What is Auditory Processing Disorder?
Auditory Processing Disorder (APD) is a neurological disorder that affects how the brain processes auditory information. Individuals with APD often struggle to understand and interpret sounds, particularly in complex or noisy environments. This can lead to difficulties in following instructions, comprehending spoken language, and participating in conversations.
If you are searching for an audiologist for auditory processing disorder near Austin or the Hill Country, our Lakeway office offers comprehensive testing and clear explanations -- so you understand both auditory processing disorder symptoms and next steps.
On a standard hearing evaluation, someone with APD will have normal test results despite their reported inability to hear well. This is because a standard hearing test only evaluates the ear canal, middle ear space and cochlea. But this is just the start of the auditory system!
Once the sound has made it to the auditory nerve, it travels through the brain for processing. The central auditory system is a very complex system that preserves, refines, analyzes, modifies, organizes, and interprets information from the ears. If this system is not working properly it can result in difficulty interpreting sounds in complex auditory input, such as rapid speech, speech in noise, and long bouts of speech.
The 4 Types of Auditory Processing Disorder
Decoding
Difficulty quickly and accurately digesting and organizing auditory information. May struggle with understanding complex or rapidly presented speech, and recognizing subtle differences in sounds.
Tolerance Fading Memory (TFM)
Struggle with auditory memory and the ability to retain and recall auditory information over time. Difficulty remembering multi-step instructions, especially in the presence of background noise.
Organization
Difficulty organizing and producing verbal output, following oral instructions in order, and formulating coherent responses. Typically occurs with decoding and/or TFM deficits.
Integration
Difficulty performing auditory tasks alongside other tasks, since bringing information together across multiple processing centers is challenging -- for example, coordinating movement with sound cues.
APD in Children
Some studies suggest that APD affects around 2-7% of school-aged children. However, other research indicates higher rates, with prevalence estimates ranging from 5% to as high as 20% in certain populations. APD affects boys more than girls at a ratio of approximately 2:1.
Learn more about our pediatric audiology services.
APD in Adults
Auditory processing disorder in adults is more common than many realize. In adults over 55, the prevalence of APD is estimated to be 23-76%. Age-related changes in the central auditory system can lead to auditory processing issues even when hearing sensitivity remains normal on a standard hearing test.
Adults with APD often struggle in meetings, on phone calls, and in restaurants despite "passing" a basic hearing exam. When hearing loss is also present, hearing aids combined with auditory training can improve both amplification and the brain's ability to process speech.
What Causes APD?
The cause of APD may be linked to a specific condition, or may be unknown. Common causes and risk factors include:
Genetics
Neurological Disorder or Injury
Prenatal / Neonatal Factors
Ear Disease or Injury
Age-Related Changes
Auditory Deprivation
Auditory Processing Disorder Symptoms
If you or your child experiences several of these, an APD evaluation may be recommended:
- Difficulty localizing or pinpointing the source of sounds
- Problems with speech sound discrimination
- Mishearing or misinterpreting spoken language
- Fatigue easily when listening
- Easily distracted by sounds
- Difficulty understanding speech in noise
- Difficulty when multiple people are talking
- Struggles processing rapid speech
- Trouble following multi-step instructions
- Attention difficulties
- Challenges recalling information heard orally
- Trouble with reading, spelling, and language tasks
- Poorer performance in language than math/science
- Issues with organizing auditory information
ADHD, Autism, and Auditory Processing Disorder
APD can coexist with other conditions. Understanding the differences helps ensure the right diagnosis and treatment.
Dyslexia vs. APD
Dyslexia
- Difficulty manipulating language verbally and/or when reading and spelling
- Difficulty with phonological processing
- Fatigue easily when reading
- Difficulty processing what they read
- Difficulty following written directions
- May spell words phonetically but far from correct (e.g., frens/friends)
APD
- Difficulty processing sound
- Difficulty recognizing subtle differences in sounds (e.g., short -i- vs short -e-)
- Fatigue easily when listening
- Need more time to process information heard
- Poor listening skills
- Academic difficulties especially in language
- Difficulty following directions orally
- Spelling errors tend to be omissions or wrong sounds (e.g., blump/blunt)
ADHD vs. APD
ADHD
- Inattentive
- Distracted
- Hyperactive
- Fidgety/restless
- Hasty/impulsive
- Interrupts/intrudes
APD
- Difficulty hearing in background noise leading to perception of inattentiveness
- Difficulty following oral directions
- Poor listening skills
- Academic difficulties especially in language
- Poor auditory association skills
- Distracted
- Inattentive
There is a higher prevalence of APD among children with ADHD, and vice versa. It is also possible for a child with APD to be misdiagnosed with ADHD because their inability to understand what is being said can be seen as inattentiveness.
Other Conditions That May Co-Occur With APD
Autism Spectrum Disorder
Sensory processing issues, including auditory processing difficulties, are often observed in individuals on the autism spectrum.
Developmental Coordination Disorder
Conditions such as dyspraxia can co-occur alongside APD.
Speech Sound Disorders
Difficulties with articulation or phonological processing.
Learning Disabilities
Difficulties with reading, writing, or math that may overlap with auditory processing challenges.
Sensory Processing Disorder
Difficulties processing and integrating sensory information, including auditory input.
While APD can co-occur with other conditions, not every individual with APD will have comorbidities. Each case is unique, requiring a thorough evaluation by professionals like audiologists, speech-language pathologists, or psychologists to accurately assess and diagnose these conditions.
Frequently Asked Questions
An auditory processing disorder test -- sometimes called a test of auditory processing -- evaluates how your brain handles sound after it leaves the ear. It includes specialized listening tasks (often after a full hearing evaluation) and helps distinguish APD from hearing loss, attention issues, and language disorders.
APD means the auditory system detects sounds adequately, but the brain struggles to decode, organize, or remember auditory information. It is related to auditory processing issues in the central pathways, not just volume or clarity at the ear.
People with APD often report trouble in noise, fatigue when listening, difficulty following directions, and mishearing words -- see our symptom checklist above. In adults, this may show up as difficulty on the phone or in meetings; in children, school performance and listening in the classroom are common concerns.
ADHD and auditory processing can overlap: poor listening in noise can look like inattention. Auditory processing disorder and autism may also co-occur with sensory differences. Testing helps clarify whether listening challenges are primarily auditory processing, attention, language, or a combination -- so intervention matches the diagnosis.
Golden Ears Audiology performs APD evaluations at 1008 Ranch Rd 620 S, Suite 203, Lakeway TX 78734, serving Austin, Bee Cave, Westlake, Spicewood, Steiner Ranch, and Central Texas. Call (512) 222-6880 or schedule online.
Further reading: APD vs ADHD in the classroom · When speech-in-noise scores suggest APD
Schedule Your APD Evaluation
Book
Schedule a 90-minute appointment online or by phone.
Test
Full hearing evaluation followed by processing testing in the sound booth.
Results
Preliminary results same day, with a formal review call the following week.
Insurance Accepted: We accept most major insurance plans for APD evaluations. Contact us to verify your coverage and we'll help you understand your benefits.
Already diagnosed? Learn about our APD treatment options including auditory training, compensatory strategies, and care management. We also offer pediatric audiology services and speech-in-noise testing.
APD Treatment Options
Treatment for auditory processing disorder may include auditory training, speech therapy, use of hearing aids or assistive listening devices to improve sound clarity, and educational support like visual aids. Learn more about our full range of auditory processing disorder treatments and how we address auditory processing issues in both children and adults.