On occasion, most of us have experienced being unable to understand instructions we needed to hear. Perhaps the speaker mumbled, the audio equipment distorted the sound or there was too much background noise. Despite concentrating very hard, we missed large portions of what was said, and ended up not knowing what to do.

Now imagine that when the speaker finished, everyone else who was listening started to act on the instructions.

Suppose every day in school were like that — wouldn't it be hard to keep up?

A student with an Auditory Processing Disorder (APD) continually faces challenges with listening in the classroom. Children with an APD (sometimes known as Central Auditory Processing Disorder) can have difficulty following directions, absorbing a lecture or answering verbal questions — often to the point where they stop paying attention altogether.

Indicators

An APD doesn’t mean the child’s physical ability to hear is impaired: the sounds hit the eardrum and are conveyed to the brain just fine. However, with APD, one or more aspects of the listening process, in which the brain analyzes and interprets the audio signal, aren't functioning properly.

Among the possible problem areas: Separating background noise from the important sounds, being able to distinguish between similar-sounding words, discerning where particular sounds are coming from, being able to fill in what was said if short gaps were inaudible, and remembering all that was said.

Additional indicators of APD are when there’s a pattern of losing track of a conversation, misinterpreting what's said, and being easily distracted by noise. Also, a person with APD may talk a lot, as a way to minimize the time he or she has to listen.

Possible Causes

Estimates vary that anywhere from 3 to 20 percent of the population have an Auditory Processing Disorder. It is more common in boys than girls.

Among the risk factors for APD are traumatic birth, severe illness in early infancy and a family history of APD. Many experts believe that frequent or lengthy middle ear infections also can be a contributing factor.

Similarity to ADHD

To a classroom observer, APD symptoms can be hard to distinguish from those of Attention Deficit/Hyperactivity Disorder (ADHD). Students with either disorder have difficulty paying attention and following instructions.

The difference is that a student with ADHD can comprehend what the teacher is saying, once the teacher has his or her attention. A student with APD may not fully comprehend what’s being said even if the teacher does have his or her attention.

Similarly, the student with ADHD has difficulty following directions due to poor executive functioning in the brain. The student with APD may have good executive brain function, but can’t follow directions well because he or she didn’t fully understand them.

Both disorders may affect a child’s memory, comprehension, reading, spelling, relationships, confidence and well-being. APD can impact reading and spelling because the student is likely to have weaknesses with phonics.

Diagnosis and Coping Strategies

Since the warning symptoms are variable, APD is not easily diagnosed. Onlookers should therefore resist jumping to conclusions about who has the disorder. An audiologist or other professional with specialized training would have to perform several tests and assess extensive background information about the patient before making a diagnosis.

As with learning disabilities and other processing disorders, diagnosis and follow-through at a younger age lead to better outcomes later in life.

However, it’s never too late to get help. Teens and adults who are suspected of having APD can still benefit from proper diagnosis, treatment, and use of coping strategies.

A student with APD can benefit from adaptations and modifications used in the classroom, including seating adjustments, the use of cues and multisensory approaches to teaching. These strategies can be part of the student’s 504 plan or IEP.

Beyond accommodations, there are therapies that can actually improve a person's ability to process auditory information. Therapy may be available from specially trained audiologists, clinicians or other centers that help students with learning disabilities. To be effective, the therapy often must be tailored to the individual’s specific deficits.

Learning more about APD is the first step in recognizing what might be behind a student's poor listening skills. Proper diagnosis, interventions and even treatment can lead to a brighter future in academics and in life.