Auditory Processing Disorder (APD)

APD is a listening difficulty. It happens when the brain has trouble making sense of sounds, even though your child’s hearing is normal.

Think of it this way: your child’s ears pick up sound just fine, but somewhere between the ear and the brain, the message gets jumbled. The brain receives a “distorted” version of what was actually said.

APD is not about intelligence, laziness, or bad behaviour. Your child’s ears work fine.
It is the brain’s listening system that needs support.

Every child with APD is different. You or your child’s teacher might notice some of the following:

• Difficulty hearing when it is noisy, such as in a classroom or playground
• Often saying “what?” or “pardon?”
• Trouble following instructions, especially long or fast ones
• Mixing up similar-sounding words
• Struggles with reading, spelling, or phonics
• Forgetting things they have just been told
• Seeming easily distracted or not paying attention
• Difficulty with music or recognising tunes

Many of these signs can also be seen in children with other conditions such as ADHD, language difficulties, dyslexia, or autism. That is why a proper assessment matters, rather than guessing from a list of signs alone.

The New Zealand Audiological Society (NZAS) recommends an APD assessment when a child is reported to have difficulty understanding what they hear in some situations, despite having normal results on a standard hearing test.

An assessment is also recommended for children with:

• Dyslexia or reading difficulties
• Language difficulties
• A significant history of glue ear
• Autism spectrum disorder
• ADHD, where listening concerns continue even after treatment has started

A referral can come from a parent, teacher, GP, or other health professional.

APD testing is carried out by an audiologist using a set of specialised listening tasks. Testing is generally done from around age 7, because the brain’s hearing pathways are still developing before this and results can be unreliable. Some tests or screening test are available for younger children.

How long will it take? Allow approximately 1.5 to 2 hours for the full appointment, including a hearing check, the listening tests, and time to discuss results. Assessments made be broken up into more than one appointment.

What to bring on the day

• Any previous hearing test results
• School reports or teacher comments about your child’s listening
• Completed questionnaires (if sent to you beforehand)
• A snack and water for your child

How to prepare your child

• Make sure they have a good night’s sleep the night before
• Any previous hearing test results
• School reports or teacher comments about your child’s listening
• Completed questionnaires (if sent to you beforehand)
• A snack and water for your child
• Let them know they will be listening to sounds and words through headphones in a quiet room
• Reassure them it is not a test they can pass or fail, and there are no needles or anything that hurts
• Let them know they can have breaks if they need to

During the assessment

Your child will sit in a quiet, soundproof room wearing headphones. The audiologist will play different listening tasks, and your child will be asked to repeat or respond to what they hear.

The types of tasks include:

• Listening in background noise: Words or sentences are played while noise plays at the same time. This checks how well your child can pick out speech when it is not quiet.
• Listening with both ears at once: Different words are played to each ear at the same time, and your child says what they heard. This checks how well the brain manages sound arriving from both sides.
• Picking up patterns and gaps in sound: Your child listens for small gaps between sounds or patterns of high and low tones. These skills are important for understanding the rhythm and flow of everyday speech.

Before APD testing can go ahead

A standard hearing test must be completed first to confirm your child’s hearing is normal. This needs to have been done within three months before the APD appointment.

The audiologist will explain the results and let you know whether your child meets the criteria for APD. If APD is confirmed, the audiologist will put together a plan tailored to your child.

This may include:

• Classroom changes: Seating your child closer to the teacher, reducing background noise, and improving classroom acoustics
• A personal listening device (FM system): A small wireless device where the teacher wears a microphone and your child wears a receiver. The teacher’s voice goes directly to your child’s ear, making it much easier to hear over classroom noise
• Low-gain hearing aids: In some cases, mild amplification may be helpful even when hearing is normal on a standard test
• Listening training: Exercises, often computer-based, that help strengthen the brain’s ability to process sound over time
• Everyday strategies: Teaching your child to ask for things to be repeated, use visual cues, and break instructions into smaller steps
• Teamwork: APD is best managed when audiologists, speech-language therapists, teachers, and learning support staff all work together