By Maria Romaszkan
Do you have problems understanding what people are saying but can otherwise hear just fine? Do you get easily distracted by sounds that other people seem to ignore? Do you forget verbal instructions almost immediately? You may have not only ADHD but also auditory processing disorder. Or you may have been misdiagnosed with one when you have the other.
What is Auditory Processing Disorder?
Auditory processing disorder, or APD, has nothing to do with hearing loss. It’s about how your central nervous system processes auditory information. Hence, you can have excellent hearing but struggle to understand what someone is saying, especially in a noisy environment. Common symptoms of auditory processing disorder are:
- Difficulty understanding and remembering verbal instructions
- Mistaking similar-sounding sounds and words (e.g. “big” and “gig”)
- Being easily distracted by sounds most people don’t notice, such as the tapping of a pen or water dripping
- Difficulty in keeping up with the conversation in a loud environment, like a cafe or bar
- Troubles with comprehending heavily accented or fast speech
- Sensitivity to certain sounds, sometimes to the point of pain (for example, to a loud bang or shrill sound)
- Delayed comprehension of words you hear
- High probability of co-occurring reading, writing or learning problems.
Can You Have Both ADHD and Auditory Processing Disorder?
Clinical professionals agree that the possibility of having both ADHD and APD — or any sensory processing disorder, for that matter — is relatively high. However, no reliable statistics of people having both conditions exist. One often-quoted study found that about 50% of children with ADHD had also had auditory processing disorder. But it’s important to note that the study included only 30 children.
Medical providers often misdiagnose auditory processing disorder as ADHD. That may be because they have some similar symptoms.
ADHD and Auditory Processing Disorder: the Differences
Still, these two conditions are very different. The most obvious distinction is that any distractibility or lack of attention present in auditory processing disorder comes from issues with processing sounds. A person with APD can usually focus much better in a quiet space.
“A person with APD typically presents as inattentive because of the difficulties following verbal information, especially in a lecture-type environment, delayed responses due to the time needed to comprehend what was said and difficulties remembering auditory information,” says Michele DiStefano, audiologist and director of the Center for Hearing and Communication in New York City. “Similarly, a person with ADHD will exhibit inattentiveness, distractibility, difficulties following multi-step directions and delayed responses. This overlap of behaviors common for both APD and ADHD makes misdiagnosis — especially without full, appropriate evaluations by experienced professionals — a common occurrence.”
How to Diagnose Auditory Processing Disorder
Only audiologists can officially assess this condition. They use different listening tests to exclude any hearing loss. They might ask you to listen to speech with background noise or try to differentiate similar sounds.
“It’s important to rule out inattentiveness as a factor in the inability to decode auditory information,” says Ruth Reisman, audiologist and founder of New York City-based Urban Hearing. “In this way, when we develop a rehabilitation plan, we are intentional in how we are treating APD.”
When testing people diagnosed with ADHD for APD, Reisman points to the importance of stimulant medication.
“If the individual takes such medication, it’s best to assess them while they’re on it to make sure that we are ruling out inattentiveness,” she says. “For those who opt not to take medication, I’ll often encourage them to have some sort of natural stimulant before our testing, such as beverages or food that has caffeine.”
Treating Auditory Processing Disorder
There is no cure for auditory processing disorder. However, there are ways to manage symptoms and improve your ability to process sounds and communicate more effectively.
The most common way to do that is with auditory training, which aims to improve such skills as auditory processing speed or sound discrimination — or differentiating between speech sounds. Nowadays, you don’t even need to go to a doctor’s or speech therapist’s office — plenty of programs or on-demand training are available online.
Still, it’s best to consult a doctor to understand which areas are especially problematic for you and tailor the treatment accordingly.
Tips on Managing Auditory Processing Disorder
Besides treatment, it’s vital that you find ways to manage your everyday life to better process sound and communicate with others. Perhaps you already have developed some strategies. Here are several suggestions from experts:
• Respect Your Needs
You can feel like it’s too much to ask others to repeat or clarify things constantly. Remember that you have a right to participate in discussion or decision-making actively. The speaker usually wants the same – that’s why they’re communicating with you.
Respect your needs. Ask people to repeat things, speak slower or louder, to look at you when talking. It’s also okay to ask for different methods of communication, such as texting or email.
• Write Things Down
You can carry around a notebook to jot down any important information — or ask others to write down the key ideas they’d like you to know.
Alternatively, you can use a voice recorder or a text-to-speech mobile application.
• Minimize Distractions
The more auditory information you get from your surroundings, the less focused and less likely you are to process what’s being said.
Try to create a quiet environment, primarily where you work or study. Assistive technology or other accommodations can help.
You can always turn off the TV or close the windows at home.
Consider avoiding places where sounds are likely to echo, as the voices can overlap, making it difficult to understand what people are saying.
• Consider Assistive Technology
Numerous assistive technology tools are available for people with an auditory processing disorder.
Helpful technology includes captioning devices, noise-canceling headphones or text-to-speech software. Some people also use low-gain hearing aids, which an audiologist specially programs to enhance speech sounds.
Another popular tool is a personal listening device, or PLD. Its purpose is to make the speaker’s voice easier to hear by using a special microphone for the speaker and an earpiece for the listener. The most popular type of PLD is the frequency modulation system.
• Apply for Accommodations
Whether you’re a student or already working, you may be eligible for accommodations under the Americans with Disabilities Act if you have an auditory processing disorder. Accommodations might include providing or allowing you to use assistive technology. Other accommodations might include:
- Preferential seating
- Providing information and instructions in writing
- Delivering important details and materials before meetings
- Supplying meeting minutes on demand
- Providing a quiet environment with as little noise as possible
- Encouraging you to ask for clarification or repetition of information
- Allowing ample time for processing and responding.
• Consider therapy
Living with auditory processing disorder can be frustrating and alienating. You may not participate in discussions as much as you’d like. And people can lack understanding and get frustrated with frequently repeating their words or with you asking questions.
A therapist can help you adjust to living with APD, cultivate self-compassion, and find coping strategies for handling stress and difficult emotions.
