Auditory Processing Disorder in Adults: Symptoms, Causes, Diagnosis, and Treatment
Amanda Unrau CCC-SLP
December 09, 2024
Auditory Processing Disorder (APD), also called Central Auditory Processing Disorder (CAPD), is a disorder that impacts the ability to process incoming auditory information, such as speech. While it can affect both adults and children, Auditory Processing Disorder in adults can be less noticeable than in children.
This article will cover the symptoms and possible causes of APD in adults, how it is diagnosed, treatment options, and practical tips to cope with APD.
Symptoms of Auditory Processing Disorder in Adults
Common symptoms of APD disorder in adults include:
- Difficulty understanding and participating in conversation, especially in noisy environments: Louder settings, such as restaurants with many other competing conversations, can be challenging locations for adults with auditory processing disorder to converse with others.
- Difficulty multitasking: For example, an adult may struggle to attend to a phone conversation when there is background noise.
- Poor spelling skills and reading comprehension: This is a challenge that can begin in childhood and last through adulthood.
- Poor auditory memory: Adults with APD can have a hard time remembering incoming information long enough to write it down.
- Sensitivity to sound: Adults with auditory processing disorder may notice and be distracted by sounds that others do not seem to notice, such as the hum of fluorescent lights or a tapping pen.
- Difficulty interpreting nonverbal aspects of language: Individuals with APD may misinterpret sarcasm, humor, and tone of voice.
- Difficulty following spoken instructions: This may make it seem like adults with APD lack follow through or don’t care, when in fact they may not understand or be able to attend to the instructions.
- Frequent need for repetition: Because they may not fully understand or be able to process incoming auditory information right away, adults with auditory processing disorder may need to hear things multiple times in order to fully grasp them.
- Struggle with distinguishing similar sounds: Since each spoken word is made up of very specific sounds, any difficulty identifying sounds in words means the individual with APD may hear a different word or or sounds that aren’t a word. This can lead to a misunderstanding or a complete lack of understanding of spoken language.
Causes of Auditory Processing Disorder in Adults
The causes of central auditory processing disorder in adults are not well known, but there are several potential causes:
- Genetics: It is suspected that auditory processing disorder may be passed down, although the specific genes have not yet been identified.
- Untreated hearing loss: When hearing loss is not treated, it can lead to poor auditory processing. It is important to note that individuals with APD do not necessarily have hearing loss.
- Related conditions: APD in adults is often associated with other health conditions such as multiple sclerosis, or other neurological conditions such as ADHD and dyslexia.
- Prenatal/neonatal factors: Prematurity, low birth weight, prenatal drug exposure, and other factors can lead to difficulty with auditory processing.
- Trauma to the brain: Any form of trauma to the brain can lead to auditory processing problems. This can include head injuries or anoxia (periods of oxygen not getting to the brain), which can happen during events such as strokes.
Diagnosis of APD in Adults
Auditory processing disorder is diagnosed by an audiologist. The diagnosis of APD consists of several components. All of these steps combine to ensure a fully comprehensive picture of the individual’s auditory and communication strengths and weaknesses. Key components of the diagnostic process include a case history, an audiological evaluation, and speech and language evaluation.
Case History
A detailed case history is essential for identifying potential contributing factors and the scope of the problem. It should cover:
- Medical history
- Family history of hearing loss, auditory processing deficits, and communication difficulties
- Presence of any comorbid conditions, such as medical or cognitive disorders
- Linguistic and cultural background
- Speech and language development
- Social development
- Educational and work history
- Auditory and communication difficulties the individual experiences
Audiological Evaluation
Audiologists employ a variety of tests in order to reach a diagnosis. First, a hearing test is given to rule out a physical hearing loss or blockage. Other tests may include any of the following:
- Auditory discrimination: assessment of one’s ability to differentiate incoming auditory stimuli with different frequency, intensity, or duration.
- Auditory temporal processing and patterning: assessment of one’s ability to analyze acoustic stimuli over time, such as sequencing and patterns.
- Dichotic speech tests: assessment of one’s ability to separate or combine unique auditory stimuli presented to each ear at the same time.
- Monaural low redundancy speech tests: assessment of one’s ability to identify altered speech stimuli presented to one ear at a time, such as speech in noise.
- Binaural interaction tests: assessment of one’s ability to process binaural acoustic stimuli (presented in both ears) that is dependent on differences in time or intensity.
- Electroacoustic measures: recordings of acoustic signals in the ear canal that are produced spontaneously or as a response to acoustic stimuli.
- Electrophysiologic measures: recordings of electrical potentials that show activity created by the CNS (Central Nervous System) as a response to acoustic stimuli.
These tests evaluate how the individual processes auditory stimuli.
Speech and Language Evaluation
A speech language pathologist administers specific assessments related to the communication deficits that the individual is experiencing. This allows them to determine the impact of the auditory processing deficits on different aspects of language processing.
As a helpful first step, try out our free APD test in order to help you understand if you should pursue further evaluation. It is important to consult specialists in order to be evaluated and determine if you have APD.
Treatment and Coping Strategies for Adults with APD
While there is no cure for APD, there are a variety of options for auditory processing disorder treatment in adults. Adults with central auditory processing disorder can also employ coping strategies to help them manage their APD symptoms in daily life.
Speech Therapy
Speech therapy can help adults who have auditory processing disorder in a couple ways. Speech therapists work on auditory training as well as teach compensatory strategies. For example, individuals may learn how to advocate for themselves by requesting clarification from a boss or come up with a system for taking notes to retain importation information. Auditory training may include learning how to discriminate between speech and background noise. Speech therapists may help individuals improve their working memory or auditory memory by practicing repeating directions or series of numbers.
Assistive Technology
Assistive listening devices such as FM listening devices help individuals with APD better hear speech in noisy environments. An FM device increases the volume of the speaker and sends it directly to the listener via a headset or earbuds without increasing the background noise. A digital voice recorder is an affordable option for recording importing information or instructions. Forbrain is another tool that provides auditory feedback so that individuals can hear speech more clearly.
Environmental Modifications
Environmental modifications may need to be made. Adults with auditory processing disorder can set up their work or home environment to best suit their needs. Individuals may need to keep notepads and pens near the phone so they can write down information during phone calls. Using closed captioning when watching movies or television shows can also be helpful. Adults who work in an office may want to wear noise blocking headphones to eliminate distractions and improve focus.
Coping Strategies
Coping strategies help adults with auditory processing disorder function optimally in their normal environments. Examples of coping strategies include:
- Lip reading: Using this can help individuals understand what is being said. In this case, one may opt for video calls versus phone calls.
- Self-advocacy: Adults with APD learn to advocate for themselves by asking people to repeat what they said. They also remind others to speak slowly, loudly, clearly, and in short sentences.
- Relocate: Individuals with APD may also learn to move to a quieter environment when they need to focus or have an important conversation.
Using Forbrain to Help with Auditory Processing Disorder
Forbrain is a tool that can benefit adults with auditory processing disorder. Forbrain is a bone-conduction headset equipped with a microphone that provides auditory feedback. It helps individuals with APD by amplifying the volume of speech and enhancing the speed with which the auditory input reaches the brain. This immediate feedback is especially helpful for improving auditory processing skills. It also improves auditory attention and helps individuals to hear and understand speech more clearly. Use our free APD test to determine if Forbrain may be helpful for you.
Final Words
Auditory processing disorder in adults impacts their daily lives in their social, home, and work environments. With proper evaluation and diagnosis, adults with APD can receive appropriate treatment and learn effective coping strategies. If you or someone you know struggles to process auditory information, take our APD test and use the tips in this article.
References
Auditory Processing Center. (Accessed 2024, November 29). Adults with Auditory Processing Disorder (APD). Auditory Processing Center. https://auditorycenter.com/symptoms-of-auditory-processing-disorder-apd/adults-with-apd/
ASHA. (Accessed 2024, November 10). Central Auditory Processing Disorder. American Speech-Language-Hearing Association. Source.
ASHA. (2005). Technical Report: (Central) Auditory Processing Disorders – Working Group on Auditory Processing Disorders. American Speech-Language-Hearing Association. Source.
Erickson, Kris. (2008, December 15). (C)APD Testing and Interpreting 101: Recommendations for Audiologists. Audiology Online. https://www.audiologyonline.com/articles/c-apd-testing-and-interpreting-896
Karp, Melissa. (2023, March 5). Auditory Processing Disorder in Adults. VeryWell Health. https://www.verywellhealth.com/auditory-processing-disorder-in-adults-1048289
Morgan, Danielle. (2024, May 13). A Guide on Auditory Processing Disorder. Audiologists. https://audiologists.org/resources/conditions/auditory-processing-disorders
Rodden, Janice. (2024, April 8). What Does Auditory Processing Disorder Look Like in Adults? ADDitude. Source.
Amanda Unrau
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