Attention Deficit Hyperactivity Disorder & Auditory Processing Disorder




Frustration with not being able to properly process verbal interactions with others leads to behavioral issues similar to those with the condition of Attention Deficit Disorder (ADD),  and in fact many with ADD overtly suffer from APD. Severe APD may be the cause for disassociation and lack of concentration and attention of those with ADD.



Symptoms A child with Auditory Processing Disorder (APD) 
1. Has difficulty listening for extended periods of time in school and “zones out”.

2. Does not respond to or has difficulty following verbal instructions.

3. Cannot communicate well in noisy environments.

4. Exhibits sound sensitivity and becomes easily stressed in noisy environments.

5. Has difficulty remembering information received verbally or through the written word.

6. Is over stimulated by or distracted by random noises.

7. Delayed speech.

8. Lack of attention and concentration.


9. Problems following verbal communications and directions.

10. Limited vocabulary.

11. Sound sensitivities. 

12. Agitated and easily distracted by noise.

13. Delayed reading skills.

14. Difficulty reading aloud.

15. Specific confusion with consonants and similar sounding words. 

16. Difficulty with colors, shapes, numbers, alphabet, etc. 



17. Letter and number reversals or transpositions.

18. Difficulty remembering facts.

19. Lack of mental flexibility and ability to learn new skills.

20. Other academic problems.

21. Problems grasping abstract concepts like the concept of time.

22. Slow development of fine motor skills and handwriting.
23. Underdeveloped balance and proprioception. 

24. Injury prone. 

25. Difficulty communicating their needs.

26. Disassociation and lack of empathy.

27. Frustration with other children.

28. Does not understand body language and facial expressions.

29. Difficulty making friends. 

30. Impulsive behavior.


Auditory processing disorder (APD) is a hearing problem that affects about 5% of school-aged children.


What Are the Signs & Symptoms of Auditory Processing Disorder?

Symptoms of APD can range from mild to severe and can take many different forms. If you think your child might have a problem processing sounds, ask yourself:

Is my child easily distracted or unusually bothered by loud or sudden noises?
Are noisy environments upsetting to my child?
Does my child's behavior and performance improve in quieter settings?
Does my child have trouble following directions, whether simple or complicated?
Does my child have reading, spelling, writing, or other speech-language difficulties?
Are verbal (word) math problems hard for my child?
Is my child disorganized and forgetful?
Are conversations hard for my child to follow?


APD is often misunderstood because many of its symptoms can happen with other problems, like learning disabilities, attention deficit hyperactivity disorder (ADHD), and even depression.

How Is Auditory Processing Disorder Diagnosed?

If you think your child is having trouble hearing or understanding when people talk, have an audiologist (hearing specialist) examine your child. Only audiologists can diagnose auditory processing disorder.


Audiologists look for five main problem areas in kids with APD:
Auditory figure-ground problems: This is when a child can't pay attention if there's noise in the background. Noisy, loosely structured classrooms could be very frustrating.


Auditory memory problems: This is when a child has trouble remembering information such as directions, lists, or study materials. It can be immediate ("I can't remember it now") and/or delayed ("I can't remember it when I need it for later").

Auditory discrimination problems: This is when a child has trouble hearing the difference between similar words or sounds (COAT/BOAT or CH/SH). This can affect following directions and reading, spelling, and writing skills, among others.


Auditory attention problems: This is when a child can't stay focused on listening long enough to complete a task (such as listening to a lecture in school). Kids with CAPD often have trouble maintaining attention, although health, motivation, and attitude also can play a role.


Auditory cohesion problems: This is when higher-level listening tasks are difficult. Auditory cohesion skills — drawing inferences from conversations, understanding riddles, or comprehending verbal math problems — need heightened auditory processing and language levels. They develop best when all the other skills (levels 1 through 4 above) are intact.
Because most tests done to check for APD require a child to be at least 7 or 8 years old, many kids aren't diagnosed until then or later.



At Home
Strategies applied at home and school can ease some of the problem behaviors associated with APD.

Kids with APD often have trouble following directions, so these suggestions may help:

Reduce background noise whenever possible at home and at school.
Have your child look at you when you're speaking.
Use simple, expressive sentences.
Speak at a slightly slower rate and at a mildly increased volume.
Ask your child to repeat the directions back to you and to keep repeating them aloud (to you or to himself or herself) until the directions are completed.
For directions that are to be completed later, writing notes, wearing a watch, or maintaining a household routine can help. So can general organization and scheduling.
It can be frustrating for kids with APD when they're in a noisy setting and need to listen. Teach your child to notice noisy environments and move to quieter places when listening is necessary.
Other tips that might help:
Provide your child with a quiet study place (not the kitchen table).
Maintain a peaceful, organized lifestyle.
Encourage good eating and sleeping habits.
Assign regular and realistic chores, including keeping a neat room and desk.
Build your child's self-esteem.


At School

It's important for the people caring for your child to know about APD. Tell teachers and other school staff about the APD and how it may affect learning. Kids with APD aren't typically put in special education programs, but you may find that your child is eligible for a 504 plan through the school district that would outline any special needs for the classroom.

Some things that may help:

changing seating plans so your child can sit in the front of the classroom or with his or her back to the window
study aids, like a tape recorder or notes that can be viewed online
computer-assisted programs designed for kids with APD
Stay in touch with school staff about your child's progress. One of the most important things that both parents and teachers can do is to acknowledge that APD is real. Its symptoms and behaviors are not something that a child can control. What the child can control is recognizing the problems associated with APD and using the strategies recommended both at home and school.
A positive, realistic attitude and healthy self-esteem in a child with APD can work wonders. And kids with APD can go on to be as successful as their classmates. Coping strategies and techniques learned in speech therapy can help them go far.

Source: KidsHealth



Jack Katz, Ph.D., Nancy Austin Stecker, Ph.D., and Donald Henderson, Ph.D., describe auditory processing as "what we do with what we hear” in Ce
ntral Auditory Processing: A Transdisciplinary View (1992). It is the ability of the brain (i.e., the central nervous system) to process incoming auditory signals.

Auditory Processing Disorder (APD), also called central auditory processing disorder (CAPD), happens when the brain is unable to process sounds. APD is the result of impaired neural function.

Individuals with APD have difficulties with sound localization—the ability to identify sound sources, specifically their ability to isolate a sound source in social environments.
APD is distinct from hearing loss. A person with APD can hear sounds; in fact, many have normal audiogram results. With APD, the way the brain translates those sounds is disrupted, resulting in jumbled messages.

Individuals with APD often are unable to hear sounds as words and have learning problems, including difficulty in reading, spelling, and language comprehension.
Those with APD have trouble distinguishing between words or syllables that sound alike (auditory discrimination) and recalling what they heard (poor auditory memory). They show delayed responses to verbal requests and instructions and often will ask someone to repeat what has been said.

Sources: Auditory Processing Center; Texas School for the Blind and Visually Impaired



In recent years, there has been a dramatic upsurge in professional and public awareness of Auditory Processing Disorders (APD), also referred to as Central Auditory Processing Disorders (CAPD). Unfortunately, this increase in awareness has resulted in a plethora of misconceptions and misinformation, as well as confusion regarding just what is (and isn't) an APD, how APD is diagnosed, and methods of managing and treating the disorder. The term auditory processing often is used loosely by individuals in many different settings to mean many different things, and the label APD has been applied (often incorrectly) to a wide variety of difficulties and disorders. As a result, there are some who question the existence of APD as a distinct diagnostic entity and others who assume that the term APD is applicable to any child or adult who has difficulty listening or understanding spoken language. The purpose of this article is to clarify some of these key issues so that readers are better able to navigate the jungle of information available on the subject in professional and popular literature today.


Terminology and Definitions

In its very broadest sense, APD refers to how the central nervous system (CNS) uses auditory information. However, the CNS is vast and also is responsible for functions such as memory, attention, and language, among others. To avoid confusing APD with other disorders that can affect a person's ability to attend, understand, and remember, it is important to emphasize that APD is an auditory deficit that is not the result of other higher-order cognitive, language, or related disorder.


There are many disorders that can affect a person's ability to understand auditory information. For example, individuals with Attention Deficit/Hyperactivity Disorder (ADHD) may well be poor listeners and have difficulty understanding or remembering verbal information; however, their actual neural processing of auditory input in the CNS is intact. Instead, it is the attention deficit that is impeding their ability to access or use the auditory information that is coming in. Similarly, children with autism may have great difficulty with spoken language comprehension. However, it is the higher-order, global deficit known as autism that is the cause of their difficulties, not a specific auditory dysfunction. Finally, although the terms language processing and auditory processing sometimes are used interchangeably, it is critical to understand that they are not the same thing at all.


For many children and adults with these disorders and others—including intellectual disabilities and sensory integration dysfunction—the listening and comprehension difficulties we often see are due to the higher-order, more global or all-encompassing disorder and not to any specific deficit in the neural processing of auditory stimuli per se. As such, it is not correct to apply the label APD to these individuals, even if many of their behaviors appear very similar to those associated with APD. In some cases, however, APD may co-exist with ADHD or other disorders. In those cases, only careful and accurate diagnosis can assist in disentangling the relative effects of each.


Diagnosing APD

Children with APD may exhibit a variety of listening and related complaints. For example, they may have difficulty understanding speech in noisy environments, following directions, and discriminating (or telling the difference between) similar-sounding speech sounds. Sometimes they may behave as if a hearing loss is present, often asking for repetition or clarification. In school, children with APD may have difficulty with spelling, reading, and understanding information presented verbally in the classroom. Often their performance in classes that don't rely heavily on listening is much better, and they typically are able to complete a task independently once they know what is expected of them. However, it is critical to understand that these same types of symptoms may be apparent in children who do not exhibit APD. Therefore, we should always keep in mind that not all language and learning problems are due to APD, and all cases of APD do not lead to language and learning problems. APD cannot be diagnosed from a symptoms checklist. No matter how many symptoms of APD a child may have, only careful and accurate diagnostics can determine the underlying cause.


A multidisciplinary team approach is critical to fully assess and understand the cluster of problems exhibited by children with APD. Thus, a teacher or educational diagnostician may shed light on academic difficulties; a psychologist may evaluate cognitive functioning in a variety of different areas; a speech-language pathologist may investigate written and oral language, speech, and related capabilities; and so forth. Some of these professionals may actually use test tools that incorporate the terms "auditory processing" or "auditory perception" in their evaluation, and may even suggest that a child exhibits an "auditory processing disorder." Yet it is important to know that, however valuable the information from the multidisciplinary team is in understanding the child's overall areas of strength and weakness, none of the test tools used by these professionals are diagnostic tools for APD, and the actual diagnosis of APD must be made by an audiologist.


To diagnose APD, the audiologist will administer a series of tests in a sound-treated room. These tests require listeners to attend to a variety of signals and to respond to them via repetition, pushing a button, or in some other way. Other tests that measure the auditory system's physiologic responses to sound may also be administered. Most of the tests of APD require that a child be at least 7 or 8 years of age because the variability in brain function is so marked in younger children that test interpretation may not be possible.


Once a diagnosis of APD is made, the nature of the disorder is determined. There are many types of auditory processing deficits and, because each child is an individual, APD may manifest itself in a variety of ways. Therefore, it is necessary to determine the type of auditory deficit a given child exhibits so that individualized management and treatment activities may be recommended that address his or her specific areas of difficulty.



Treating APD

It is important to understand that there is not one, sure-fire, cure-all method of treating APD. Notwithstanding anecdotal reports of "miracle cures" available in popular literature or on the internet, treatment of APD must be highly individualized and deficit-specific. No matter how successful a particular therapy approach may have been for another child, it does not mean that it will be effective for your child. Therefore, the key to appropriate treatment is accurate and careful diagnosis by an audiologist.


Treatment of APD generally focuses on three primary areas: changing the learning or communication environment, recruiting higher-order skills to help compensate for the disorder, and remediation of the auditory deficit itself. The primary purpose of environmental modifications is to improve access to auditorily presented information. Suggestions may include use of electronic devices that assist listening, teacher-oriented suggestions to improve delivery of information, and other methods of altering the learning environment so that the child with APD can focus his or her attention on the message.


Compensatory strategies usually consist of suggestions for assisting listeners in strengthening central resources (language, problem-solving, memory, attention, other cognitive skills) so that they can be used to help overcome the auditory disorder. In addition, many compensatory strategy approaches teach children with APD to take responsibility for their own listening success or failure and to be an active participant in daily listening activities through a variety of active listening and problem-solving techniques.


Finally, direct treatment of APD seeks to remediate the disorder, itself. There exist a wide variety of treatment activities to address specific auditory deficits. Some may be computer- assisted, others may include one-on-one training with a therapist. Sometimes home-based programs are appropriate whereas others may require children to attend therapy sessions in school or at a local clinic. Once again, it should be emphasized that there is no one treatment approach that is appropriate for all children with APD. The type, frequency, and intensity of therapy, like all aspects of APD intervention, should be highly individualized and programmed for the specific type of auditory disorder that is present.


The degree to which an individual child's auditory deficits will improve with therapy cannot be determined in advance. Whereas some children with APD experience complete amelioration of their difficulties or seem to "grow out of" their disorders, others may exhibit some residual degree of deficit forever. However, with appropriate intervention, all children with APD can learn to become active participants in their own listening, learning, and communication success rather than hapless (and helpless) victims of an insidious impairment. Thus, when the journey is navigated carefully, accurately, and appropriately, there can be light at the end of the tunnel for the millions of children afflicted with APD.


Key Points:

APD is an auditory disorder that is not the result of higher-order, more global deficit such as autism, intellectual disabilities, attention deficits, or similar impairments.
Not all learning, language, and communication deficits are due to APD.
No matter how many symptoms of APD a child has, only careful and accurate diagnosis can determine if APD is, indeed, present.

Although a multidisciplinary team approach is important in fully understanding the cluster of problems associated with APD, the diagnosis of APD can only be made by an audiologist.
Treatment of APD is highly individualized. There is no one treatment approach that is appropriate for all children with APD.

Source: American Speech-Language-Hearing Association (ASHA) 

Find an audiologist in your area at 1-800-638-8255




Sensory Auditory Processing Tools & Toys



Snug Kids Earmuffs/Hearing Protectors – Adjustable Headband Ear Defenders for Children and Adults
Little ears need protection from the high frequency and loud noises that come with crowds, sporting events, fireworks, monster trucks, or even everyday household items like a lawn mower, edger, or vacuum cleaner. Snug ear muffs muffle any intense sound around.
Unlike some ear muffs that don't rotate or adjust, Snug ear muffs hug little ears with a soft padded headband and a skin-friendly breathable plush ear pad. These ear defenders give all-day comfort without feeling squeezed. Fits on a wide range of ages, may fit on some adults.


The b-Calm GP system with AudioSedation functions as an “acoustic shield”, allowing the individual to have control of the sound environment, and helping reduce off task behaviors and irritability. Individuals will love how disturbing noises are blocked and replaced with familiar and soothing sounds from nature and the world around them. Options of headphones or earbud style headphones allow an individual to blend in with their peers, rather than looking different or standing out in an awkward way. We all deserve quality of life. The b-Calm system has been developed as practical intervention tools designed to relax and calm those with mental stress caused by sensory challenges – thus supporting quality of life for those diagnosed with Autism, ADHD and other disabilities, as well as their family members. 


Blue Toobaloo Auditory Feedback Phone - Accelerate Reading Fluency, Comprehension and Pronunciation with a Reading Phone.
Ease reading, speech, comprehension and pronunciation challenges with the Toobaloo. Created by a teacher, the Toobaloo is an educational tool designed to provide auditory feedback which helps children learn to read, increase fluency and comprehension and meet special needs such as autism, APD, stuttering and dyslexia.

By speaking into the Toobaloo, children hear themselves (auditory feedback) and can make adjustments to fluency, pronunciation and even increase comprehension.

WhisperPhone is a hands-free, acoustical headset that helps children and adults focus and hear the individual sounds of words more clearly as they learn to read, spell and process language aloud. This hands-free, acoustical voice-feedback headset helps children hear phonemes, the sounds that compose words. Phonemic awareness is a key predictor of literacy success, according to the National Reading Panel. Reading has a strong auditory foundation. That is why students learning to read "sound-it-out" and read aloud. A 2003 test conducted by two universities showed the signal-to-noise ratio increased 10-fold with the use of WhisperPhone.


Forbrain Auditory Feedback Headphones with Bone Conduction Technology - Tool to Enhance Speech Memory and Attention - Used by Singers Vocalists Kids with Autism ADD ADHD Speech Delays
FORBRAIN headphones leverage high frequency vibration to help the user create and process sound. The patented electronic dynamic filter blocks out environmental noise—isolating and amplifying the user’s voice, giving the nervous system a solid sensory workout. It also enhances long vowels and other sounds critical to the construction of language. The resulting sound is delivered through the bones and bone conduction, not the ears or air conduction, to the nervous system and brain.
What are the benefits of Forbrain?
Attention: Forbrain's dynamic filter trains the brain to be more attentive improving not only attention but auditory processing and sensory integration.



Hamilton Buhl HG26B NoiseOff Lightweight Hearing Protection
When it comes to reading a favorite book, studying, focusing on important work, or simply looking to unwind, turning off the noise as well as the hustle and bustle can help create the ideal environment for the task at hand.
Ideal for on/off situations where noise comes and goes, NoiseOff enables strain-free conversations in noisy environments without the need to remove the unit to hear. Beyond reducing noise, NoiseOff creates a peaceful environment, reducing stress levels and helping increase concentration and focus. NoiseOff Is The Essential Device For Kids With Special Needs And On The Autistic Spectrum. 

Muted Designer Hearing Protection for Infants & Kids - Adjustable Children's Ear Muffs from Toddler to Teen
Children's hearing protection that is not just functional, but fashionable too. Our earmuffs are rated up to 27 decibels and meet ANSI requirements. Adjustable head band and cushioned ear cups ensure a perfect fit. Ideal for sporting events, concerts or everyday loud noises in a stylish pattern that any child would love to wear. Muted's unique patterns and colors will match even the most demanding kids' style. 

Muted Designer Hearing Protection for Infants & Kids - Adjustable Children's Ear Muffs from Toddler to Teen
Children's hearing protection that is not just functional, but fashionable too. Our earmuffs are rated up to 27 decibels and meet ANSI requirements. Adjustable head band and cushioned ear cups ensure a perfect fit. Ideal for sporting events, concerts or everyday loud noises in a stylish pattern that any child would love to wear. Muted's unique patterns and colors will match even the most demanding kids' style.