What is auditory processing disorder?

Auditory processing is how the brain interprets and makes sense of the sounds we hear. While hearing involves our ears detecting sound, auditory processing is what happens next. It’s how the auditory nervous system and brain organize, analyze and understand those sounds. This includes skills like distinguishing the differences between similar sounds, understanding speech in noisy environments and following spoken directions. 

Some children have difficulty with these skills, even though their hearing is normal. This is known as auditory processing disorder (APD). Children with APD may struggle to keep up with conversations, misunderstand instructions or have difficulty in classroom settings where listening is essential. It is also important to recognize that children with other diagnoses such as autism, ADHD, learning disabilities or generalized anxiety disorder may show similar listening challenges.

At Children’s Hospital of Philadelphia (CHOP), audiologists with specialized training in auditory processing work closely with families and schools to understand each child’s unique listening profile and provide practical, evidence‑based recommendations.

What are signs or symptoms of auditory processing disorder?

While symptoms vary in every case, children with auditory processing disorder (APD) may:

• Frequently ask for repetition or often say “what?”
• Have trouble following multi-step directions 
• Struggle to understand speech in noisy environments 
• Confuse similar-sounding words or sounds 
• Show difficulty with reading, spelling or phonics 
• Appear inattentive or easily distracted

How common is auditory processing disorder?

Approximately 5% of children have some form of auditory processing disorder (APD). This number may not include children with other diagnoses such as autism, ADHD, learning disabilities or generalized anxiety disorder who may show similar listening challenges. In these cases, auditory difficulties are often part of a broader developmental or learning profile rather than a separate diagnosis. 

What causes auditory processing disorder?

While the exact cause of auditory processing disorder (APD) is not always known, in general, there are three main types: 

1. Developmental APD: This is present in childhood despite normal hearing. It may run in families and can continue into adulthood. 
2. Acquired APD: This develops due to injury or illness. 
3. Secondary APD: This occurs along with or as a result of another diagnosis.

How is auditory processing disorder diagnosed?

At CHOP, to diagnose auditory processing disorder (APD), an audiologist will review your child’s symptoms and your concerns. Based on this information and your child’s age and abilities, the audiologist will conduct a series of tests to assess how your child hears and how they process sound. For more details on how to prepare for your child’s auditory processing evaluation, click here.

How is auditory processing disorder treated?

Treatment for auditory processing disorder (APD) is different for every child, so your child’s care plan should be customized to fit their needs. Common treatment options may include: 

• Auditory training: therapy that improves auditory processing skills
• The use of technology and listening devices that make the speaker's voice easier to hear in noisy places
• Environmental modifications: simple changes at home or school that help with listening
• Teaching strategies like helping children to feel comfortable asking others to repeat or explain information

What is the prognosis for children with auditory processing disorder?

While there is no cure for auditory processing disorder (APD), symptoms in children can be managed and may even improve over time with treatment and ongoing support from a dedicated care team. 

CHOP care for auditory processing disorder

The Department of Audiology at Children’s Hospital of Philadelphia (CHOP) provides comprehensive, child-centered care to evaluate and support auditory processing skills. Our care team carefully evaluates each child’s strengths and needs and, when appropriate, focuses on targeted, deficit-specific recommendations. 

Our goal is to understand how your child processes sound and provide practical recommendations and guidance that support everyday communication and learning.

We do this by offering services including: 

• Comprehensive evaluations using age-appropriate, evidence-based measures 
• Individualized recommendations based on each child’s specific profile 
• Parent education with practical strategies to implement at home 
• School collaboration to support classroom success 
• Ongoing monitoring to track progress and adjust recommendations