Auditory Processing

Auditory Processing ImageryWhat is an Auditory Processing Disorder (APD)?

A person with an Auditory Processing Disorder has difficulty processing or interpreting auditory information.  In other words, it refers to “what we do with what we hear”.  People with APD may have difficulty with the following: understanding speech in the presence of background noise, identifying the difference between similar speech sounds and/or following spoken multistep directions.  According to the American Speech-Language-Hearing Association, APD is an auditory deficit that can only be diagnosed by an audiologist. 

Symptoms of APD

  • Appears to have difficulty hearing, although hearing is known to be normal
  • Requires frequent repetition; often asks “what?”
  • Trouble paying attention to and remembering information presented orally
  • Problems carrying out multistep directions
  • Poor listening skills
  • Needs more time to process auditory information
  • Difficulty with reading, comprehension, spelling, and vocabulary

Children with APD may also have low academic performance, behavior problems and/or language difficulties.

Who Should Have an Auditory Processing Evaluation?
Children and adults who present with one or more of the above symptoms may qualify for an Auditory Processing Evaluation.  Most children that are evaluated are between 7-16 years of age, because few tests are valid below the age of 7.   Therefore, 5-6 year old children are often too young to be tested for APD.

Some children with learning or language problems, Attention Deficit Disorder or other disabilities cannot be accurately tested for APD. Attention Deficient can cause a child to have difficulty interpreting information (including auditory information).  Therefore, if the Attention Deficit is not controlled, a true APD cannot be diagnosed.  APD can only be diagnosed if these other problems are ruled out as contributing to the person’s difficulties.    Children with Attention Deficit may be tested if they are able to attend long enough for the testing to be completed and/or are currently taking medications to control the disorder.   

The Auditory Processing Evaluation

Our center performs a comprehensive APD evaluation.  Our audiologists will administer a series of tests in a sound treated room.  First, a standard hearing test is performed to confirm that the child’s hearing and middle ear function are normal.  Following that, several tests will be performed that require the child to respond to what they hear.  These can be words, numbers, sentences, or tones presented in complex listening environments (such as with background noise).  All that is required from the child is to pay attention and give their best effort.  Several different categories of auditory processing are evaluated.  These include:

  • Auditory Memory:  the ability to accurately recall information recently heard
  • Auditory Figure-Ground:  the ability to listen in noisy situations
  • Organization & Sequencing:  the ability to recall information in the proper order or sequence
  •  Auditory Decoding:  the ability to understand differences in speech sounds
  • Temporal Processing:  the rate at which we can process auditory information
  • Auditory Closure:  the ability to understand a whole message, when part is missing

Other tests that measure the auditory system’s physiologic responses to sound will also be administered.  These tests do not require responses from the child, and are not uncomfortable in any way.

The evaluation for children requires 2 separate visits (90 minutes the first visit and 60 minutes the second).  Adults can usually be tested in one visit.  A written report (within 2-3 weeks of the appointment) will be completed, including recommendations for both home and school situations.

How Appointments are Made
Prior to making an appointment, it is important to discuss your concerns with your primary care physician.  He/she will provide you with a prescription if the test is needed.  All patients must be referred by a Medical Doctor.  For children, the parent would read the APD Letter to the Parents, APD Instructions and complete the APD History Form.  Adults would complete the Adult History Form.  Forms can be found under the forms section of our website, clicking below or calling 444-4191.  The completed form would need to be returned to the Department (fax 444-4582), along with a copy of any other evaluations and current IEP (children, if available).  This information will be reviewed by an audiologist and you will be contacted to schedule an appointment.   A perscription from your referring physician would need to be attached to the history form.


Will the insurance company pay for the testing?
Certain insurance companies may not.  You should call your insurance company prior to the testing and confirm that the following procedure codes are covered: 92552, 92556, 92570, 92585, 92620, and 92621.