APD vs ADHD. Symptoms of APD, auditory processing disorder, are similar to those of ADHD. Overlapping symptoms of ADHD and APD include disorganization, inattention, difficulty following directions, and “not listening”. The similarities make the two conditions easy to confuse. As an educator and parent of children with both APD and ADHD, I understand this all too well. So, today, let’s discuss APD vs ADHD and what we can do to help our kids.
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What is APD?
Auditory Processing Disorder describes challenges in how the brain processes auditory input. Some refer to it as CAPD (central auditory processing disorder) because it’s related to sound perception in the central nervous system.
Interestingly, a child with an APD does not have hearing loss. Rather, their hearing is completely normal. However, the brain struggles to process incoming auditory information. It goes something like this.
Auditory Traffic Jam
Auditory stimuli enter through the ear, travel through the hearing canal, and make their way to the brain. When things are working as they should, the same auditory input that enters the ear canal is the same information that the brain receives.
However, with CAPD, that’s not always the case. It’s like the auditory information has a car accident on its way to the brain. As such, the sound reaches the brain in a distorted form. Because the brain receives a distorted message, the child has difficulty understanding the original message.
**It’s important to note that in adults, a head injury can lead to an APD diagnosis. However, today, we’re focusing on developmental CAPD in children.
Signs of APD (Auditory Processing Disorder)
According to the American Academy of Audiology CAPD Guidelines, signs of auditory processing disorder include:
- Difficulties understanding speech in noisy environments
- Inattention
- Challenges identifying the location of sound
- For example, Mom calls the child from the bedroom, but the child looks for Mom in the opposite direction.
- Responses don’t match the questions asked
- Challenges following multi-step directions40
- Difficulties understanding subtle differences in tone (sarcasm, humor)
- Learning difficulties
As part of the assessment process for APD, audiologists will look for overlapping symptoms related to ADHD.
APD vs ADHD: The Why Behind Behavior
From the above signs of APD, it’s clear to see an overlap with symptoms of ADHD.
- Difficulties with attention,
- Learning challenges,
- Social skills challenges,
- Difficulties following multi-step directions
Because of this, a proper diagnosis must be determined based on why a child struggles with such behavioral issues.
Same Symptoms, Different Reasons
For example, a child with ADHD may have difficulties sustaining attention for many reasons. Difficulties paying attention may be due to low levels of dopamine or issues with working memory.
A child with APD may have the same difficulties, but the main difference is the processing and comprehension of speech and auditory information.
Types of Auditory Processing Disorder
There are several types of auditory processing disorders. Some sub-types include:
- Organizational APD
- Disorganization and planning challenges
- Decoding
- Specific deficit in phonemic awareness and decoding
- Integration
- The process of integrating visual information with auditory information is slow
- Prosodic
- Challenges processing verbal information while it’s being given
- Auditory Hypersensitivity
- Great difficulty hearing auditory input when exposed to background noise
- Considered a type of sensory processing disorder
Accuracy of the Label APD
Public awareness of auditory processing disorders has risen. With that, experts have been trying to determine the validity of the APD diagnosis. Auditory processing challenges aren’t yet fully understood, nor is there a consensus among experts. Some experts differentiate between APD and CAPD noting that APD can be a result of other higher-order causes such as:
- Autism,
- Learning disability,
- Language and speech disorders,
- Attention-deficit hyperactivity disorder,
- Another learning disorder such as dyslexia
Again, a wide variety of difficulties related to APD may be due to the possible causes listed above. CAPD, on the other hand, is defined as “difficulties processing auditory information, not due to any higher-order issue.“
How Does APD Impact Learning?
Like ADHD, auditory processing challenges can greatly impact a student’s ability to learn. For example, children with…
- Decoding APD struggle with learning to read
- Integration and Prosodic APD may have difficulties with
- A traditional classroom processing lecture-based lessons
- Social challenges interacting with non-autistic people
- Auditory hypersensitivity APD may have a hard time in social situations
- Organizational APD can lead to disorganization in multiple areas
When a child’s teacher is speaking, subtle background noise can add to the student’s auditory processing problems.
Mental Health Impact of APD and ADHD
Unfortunately, children with APD and ADHD are commonly labeled as:
- “Poor listeners”
- Purposefully “not paying attention”
- Disobedient
When they continually try to pay attention and process verbal input, inherent language problems prevent them from making progress. This can be defeating and demoralizing. Even worse, they’re shamed as not trying hard enough.
APD vs ADHD: Social Communication Challenges
Again, kids with APD have normal hearing, but the brain’s ability to process language is challenged. This means that APD can be misdiagnosed as ADHD. In children with APD and ADHD, children can experience difficulties in social communication.
- A child with APD may have trouble following social language in noisy environments.
- Another child with ADHD may struggle in that same social situation because of trouble with working memory or attention.
In the end, both conditions can lead to social traffic jams. As complicated as this may seem, there’s a lot of good news.
APD vs ADHD: The Mix-Up
Before we move on to getting an APD diagnosis, it’s important to understand how APD can be mistaken for or impacted by ADHD. And vice-versa. Attention deficit hyperactivity disorder (formally called attention deficit disorder) is one of the most common childhood neurodevelopmental disorders.
ADHD is primarily related to challenges with executive functions such as:
- Self-awareness
- Working memory
- Impulse control
- Motivation
- Task initiation
- Emotional regulation
A child with a diagnosis of ADHD may display similar characteristics as a child with APD.
APD, ADHD, and Schoolwork
For example, a child’s difficulties with schoolwork could be related to either APD, ADHD or a combination of both. While there’s a correlation between the two, Donna Geffner, Ph.D., an audiologist, speech-language pathologist, and expert in CAPD, states that ADHD does not cause APD.
The evidence supports our position that global attention and memory issues are not the primary cause of CAPD in children.
Ultimately, if you’re concerned about your child’s ability to process language, it’s important to consider APD.
Who Diagnoses APD?
To get an accurate diagnosis of auditory processing disorder, it’s important to see a qualified audiologist. However, a good first step may be to take your child to be evaluated by a PRIVATE speech-language pathologist. But, here’s the important caveat.
Yes, a speech-language pathologist is an essential asset to your child’s speech and language team. However, an SLP CANNOT give a diagnosis of APD. However, an SLP can screen for APD by completing a full speech and language evaluation. In other words, they can assess your child’s speech and language skills to root out any other potential issues such as:
- Speech delays,
- Speech disorders,
- Or other specific language impairment.
Once your child’s speech-language pathologist completes the evaluation, you can take that information to the proper audiologist.
Auditory Processing Tests for APD
A qualified audiologist will assess your child’s auditory pathways using a comprehensive hearing test to rule out a hearing problem. Additionally, they’ll assess APD symptoms, looking at different things in your child’s case history.
Specifically, they’ll look for risk factors presented in earlier development. For example, risk factors for auditory processing issues may include:
- Premature birth
- Family history of hearing loss
- Co-occurring conditions
- Speech and language development history
- Social development
Additionally, they’ll look at the types of symptoms presented in parent and teacher reports as well as speech-language evaluations, for example.
APD Test Tools
Then, the audiologist will implement a series of tests to assess:
- Auditory Memory
- Dichotic Speech
- child’s ability to repeat words presented in the left and right ears simultaneously
- Phonemic Decoding
- Perception of speech sounds and blending them into a word
- Listening in Noise
- Impact of background noise on a child’s ability to focus on target sensory input
- Temporal Processing
- Assesses the function of the corpus callosum and its connection with both hemispheres of the brain
After examining the test results, your specialist will determine the existence of APD.
Treatment of APD
If your child is diagnosed with APD, your audiologist will suggest treatment options. These will likely include a multidisciplinary team approach. The appropriate intervention will depend on your child’s specific type of APD. However, here are some general guidelines and options.
- Speech therapy
- Occupational therapy
- Environmental modifications
- Medication to address potential ADHD symptoms
- Auditory training
- Language strategies
- Educational accommodations, modifications, and other interventions
Children and adults with APD naturally develop compensatory strategies to assist themselves. I’ll dive into a few of these a bit more deeply.
3 School Accommodations for APD and ADHD
If your child is in public school, here are a couple of IEP accommodations to request.
1. Electronic Devices
Ask for the use of electronic devices to support your child’s auditory deficit. For example, assistive listening devices can be used to separate speech from background noise. One option is FM systems that amplify sound via radio waves. In this case, a teacher wears a small microphone that transmits a signal to a hearing-aid-type device worn by the student.
2. Preferred Seating
Another simple option is to request a change in seating that moves your child closer to the front of the class.
3. Alternative Seating to Improve Focus
Additionally, alternative seating options can support attention and focus. Some options are wobble chairs, sensory bands, and other sensory chairs.
Auditory Training
Several auditory training programs can be done at home. Your child’s audiologist or speech-language pathologist can guide you to the right choice based on your child’s specific auditory needs. A few of these computer-based programs include:
- Earobics
- CAPDOTS (The Listening Academy)
- Sound Auditory Training
- Fast Forward
- LiSN and Learn
A 2015 article reviewed several auditory training programs. Their review was shaped by an overview of anecdotal reports and also included studies into the effectiveness of each program.
Each program targets specific areas of auditory processing weaknesses. For example, Earrobics may be a good program to support phonological and phonemic awareness.
LiSN and Learn show promise with a type of auditory hypersensitivity that makes it difficult to accurately hear with competing background noise. Further, many of these auditory training programs can help improve ADHD symptoms including attention, focus, and organization of language.
APD and ADHD Parenting Strategies
Treatment activities for both APD and ADHD don’t have to be formal. Children with APD and ADHD often naturally develop compensatory strategies.
For example, it’s not uncommon for kids to look to use the body language and gestures of those around them to support their auditory deficits.
Specifically, many children follow the lead of other children when a teacher gives instructions. You can use this to your child’s advantage when giving them directions.
1. Use Visual Input
Don’t rely solely on verbal and auditory communication. Include lots of visual input.
- Make sure your child is looking at you when you give instructions.
- Use body language and hand gestures to reinforce your message.
When you do use language, make sure to chunk your instructions into small, manageable pieces of information.
2. Stop Talking
When addressing any child with APD, ADHD, or any learning challenges, it’s important to stop talking so much. Keep your ears open and your words clear and few. Try engaging in listening activities with your child to help you both strengthen listening skills.
3. Chunk Your Spoken Messages
If you want your child to get ready for bed, don’t holler at them from another room. Instead, go to your child and make sure they’re looking at you. Chunk your messages into small pieces.
Say,
- “Time to get ready for bed.”
- “Upstairs.” (Point to the stairs.)
- “PJs.”
- “Toothbrush” (Pretend to hold a toothbrush.)
- “Toothpaste.” (Mime the action of squeezing toothpaste onto the toothbrush.)
Then repeat them aloud to your child and ask them to repeat them to you.
Doing so lessens cognitive load and reduces demands on working memory (ADHD). Further, it gives your child successful experiences processing language.
Related Post:
Recap: APD vs ADHD
When comparing APD vs ADHD, there are many similarities. Symptom overlap includes inattention, trouble following directions, and social challenges. Is it APD or ADHD? Or is it a combination of both? The research is still unclear.
If your child appears to not hear you, struggles with symptoms of ADHD, can’t follow directions, or you’re just concerned, speak to your doctor. Early treatment can make a huge difference for your child.
So, Friend. Does your child have APD or ADHD? Maybe both?
About the Author:
Lindsay is a trauma-informed educator with a Master’s Degree in Teaching. Her mission is to support moms to equip neurodivergent kids (ADHD, Autism, Dyslexia, Anxiety) to thrive as exactly who they’ve been created to be. Wait until you hear the story that led to it all…
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- Auditory Processing vs Language Processing
- How they impact literacy, communication & behavior
- What you can do to change the trajectory of your child’s future by addressing underlying issues!
About the Author:
Lindsay is a trauma-informed educator with a Master’s Degree in Teaching. Her mission is to support moms to equip neurodivergent kids (ADHD, Autism, Dyslexia, Anxiety) to thrive as exactly who they’ve been created to be. Wait until you hear the story that led to it all…
