Auditory Processing Disorder (APD)


What is APD?

APD refers to how the central nervous system (CNS) uses auditory information (Teri Bellis). In simple terms it refers to “what we do with what we hear” (J.Katz).

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.

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. Once a diagnosis of APD is made, the nature of the disorder is determined.

Treatment of APD must be highly individualized and deficit-specific. Therefore, the key to appropriate treatment is accurate and careful diagnosis by an audiologist.

By Teri James Bellis, PhD, CCC-A.


Although it is very important to use a multidisciplinary team in understanding all areas of difficulty, only an audiologist can diagnose APD. They will do so by a multitude of specialized tests in a sound treated room. Some of these tests may include dichotic speech tests, phonemic decoding tests, and speech-in-noise tests. Behavior checklists and history questionnaires are also obtained from parents and teachers to provide information on the child’s listening skills, behavior, and academic performance.


There are many different symptoms of APD. Even if your child has a multitude of these symptoms, the only way to properly diagnose is by careful and accurate testing.

  • Difficulty understanding speech in noisy environments

  • Difficulty following directions

  • Difficulty discriminating similar-sounding speech sounds

  • Difficulty with spelling, reading, and verbal instruction

  • Difficulty remembering what was heard

Academic Concerns

There may also be some academic concerns that prove to be symptoms of APD.

  • Academic performance lower than potential

  • Failure to complete assignments

  • Difficulty functioning in group settings

  • Reading (word accuracy/comprehension)

  • Spelling (accuracy/reversals)

  • Writing (organization/sequencing/neatness)

  • Receptive/Expressive language deficits

Key Points About APD

  • APD is an auditory disorder that is not the result of a 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 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 very individualized. There is no one treatment approach that is appropriate for all children with APD.

    By Teri James Bellis, PhD, CCC-A.