What is Auditory Processing and how do I know if I have a disorder?

Auditory processing is how the brain makes sense of what the ear “hears”.  We often make the mistake of thinking that we hear with our ears.  In reality, our ears detect sound but we really hear with our brain.  As sound travels from the ear up to the cortex in the brain, there are many places it gets processed along the way.  The brain extracts specific information from the auditory signal at distinct places along its pathway.  This information is what enables you to decode what was said.  For example, did you hear /d/ or /b/.  Was the word “date” or “bait”?  It enables you to perform much higher complex tasks such as filter out background noise or locate where sound comes from around you.  If you are shopping at Costco with your spouse and they call to you, do you know where they are?  Can you maintain a conversation in a busy bar or restaurant?  Our brains are amazing and so often we don’t realize the hard work they perform for us until something isn’t working right.    If there is dysfunction in one of these places along the pathway you will have an auditory processing disorder.  Because there are many places for dysfunction, there are many types of auditory processing disorders.  

What are the signs of an Auditory Processing disorder?

People with auditory processing disorders often have normal hearing but they may act like they have a hearing loss.  Frequently they may have been to an audiologist and been told that they have normal hearing and to return in a few years.  However, even with a normal audiogram, they feel frustrated because they feel they don’t hear well. People with an auditory processing disorder may have a hard time distinguishing between words that sound similar, like: cat, hat, bat, that.  Or they may confuse words like “seventeen” and “seventy”.  People with auditory processing difficulties often struggle to hear in background noise.  They have difficulty filtering out what they don’t want to hear and paying attention to what they do want to hear.  Symptoms of an auditory processing disorder may include difficulty with: communication, thinking, attention, and behavior. 

Auditory Processing Disorders in Children

Auditory processing disorders may be present at birth or they may develop as the child grows. Many parents say they notice something isn’t right around age 3 or 4.  Parents and caregivers remark that their child is bright but has a hard time following directions and listening.  The child may ask for repetition and behaviorally, the child may have frequent meltdowns.  They may be getting in trouble for not following directions when they didn’t hear or understand the directions. Parents may feel like their child has attention deficits or behavioral issues and this can make for a rocky early childhood environment if parents don’t understand the root cause of unwanted behavior. 

School age children with auditory processing disorders often have a hard time learning to read, write, and follow directions.  While older children start to have trouble with friends because social interactions become more complex. Children may seem confused and lost in conversation because they can’t keep up.  They continue to struggle to follow directions.  At first glance, it may look like a learning disability or attention deficit problem.  The auditory pathways don’t fully develop until age 13, so there is a chance that as the auditory system matures, the child may grow out of their auditory processing disorder.  Unfortunately, there is no way to know who will mature out of the dysfunction and who will continue to struggle.  Either way, auditory training and environmental changes can make a big improvement in overall functioning. 

Auditory processing disorders during menopause

Estrogen impacts many body systems.  Once a woman enters peri-menopause she really understands the importance of this hormone!  Estrogen has been shown to be produced by auditory neurons and it impacts neurotransmission in the brain.  Estrogen also has been shown to affect blood flow in the inner ear.  Due to its role in the auditory system, a drop in estrogen has been shown to impact women’s auditory processing abilities.  

Age-related APD

Unfortunately, as we all get older, we have to contend with many age-related changes.  Some of these changes happen on the outside of our bodies and are readily visible.  Other changes happen internally that we can not see.  One change that happens in our brain as we age is that the corpus callosum does not transmit information between the hemispheres as effectively as it did when we were younger.  This leads to difficulty hearing in background noise among other auditory processing issues.

It is not uncommon for people in their mid-30s with normal hearing tests to report no longer being able to hear well in bars! A round of auditory training may help this!  When you compound age-related APD with age-related hearing loss in older adults, hearing aids and auditory training are both recommended for optimal outcomes.