What is auditory processing?

Auditory processing is what happens when your brain recognizes and interprets the sounds around you.  Humans hear when energy that we recognize as sound travels through the ear and is changed into electrical information that can be interpreted by the brain.  In children with an auditory processing disorder (APD), something is adversely affecting the processing or interpretation of the information.  They may have difficulty processing auditory input, especially in conjunction with background noise.  They also may have problems using auditory information to communicate and learn.  


APD goes by many other names.  Sometimes it is referred to as central auditory processing disorder (CAPD).  Other common names include auditory perception problem, auditory comprehension deficit, central auditory dysfunction, and central deafness.


Symptoms or Behavioral Characteristics of Children suspected of having APD: 

  • difficulty understanding spoken language in competing messages, noisy backgrounds, or in reverberant environments
  • misunderstanding messages
  • inconsistent or inappropriate responding
  • frequent requests for repetitions
  • saying “what?” or “huh?” frequently
  • taking longer to respond in oral communication situations
  • difficulty paying attention
  • easily distracted
  • difficulty following complex auditory directions or commands
  • difficulty localizing sound
  • reading, spelling and/or learning problems

Auditory processing difficulties can have a huge impact on learning, from the ability to absorb content presented verbally to utilizing phonics strategies when reading and spelling.  Children spend 45-60% of their day focused on listening, much of that time in school. Classrooms can be noisy places and children have an even harder time than adults hearing speech in noisy environments since their CNS has not fully matured until approximately 12 years of age.


What to do if you think your child or student has APD?

Have the child’s hearing tested and rule out fluctuations in hearing due to middle ear pathology or sensorineural hearing loss.  If your child’s hearing is normal, and there is sufficient evidence of possible APD, the audiologist can determine an appropriate battery of tests that target the various processes that contribute to effective auditory processing.  These processes include: 

  • Binaural Integration:  the ability to discriminate different messages presented to each ear simultaneously.
  • Auditory Closure:  the ability to “fill-in” auditory information when a portion of the message is missing or distorted.
  • Tests of the prosodic aspects of speech such as rhythm, intonation, syllabic stress and key word detection.
  • The ability to discriminate speech in the presence of background noise.

What Can be Done if my Child is Diagnosed with APD?

The central auditory nervous system has plasticity, defined as the ability to make organizational changes as a result of internal or external processes.  Auditory processing is a skill much like musical ability: all of us have some aptitude at birth, all of us can improve with training (due, in part, to neural plasticity), but not all of us will reach the same level of proficiency.  Children with APD will have strengths and weaknesses with the various processes that contribute to auditory learning.  Once determined, these deficits can be remediated using skill building, environmental modifications and compensatory strategies.  Specific techniques to accomplish this can then be incorporated into an individualized intervention program.  

To learn more about APD or schedule an appointment with our pediatric audiologist, please call (205) 874-9436.


Providing Pediatric ENT services for children ages 0-21 to the greater Birmingham area and all of Alabama.