Auditory Processing Disorder (APD)

Traumatic brain injury, often referred to as TBI, is most often an acute event similar to other injuries.

The ability to understand spoken language involves not only the ability of the ear to detect sounds, but also the ability of the brain to recognize, interpret, and use the acoustic information in our environment. Auditory Processing Disorder (APD) formerly referred to as central auditory processing disorder (CAPD) is an abnormality in the brain’s ability to filter and process sounds and words. Individuals with Auditory Processing Disorder have a neurological defect in the pathways from the auditory (hearing) nerve through the higher auditory pathways in the brain. This causes distortion and/or delay in auditory signal transmission, which results in inaccurate or incomplete coding of sound. Since these individuals struggle to process (or interpret) what they hear, it causes listening problems that often mimic a hearing loss.
Most people with Auditory Processing Disorder will usually pass a hearing test and often have normal intelligence.  However, since the brain receives sounds incorrectly, they may not recognize subtle differences between sounds in words (duh and guh for example), and they may have difficulty using those sounds for speech and language.
Children with Auditory Processing Disorder have trouble screening out background noise, so surrounding sounds from air conditioners, hallways, and noisy environments such as gymnasiums make it very difficult to understand speech.  It’s like listening to a radio station with static or other stations interfering with the reception.  In addition, these children typically try so hard to understand that they often forget parts of what they hear.
There are many types of Auditory Processing Disorder, and no two individuals are exactly alike in their symptoms. Auditory processing evaluations are most often performed on school-age children, although many adults are also tested.
Some of the more common problems in individuals with APD include poor ability to:
• Direct, sustain, or divide attention
• Discriminate subtle differences in sounds and words
• Hear in noisy situations
• Recognize and integrate a sequence of sounds into words or other meaningful combinations
• Comprehend rapidly spoken speech
• Remember and/or comprehend spoken information
• Follow multi-task directions
Up to 43% of Children with Learning Difficulties Have Auditory Processing Disorder (APD).
25% of Children with Learning Difficulties Have APD and Dyslexia.
Symptoms of APD in Elementary School Children
• Act as if a hearing loss is present, despite passing hearing screenings
• Frequently ask  ”huh?” or “what?” and often need information repeated
• Seem easily distracted or bored when conversations or activities do not include visuals
• Difficulty understanding spoken information presented in class
• Difficulty listening and following directions, especially multi-step directions in noisy environments
• Greater difficulty with verbal than nonverbal tasks
• Exhibit a language delay  (weak vocabulary and poor sentence structure)
• Misinterpretation of questions
• Difficulty understanding announcements over loudspeakers
• Have articulation errors that persist longer than they should
• Tend to be distractible, especially when background noise is present
• Difficulty following classroom discussions, or making off-topic contributions
• Difficulty carrying on telephone conversations
• Have poor social communication skills or difficulty making and/or keeping friends
• Inability to sing in tune and poor musical ability
• Difficulty understanding  riddles and jokes
• Misinterpret sarcasm or tone of voices and get feelings hurt easily
• Become frustrated with certain tasks. (i.e. saying “I don’t understand,” I can’t do this,” or “I don’t know what you mean” )
• Poor reading comprehension
• Trouble sounding out new words and poor fluency when reading aloud
• Poor spelling skills
• Confusion or reversal of letters
• Difficulty remembering people’s names
• Display poor memory for words and numbers
• Difficulty with complex language such as word problems
• Seeming to ignore others when engrossed in a non-speaking activity
• Difficulty understanding people who speak quickly
• Difficulty finding the right words to use when talking
• Slow or delayed responses to verbal instructions