Auditory Processing Disorder

What exactly is auditory processing disorder?

APD means having problems with hearing without the ear being damaged. Poor hearing results from the fact that what is heard is not transmitted between the inner ear and the brain. 

How does the disorder work?

How the disorder “works” has been widely researched and is also the basis of today's treatment concepts. Doctors are still unsure of where the disorder comes from, but is suspected to begin in childhood, therefore it is ideally treated in children. If auditory and / or visual perception disorders are suspected in a child, it makes sense to discuss this with the pediatrician as early as possible, because early therapy improves a child's ability to develop optimally.For adults, the first point of contact is a  hearing care professional and then the  ENT doctor. For children it is the pediatrician and then usually a phoniatrist or a pediatric audiologist

Causes: How does APD develop?

The question of how APD develops remains to this day. There are different approaches, but an auditory processing disorder is always linked to the area of the brain processing sounds. Theories exist which believe that there is a disturbance in the temporal processing of what is heard in the brain or other processing disorders that have to do with the distinction between certain sounds.

Auditory processing disorder symptoms

Since APD usually already exists in childhood, it is worth monitoring children closely if they show possible symptoms. It is worth nothing that boys are affected by AVWS twice as often as girls. Typical APD symptoms in children are:

  • The children confuse similar sounds.
  • They are very sensitive to volume when exposed to ambient noise.
  • They have problems recognizing the direction from which noise is coming. 
  • When there is noise, they have difficulty concentrating. 
  • It is difficult for them to remember what they have heard (particularly noticeable with rhymes).

Of course, the auditory processing disorder symptoms in adults are similar. Most of the time, adults have already developed their own techniques to improve their understanding of language. Similar hearing problems often appear for the first time in old age. A processing disorder can then be a disorder that results from a weakening of the nerves to process what is heard. The symptoms of APD are similar to those of naturally deteriorating hearing. Only an otolaryngologist can check the exact cause.

APD Diagnostic Test

The APD diagnosis is based first of all on the fact that the doctor determines that the problem is not in the hearing performance of the ear. That is why every APD test begins with a hearing test. If it is found that the inner ear is intact, various other tests follow. For adults, it continues with an APD questionnaire that covers various listening situations. Pediatric audiologists who work closely with speech therapists take care of this for children.

Use our online hearing test to get a first impression of your difficulty understanding speech with background noise. Of course, this is not an online APD test, but only a first check of your own hearing.

APD treatment: speech therapy and exercises

Several therapy programs have been developed especially for children, which are mostly carried out by speech therapists, but also by occupational therapists. It often also includes auditory perception disorder exercises, which are carried out on the computer and which are intended to train certain sound perceptions. APD therapy material can also be made available at home. Particular attention is paid to phoneme discrimination, i.e. the ability to distinguish similar sounds.

APD is not curable. For this reason, replacement strategies are also practiced in auditory perception disorder treatment for example in order to remember better. The APD exercises are primarily designed to give children equal development opportunities and reduce problems in school. APD therapy helps children develop their own ways of dealing with the disorder. Even if it is not curable, children can usually handle it well.

Hearing aids that can suppress noise can be helpful for children and adults with auditory perception disorder. An FM system (frequency modulation system) is connected to the hearing aid, which picks up the noise via microphone and filters background noise using computer control and clearly processes the speech.

Auditory processing disorder in children

The consequences of APD can include difficulties in everyday life. Speech disorders in childhood are a particular problem. However, the symptoms are often mixed and / or confused with an attention deficit disorder (ADD or ADHD). It is therefore worthwhile to see different doctors if you feel that hearing may be a problem for your child. Even if the first otolaryngologist detects intact hearing and does not suggest any other solutions, the next best step is an appointment with a pediatric audiologist. APD is not a disability, but a partial performance disorder.

APD can have a substantial impact on school performance. Auditory perception disturbance in toddlers can still be compensated for by calm, clear speech by the parents. In primary school it becomes particularly stressful for the child, as it is usually particularly loud in the classrooms in the early school years. Nevertheless, there are various ways in school to improve the situation for your child:

  • Explain the auditory perception disorder to the teachers. 
  • Make it clear that APD in children is not curable and that therapy for auditory perception disorder in children includes replacement strategies.
  • Ask whether your child can use a microphone and headphones to facilitate their hearing.
  • Ask for a seat for your child where the "better" ear always points to the teacher.
  • Encourage your child to let you know if classroom hearing is poor.
  • Encourage the teacher to change her communication towards your hearing impaired child.
  • Ask the teacher to make important announcements (tasks, appointments) facing your child. With a little help, your child will be able to follow the lessons well.

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