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Auditory processing disorder (APD) is a hearing problem where the brain is unable to process sounds in the normal way.
It can affect people of all ages, but often starts in childhood.
APD can affect people in many different ways. A child with APD may appear to have a hearing impairment, but this isn't usually the case and testing often shows their hearing is normal.
It can affect your ability to:
Many people with APD find it becomes less of an issue over time as they develop the skills to deal with it.
Although children may need extra help and support at school, they can be as successful as their classmates.
See your doctor if you or your child has difficulties with hearing or understanding speech. This may not be caused by APD – it could be the result of language difficulties.
Your doctor may refer you or your child to a hearing specialist called an audiologist for a range of tests.
Normal hearing tests aren't very effective at diagnosing APD because they're usually carried out in a quiet room without distractions and don't test the ability to hear in a normal day-to-day listening environment.
More complex tests are needed to test the ability to hear with different levels of background noise, poor quality speech, people talking with different accents, and people talking quickly.
Specific tests that may be used to help diagnose APD include:
There are a number of strategies that can help people with APD.
Auditory training involves using special activities to help train your brain to analyse sound better. You can do this on your own, with the help of an audiologist, or by using a computer programme or CD.
It involves a range of tasks, such as identifying sounds and guessing where they're coming from, or trying to focus on specific sounds when there's some slight background noise.
The tasks can be adapted for people of different ages, with children often learning through games or by reading with their parents.
Be aware of room acoustics and how it can affect your ability to hear. Rooms with hard surfaces will cause echoes, so rooms with carpets and soft furnishings are best.
Switch off any radios or televisions and move away from any noisy devices, such as fans.
If your child has problems hearing, talk to school staff about changes that may help them, such as sitting near the teacher, using visual aids and reducing background noise.
Your child may also benefit from wearing a radio receiver or having a speaker on their desk at school, which is connected wirelessly to a small microphone worn by their teacher.
Alternatively, a speaker system in the class that's connected to the teacher's microphone may help your child hear their teacher over any background noise.
It may be useful to tell other people about your hearing problems and let them know what they can do to help you hear more clearly.
Ask them to:
Other strategies that might be particularly useful when talking to children with APD include:
Organisations such as Action on Hearing Loss, Hearing Link and the National Deaf Children's Society (NDCS) may be able to provide further information and support.
The causes of APD aren't fully understood. Some cases in children may be related to having glue ear when they were younger. It may also be caused by a faulty gene, as some cases seem to run in families.
In both adults and children, APD is sometimes linked with brain damage from a head injury , stroke , brain tumour or meningitis .
It can also be caused by a traumatic birth where there's a significant lack of oxygen to the brain, severe jaundice and brain haemorrhages .
Some cases in adults have also been linked to age-related changes in the brain's ability to process sounds and progressive conditions that affect the nervous system, such as multiple sclerosis .
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.