Auditory Processing Disorder

Auditory Processing Disorder (APD), also known as Central Auditory Processing Disorder (CAPD), is a disorder that affects the link between auditory information and the Central Nervous System. Auditory Processing is the process of the brain understanding, interpreting and categorising information from the sounds around us. Auditory Processing Disorder occurs when there is a deficit in this neural processing of auditory stimuli.

The ear perceives sound through the cochlea which decodes every sound we hear, and the vestibular system which is the centre for sensory integration and motor control. Auditory Processing Disorder is the brain's inability to process the meaning of sound and recognising the difference between sounds.

It is often present from early childhood which may lead to difficulties into adulthood. Those living with Auditory Processing Disorder rarely have a hearing impairment but are unable to process the meaning of sound correctly.

There are different types of Auditory Processing Disorder, and it’s important to differentiate and understand these to accurately diagnose and treat. These include:

Associative Deficit – Difficulty in associating sounds with written language. These individuals have good sound discrimination but poor ability to recognise whole words.

Auditory Decoding Deficit – Difficulty in recognising sounds and decoding the words being spoken. They process information inaccurately and slowly, words may be misheard or confused, and rules for grammar are poorly remembered.

Auditory Integration Deficit – Difficulty understanding words as a whole, which leads to poor spelling and word recognition. They may have a problem listening to directions and performing the task and tend to wait for others to complete a task so they can gauge how to do it themselves.

Organisational Deficit – Difficulty with sequenced information, i.e. step by step tasks or directions. They may successfully receive auditory signals but do not organise them in a meaningful way to enable an appropriate response. Their ability to generate a response to information that is given verbally may also be affected.

Prosodic Deficit – Inability to modulate their voice to reflect rhythm, tone or stress, and not perceiving these subtleties in other speakers. This may cause them to experience social problems due to their difficulty to communicate efficiently.

Auditory Hypersensitivity – Inability to selectively ignore background sounds. This failure to discriminate between the many sources of sound can cause learning difficulties especially at school where they can have trouble listening to the teacher while noise is happening around them. It may also cause anxiety or meltdowns.

Diagnosing and learning how to teach those living with Auditory Processing Disorder is important as it may cause slow development in learning, speech and language. To be diagnosed it is important to make an appointment with an Audiologist who will first take a routine hearing test. Once a hearing problem has been ruled out, the Audiologist will assess central auditory function by giving a Behavioural test or Electrophysiological test.

Once diagnosed with Auditory Processing Disorder the Audiologist may implement training programs to help improve the lives of individuals living with APD. These include:

Dichotic Auditory Training – Dichotic Interaural Intensity Difference training is a procedure where stimuli such as words and numbers with differing volume intensity swap between the left and right ears to strengthen the auditory pathways.

Speech, Language and Audio-vocal exercises – Pre-recorded audio-vocal exercises that can be listened to and repeated.

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