Auditory Processing Disorder

In Adults and Children

People in a classroom

Does This Sound Like You or a Loved one?

  • Trouble Listening (noticed for a period of time)
  • Mishearing/discrimination problems
  • Problems following directions
  • Problems attending to oral message
  • Distracted by background noise
  • Poor organization of verbal material
  • Oral and written expression problems
  • Remembering what they hear
  • Difficulty learning to read
frustrated woman on laptop

What is Auditory Processing Disorder (APD)?

Gears formed like a brain

APD refers to the transmission of sound beyond the peripheral portion of the auditory system (beyond the ear canal, middle ear, inner ear and auditory) through the midbrain before the signal reaches the brain’s cortex and specific cortical language centers. It has much to do with how we listen in auditory challenging circumstances, e.g., listening to instructions and directions, listening to rapid speech, listening in noise, listening to competing information, when sorting out and clarifying words, intonation, inflections, sequences, rhythm, etc. APD assessment, according to American Speech-Language Hearing Association (ASHA) task force on central auditory processing, defines APD as poor performance on one or more of the following skills:

  • Localization of sound
  • Discrimination of differences in sounds
  • Distinguishing temporal (timing) aspects of sounds
  • Identifying auditory patterns
  • Recognizing information presented with competing background noise
  • Distinguishing auditory information that has been degraded

Testing aims to examine numerous components of auditory processing and compares an individual’s scores on standardized and normed tests to scores of same age peers. All components of tests administered incorporate examples of auditory processing occurring in our daily lives. We use the patient’s verbal responses to auditory stimuli to assess functional capabilities of the auditory system.

An auditory processing disorder (APD) is an inability to attend to, discriminate, recognize, or understand information that is presented auditorily (by listening). For many adults and children hearing test results (the booth Beep test) are within normal or near normal limits and there typically is no diagnosis of hearing loss. This may also be a factor in “hidden hearing loss” and minimal hearing losses.

APD affects approximately 43% of school-aged children struggling in school as well as adults of all ages. It is common for younger and middle-aged adults to notice symptoms of APD in specific listening situations such as the college classroom, work, and noisy social environments, and realize later in life the struggles they had growing up. It can affect those that have had traumatic brain injury and those who wear hearing aids and complain they still have difficulty understanding conversations. APD can be mistaken or occur alongside ADHD or Dyslexia.

An individual with APD may have some or all of the following symptoms:

  • Responds inconsistently to sounds
  • Short attention span
  • Easily distracted by auditory and visual stimuli
  • Have difficulty telling where sound is coming from
  • Become upset by loud sounds
  • Frequently request that information be repeated
  • Have difficulty with phonics
  • Have a tough time remembering things they have learned auditorily
  • Have a significant history of chronic otitis media (ear infections)
  • Have trouble finding the source of sounds
  • Difficulty hearing in groups

Common Myth: An Auditory Processing Disorder is a hearing problem.

Fact: The act of hearing does not end with mere detection of an acoustic stimulus. Rather, several neurophysiological and cognitive mechanisms and processes are necessary for an accurate decoding of auditory input. Much of what is considered auditory processing is preconscious; that is, it occurs without the listener being aware of it.

Family reading

A person with APD may also exhibit these behaviors:

  • Says “huh?” and “what?” throughout the day
  • Seems to hear but not understand what people say
  • Difficulty finding the source of sounds
  • Difficulty hearing in groups
  • Poor speech or language skills
  • Difficulty distinguishing between words that sound alike
  • Difficulty following verbal instructions
  • Poor reading/phonics/spelling skills
  • Is disorganized
  • Becomes anxious or stressed when required to listen
Children Learning

Common Myth: Children under seven cannot be evaluated for an Auditory Processing Disorder.

Fact: For a child to read or spell, he or she must be able to detect and recognize sounds, discriminate them from other sounds, and understand how these sounds, when analyzed and synthesized, result in associated words.

Research indicates that identifying young children at risk for an Auditory Processing Disorder as early as possible leads to intervention and support that can prevent later language, learning, and reading disorders. At Hearing Resources Audiology Center, we can screen auditory skills in children 3-6 years old who are typically not tested in these areas yet could benefit from early intervention.

How is APD different from hearing loss?

Hearing loss is damage typically located in the ear. Hearing loss creates difficulty understanding speech because certain speech sounds are not loud enough. Those with APD can typically hear all the sounds of speech at normal loudness, but still have difficulty understanding speech.
They may have difficulty grasping how someone can hear all the sounds of speech but may not be able to understand the meaning of the spoken message.

What can be done if APD is diagnosed?

Some benefit from speech and language therapy, which is specifically designed to meet each individual’s needs. Others are helped by auditory therapy. Evaluating home and work settings may be helpful to some to improve communication access. Some benefit from the use of hearing aids.  Treatment for everyone is different and depends on the specific type of auditory processing problems that the person is having.

sound wave

We are currently equipped to test:

Adults, Children ages 5 years and up, and Screen children as young as 3.5 years.

We offer APD therapy service with Speech Therapists that work through our office ( and closely with Speech Therapists outside our office.

Testing Includes:

  • Complete audiologic evaluation (diagnostic hearing test)
  • Dichotic Listening Tasks (tests that require the listener to use and integrate different information presented to each ear simultaneously)
  • Speech in noise tests
  • Tests that use degraded or filtered speech in order to assess auditory closure abilities.
  • Tests that measure the ability to use timing or temporal cues of speech.
Come See Us

Your Hearing is Important To Us

Schedule a consultation with us to see if an Auditory Processing Evaluation is your next step.


4311 NE Tillamook St
Portland, OR 97213
Phone: (503) 774-3668
Fax: (503) 774-7247


Tuesday 9-5

Wednesday 10-6:30

Thursday 10-6:30

Friday 10-4