child be at least 7 years of age because the variability in brain function is so marked in younger children that test interpretation may not be possible. APD screening can be performed with children as young as 5 years of age.

Can  APD be treated?

Yes. Once a diagnosis of APD is made, the nature of the disorder is determined. There are many types of auditory processing deficits and, because each child is an individual, APD may manifest itself in a variety of ways.

Treating APD

It is important to understand that there is not one, cure-all method of treating APD.  Treatment of APD generally focuses on three primary areas: changing the learning or communication environment, recruiting higher-order skills to help compensate for the disorder, and remediation of the auditory deficit itself.

Key Points:

  • APD is an auditory disorder that is not the result of higher-order, more global deficit such as autism, mental retardation, attention deficits, or similar impairments.
  • Not all learning, language, and communication deficits are due to APD.
  • No matter how many symptoms of APD a child has, only careful and accurate diagnosis can determine if APD is, indeed, present.
  • Although a multidisciplinary team approach is important in fully understanding the cluster of problems associated with APD, the diagnosis of APD can only be made by an audiologist.
  • Treatment of APD is highly individualized. There is no one treatment approach that is appropriate for all children with APD

Does insurance cover this test?

In some cases, insurance does not cover Auditory Processing Testing. We do not bill insurance for this test. We will be happy to provide you with the information that you need to file yourself.

Resources:

Understanding Auditory Processing Disorders in Children
www.asha.org/public/hearing/disorders/understand-apd-child.htm

National Coalition on Auditory Processing Disorders
www.ncapd.org