One of the biggest struggles for parents, doctors, and psychologists concerning auditory processing disorder (APD) is that it is similar to hearing loss, but hearing tests show normal hearing.

Because it is difficult to pinpoint, APD often remains unaddressed, causing ongoing damage to the social and academic development of children.

The fact that the hearing test of someone with APD shows up as being normal and the majority of American audiologists don’t do any additional testing for it, the condition continues to go untreated.

The damage to cognitive and social development APD causes in children motivates me to raise the awareness of APD to Gold Country patients who are still searching for answers to their child’s condition.

APD And Its Symptoms 

In the simplest terms, a person with APD hears what you are saying, but they struggle to sort out its meaning, so they don’t really understand.

The condition affects approximately 5% (2.5 million) of American school-aged children, according to Hearing Health Foundation, but due to misdiagnosis, it could impact up to 12% of the population.

Those experiencing APD tend to take a long time responding to questions or conversations, or they provide an odd response, especially in a noisy environment.

They also tend to ask others to repeat themselves with greater frequency or miss various steps in a series of instructions.

Indicators in school children often include difficulty with spelling, withdrawal, or fatigue in the classroom or at a party.

Additionally, those with APD often understand one-on-one conversations while facing the speaker better than conversations where there are many distractions.

How Is APD Diagnosed?

The first step in diagnosing auditory processing disorder is a hearing test. First, we have to know that the auditory system is functioning relatively normally. Still, it is not enough to say that hearing is normal, so you’re fine because the person is obviously struggling with something.

Our next step is to conduct a Hearing Handicap Inventory, which provides some subjective input such as how they are struggling and in which environments they are struggling.

With younger children, we often have to rely on input from parents, teachers, or other adults to assist with diagnosis.

Additional tests used by audiologists to diagnose APD are described in Kids Health and include:

  • Auditory Figure-Ground Testing (speech understanding with background noise)
  • Auditory Closure Testing (the capacity to “fill in the gaps” of speech)
  • Dichotic Listening Testing (ability to understand meaningful speech that happens simultaneously)
  • Temporal Processing Testing (capacity to distinguish between similar speech sounds such as “mat” and “pat”)
  • Binaural Interaction Testing (ability to identify the direction of sounds and localizing them in a room)

Although these tests can be conducted on children as young as three, they are most often used with children seven years old or older.

Newer electrophysiology tests involving non-invasive electrodes to check the body’s response to speech can also provide additional information about the central auditory system.

Treatment Options For APD

Auditory training, similar to what is used with severe to profound hearing loss — and for those who are going through a cochlear implant evaluation and treatment — is a useful tool in treating auditory processing disorder.

Hearing aids can help treat APD as well, depending on the specific concerns of the case.

Various forms of language therapy may include:

  • Boosting Phonological Awareness Skills
  • The Use of Inference in Speech
  • Vocabulary Enhancement
  • Comprehension Improvement Strategies
  • Social Communication Skills

The use of compensatory strategies for individuals with APD provides them with the building blocks to overcome the condition to improve school and workplace communication.

We Diagnose And Treat APD

When kids with APD go through school, school steamrolls ahead, and they build scaffolding without a good foundation, it has severe consequences on their lifestyle and quality of life moving forward.

For this reason, the Gold Country Hearing & Balance team and I take extra steps to identify APD in those who demonstrate normal hearing but struggle with speech-related communication.

If you suspect that your child or loved one is struggling with auditory processing disorder, your first step is to schedule a hearing assessment with one of our Gold Country Hearing and Balance locations audiologists or me in Grass Valley, Rocklin, Sacramento, or Lodi, California.

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Tracy Volkman , Au.D.

Dr. Tracy Volkman believes investing in the lives of her patients is the key to meeting their communication needs. She is committed to helping them find the best solution to improve their hearing and improve their quality of life. Tracy graduated from CSU Sacramento with a Master’s Degree in 2003 and earned her Doctorate degree in Audiology from A.T. Still University, School of Health Sciences in 2011.

    Grass Valley, CA


    Rocklin, CA


    Sacramento, CA


    Lodi, CA