What is (Central) Auditory Processing Disorder?


Auditory Processing Disorder (APD) is a complex problem with the ability of the brain to interpret sounds, most notably speech. An affected person may perform well on a normal hearing test (beep test) because the test does not require the use of many auditory processing abilities. However, a task that requires many auditory processing abilities, such as hearing speech in background noise, can be much harder or impossible.

How Common is APD?


It is estimated that 5% of children, 0.5-1% of young and middle-aged adults (Hind et al, 2011) and 14% of older adults (Sardone et al, 2020) have an APD.

What are the Symptoms of APD?


There are many potential symptoms. Not every person will present with all symptoms. There are also many symptoms that may relate to a different condition, e.g. a behavioural condition. As a guide, a child should have 2 or more symptoms to be considered for APD testing.

  1. Difficulty hearing in the presence of background noise
  2. Difficulty following long conversations or multi-step instructions
  3. Difficulty hearing people they are unable to see, e.g. on the phone
  4. Difficulty remembering verbal information
  5. Difficulty learning a foreign language
  6. Distractibility in noisy places
  7. Being disorganised
  8. Trouble with reading, writing or spelling
  9. Inability to focus attention or give divided attention
  10. Lack of music appreciation

How is APD Assessed?


Canberra Audiology takes a holistic approach to APD assessment.

First, a normal hearing test is performed. This is to rule out a problem with the ear’s ability to hear.

Following this, questionnaires are given and a detailed history is taken. A series of screening tests are recommended to rule out difficulties with language, phonological awareness, attention, cognition and visual processing. These conditions can mimic symptoms of APD and would require referral to an appropriate specialist for further assessment and treatment e.g. a speech pathologist.

Next the assessment is performed where the patient is required to listen to different sounds, beeps, words or sentences and report back on what they hear. Testing can take between 2 and 4.5 hours. For children and adults we recommend testing is split into sessions of no longer than 1 hour. This is because the tests are most accurately performed when attention levels are high.

Who Can be Assessed for APD?


For adults, anyone up to the age of 65 years old can be tested. The upper limit of testing is 65 years because after this age many APD tests will be inaccurate due to natural changes in the way that the brain functions beyond this age.

For children, comprehensive testing can be performed once they are 6 years old. We are currently unable to test children under 6 years of age due to a lack of suitable testing materials, plus the tests can be quite challenging for young children to both understand and stay interested in.

It is beneficial for children being assessed by an audiologist for an APD to have assessments with an Educational Psychologist and a Speech Pathologist prior to their APD assessment. However, as mentioned above, the audiologists at Canberra Audiology are able to screen for many conditions that may be relevant.

Treatment for APD


If a patient is diagnosed with an APD there are many different treatment options available. The type of treatment offered depends on the type of APD that may be present. However, with all types of APD a “management tripod” approach is recommended. This includes:

  • Fitting of a Remote Microphone System to help the listening receive sounds from a talker with more ease.
  • Auditory training – either with an audiologist or a computer-based program – to strengthen the processing skills responsible for the APD.
  • Learning compensatory strategies from an audiologist, speech pathologist and or psychologist.

For more information on APD assessment and treatment options please contact us on (02) 6156 4474.