Auditory Processing Disorder (APD): What Parents Need to Know About a Complicated—and Often Misunderstood—Diagnosis
If your child struggles to listen, follow directions, or understand speech in noisy places, someone may have suggested “Auditory Processing Disorder,” or APD. It’s a term many families hear, but few feel confident understanding—and for good reason. APD is one of the most debated and controversial diagnoses in the fields of audiology and speech-language pathology.
This blog post breaks down what APD really is, why the diagnosis is controversial, and what parents should focus on instead to help their child thrive.
✨ What Is APD—In Plain Language?
APD describes difficulty making sense of sounds, especially speech. A child may have:
Trouble following directions
Difficulty understanding speech in background noise
Mishearing similar-sounding words
Slow or inconsistent responses to spoken information
Importantly, children with APD can hear normally on a routine hearing test. The issue is not with the ears—it’s with how the brain processes sound.
✨ Why Is APD Controversial?
Even experts disagree on what APD is—and whether it should be diagnosed at all.
1. There is no single accepted definition of APD.
Some researchers argue APD is a distinct neurological disorder. Others argue the label is simply a description of listening difficulties—not a unique condition at all.
In fact, multiple studies note that APD is inconsistently defined, tested, and diagnosed (Beck et al., 2016; DeBonis, 2015; Wilson, 2018).
2. APD often overlaps with other conditions.
Research repeatedly shows that children diagnosed with APD commonly also have:
Language disorders
Attention challenges (including ADHD)
Working memory difficulties
Reading dyslexia
Executive functioning weaknesses
The systematic review by de Wit and colleagues found that listening difficulties often reflect language, attention, or cognitive factors—not purely auditory ones. ismen-emanuel-2023-auditory-pro…
That means APD-like behaviors may be symptoms of something else entirely.
3. Many APD tests actually measure memory and attention—not just auditory processing.
Studies comparing auditory processing tests with working memory and attention tasks show:
Some “auditory processing” tests are strongly influenced by a child’s memory load
Others reflect attention more than auditory skill
Test performance can look like APD when children actually have executive function challenges
For example, Magimairaj & Nagaraj (2018) found clear overlaps between auditory processing and working memory systems. magimairaj-nagaraj-2018-working…
This makes it difficult (and sometimes impossible) to separate APD from other learning differences.
4. There is no gold-standard test for APD.
Audiologists themselves report that:
There is no agreed-upon test battery
Different clinics diagnose APD using completely different criteria
Test results vary widely
The 2023 survey of U.S. audiologists (Ismena & Emanuel) found substantial disagreement about APD criteria and protocols. Many audiologists believe APD is overdiagnosed or misunderstood. ismen-emanuel-2023-auditory-pro…
5. Leading professional groups disagree.
The American Academy of Audiology (AAA) allows APD to be diagnosed even with co-occurring conditions.
ASHA states APD can only be diagnosed if language and cognitive disorders are ruled out first.
Some journals (like Ear & Hearing) temporarily refused to publish articles treating APD as a single disorder because the evidence wasn't strong enough.
In short: even experts can’t agree on what APD actually is.
✨ So… Is APD a “Real” Disorder?
Here’s the best way to understand the controversy:
Your child’s listening difficulties are real.
What’s controversial is the label, the testing, and the assumption that the problem is purely auditory.
Whether or not APD is a unique disorder, the struggles children face—difficulty listening in noise, following directions, understanding rapid speech—are absolutely valid and deserve support.
✨ What Parents Should Focus On Instead of the Label
1. Get a thorough, multidisciplinary evaluation.
Because listening challenges often reflect language, attention, and working memory difficulties, evaluating only the auditory system risks missing the bigger picture.
A helpful team may include:
A speech-language pathologist (SLP)
A psychologist
An audiologist
A teacher or learning specialist
This approach is strongly recommended in both research literature and surveys of practicing audiologists. ismen-emanuel-2023-auditory-pro…
2. Prioritize functional needs over the diagnosis.
Instead of asking “Does my child have APD?”
Ask:
“What specific skills are making listening hard, and how can we support them?”
These skills might include:
Following multistep directions
Remembering spoken information
Staying focused with background noise
Processing rapid speech
Understanding complex language
Once specific needs are identified, SLPs can target them directly with evidence-based interventions.
3. Support the whole child—not just their ears.
Strategies may include:
Environmental Supports
Preferential seating
Noise-reducing headphones
Visual schedules
Clear, short instructions
Language and Cognitive Supports
Teaching chunking and memory strategies
Building vocabulary and syntax
Explicit listening strategies
School Accommodations
Extra processing time
Repetition and rephrasing
Visual aids
Reduced background noise
These approaches are supported by research showing they help children improve functional listening and school performance—even without an APD label.
4. Be cautious about “auditory training apps.”
Many programs marketed for APD lack strong scientific support. Systematic reviews (Fey et al., 2011) highlight that research on auditory training is inconsistent and often weak.
Instead, interventions that strengthen language, working memory, and academic skills show stronger, more reliable benefits (Kelley & Spencer, 2021).
✨ The Bottom Line for Parents
APD is a real set of listening challenges, but the diagnosis itself is:
Inconsistently defined
Often overused
Highly controversial among experts
Difficult to separate from language or attention difficulties
Here’s the takeaway:
Don’t chase the diagnosis—focus on the skills your child needs to succeed.
Whether the label is APD, language disorder, attention difficulties, or “listening challenges,” the goal is the same:
To help your child better understand, communicate, learn, and thrive in their everyday environments.
And that is absolutely possible.