Auditory Processing Assessments (APD)


Auditory Processing Disorder is very much a specialty area within hearing.
Auditory Processing Disorder was referred to by Katz, Stecker and Henderson in 1992 as what we do with what we hear.  That is, how we identify, analyse and interpret what we hear. Auditory processing is how we make sense of what we hear.  
Auditory processing disorder is thought to affect 2-3% of individuals (Chermak & Musiek, 1997) and tends to be twice as prevalent in males than females.  The causes of auditory processing disorder remain unknown but there often tends to be a relationship between auditory processing disorder and middle ear pathology.  Children who have suffered with persistent middle ear infections or ongoing eustachian tube dysfunction with fluctuating hearing loss often exhibit one or more of the characteristics consistent with auditory processing assessment.  Hereditary factors are also common with family members often exhibiting similar traits and difficulties.   
Typically individuals diagnosed with auditory processing disorder will present with normal hearing and exhibit one or more of the following:  
  1. Difficulty hearing in noisy situations
  2. Difficulty remembering auditory information (i.e., spoken information)
  3. Easily distracted by other sounds in the environment
  4. Lack of organizational skills
  5. Difficulty following multi-step instructions
  6. Difficulty paying attention for the required amount of time
  7. Difficulty developing reading and/or spelling skills
  8. Poor academic performance
  9. Often appear not be listening
Auditory processing is a complex function comprising a number of skills and abilities.  For this reason a battery of tests is used to assess a number of aspects of auditory processing. This was reflected by Dempsey in 1983 when it was stated that “No single test of auditory processing can be expected to challenge the variety of functions required by the central auditory nervous system in different listening situations; therefore it is necessary to use a test-battery approach”.
Auditory processing disorder (APD) affects people of all ages and impacts the manner in which the brain processes sound. The auditory processing test involves evaluating the auditory pathways to assess how well an individual can detect the presence of sound. At Ayling Hearing & Audiology Clinic, we perform a test battery or a set of tests to assess APD.  Following the auditory processing assessment, we explain the results and offer the best solutions based on the test. With our state-of-the-art equipment and expertise, our service is unequivocal and designed to take the best care of your child’s hearing needs.
Auditory processing skills develop throughout childhood as our auditory pathways mature. For individuals with normal hearing it would be expected their auditory processing skills would reach maturity by approximately 12 years of age.  Like other developing skills, auditory processing is expected to improve with age.
The Test
Children referred for auditory processing assessment undergo hearing testing on the same day prior to the APD assessment to ascertain that there are no undiagnosed conditions. Consultation with the patient and parent, together with parent and teacher responses to questionnaires provide insight into common behaviours and areas of concern.  Assessment is carried out from 7 years of age as the responses of younger children on some of the tasks is considered to be unrepeatable and therefore unreliable.  
As auditory processing skills are expected to improve with age, results are compared with the results of other non-referred Australian children in the same age group (i.e. children who do not have an auditory processing disorder).  At Ayling Hearing we use tests with Australian normative data available for comparison and diagnosis.  Comparison to normative data provides information regarding the performance on any given task, and we can deduce from this whether the individual is processing auditory information at the expected level for their age.  
Importantly, auditory processing disorder should never be diagnosed based on the result of just one test and a hearing test should always be carried out on the day of the assessment.
After the assessment
Following the assessment a written report will be provided to the school and/or the referring specialist, and a copy of the report will be sent to the parents.  Reports will provide a description of each task and the patient’s performance and results.  
If diagnosed with an auditory processing disorder, several strategies will be proposed to assist based on the patient’s results and reported difficulties.  Patients are sometimes referred to other specialists for further assessment, particularly if there are co-existing concerns.  
It is our experience that patients diagnosed with an auditory processing disorder who follow the recommended strategies will demonstrate greater improvement than those patients who do not.   
While there are computer programs available purporting to assist in developing auditory processing skills we would only recommend the use of such programs in conjunction with a customized therapy program and not as a stand alone therapy.  
In the classroom it is particularly important that children are HEARING, SEEING, and PERFORMING.  We have a number of specialists we refer to regularly if required. 
Undiagnosed hearing and/or auditory processing conditions can cause inattention, poor social skills, an inability to follow instructions, and poor academic performance amongst others.  Children can become confused and frustrated which can in turn lead to other behavioural issues at home and in the classroom.  Behaviour is often labelled as inattentive, disruptive, and unfocussed, particularly in the classroom and the student may get into trouble for not completing tasks or behaving in a certain way.  Children may often be confused when they are told off particularly if they haven’t been able to process the instructions and haven’t understood the information properly.  Children may in fact believe they are doing what they were asked to do and therefore not understand why they are in trouble, or why they haven’t achieved a certain grade. It is relatively common for the self esteem of these children to suffer.  As children identify their weaknesses their self esteem will often be affected further.  
Diagnosing the condition is the first step in receiving the assistance your child needs.  Accurate diagnosis will provide a valuable explanation regarding characteristics and behaviours and allow for strategies to be developed to assist the patient.  It is important that patients who are diagnosed return for review to ascertain that their auditory processing skills continue to develop so that they “catch-up”, and then “keep up” with the performance of their peers.  An up-to-date assessment is often required if students change schools and for older students if they need to apply for special consideration when sitting exams. 
If your child exhibits any of the above characteristics, if they have a history of middle ear infections as a young child, if there is a family history of middle ear pathology or auditory processing disorder, or if you feel that they are struggling at school make an appointment for assessment.  
We conduct APD testing in Sandringham and Bentleigh East clinics.  Paediatric appoints are prioritised in the morning when children are fresh and alert.  

 Please call our office on 9521 8979 for more information and to make an appointment for an Auditory Processing Assessment.


·       Chermak, G.D., & Musiek, F.E. (1997). Central auditory processing disorders: New perspectives. San Diego: Singular Publishing Group.

·       Dempsey, C. (1983)  Selecting tests of auditory function in children.  In: Lasky EZ, Katz K, eds.  Central Auditory Processing Disorders: Problems of Speech, Language, and Learning.  Baltimore: University Park Press; 203-221.

·       Katz, J., Stecker, N.A., & Henderson, D. (1992). Introduction to central auditory processing. In J. Katz, N.A. Stecker & D. Henderson (Eds.), Central auditory processing: A Tran disciplinary view (pp. 3-8). St. Louis: Mosby Year Book, Inc.