What are the symptoms? Patients with suspected APD present with: difficulties with hearing and listening in noisy placesunderstanding when listening (can also be due to a language processing disorder)mishearing and asking for repetition in spite of normal hearing testspoor academic performancedifficulty understanding spoken messages and/or remembering instructions (can also be due to poor short-term memory)difficulty staying focusedpoor attention or day dreaming (can also be due to attention deficit or poor hearing)disruptive behaviour in class. Many children with APD may have other co-existing language and learning difficulties such as: dyslexiaattention deficit (AD) and/or attention deficit hyperactivity disorder (ADHD)speech and language impairmentcommunication disorders, such as autistic spectrum condition (ASD; see entry Autism Spectrum conditions). What are the causes? In most, APD is considered to be due to a neurodevelopmental disorder, such as dyslexia. In a small percentage, APD is acquired following some form of brain injury or secondary to a condition that leads to a fluctuating hearing loss, such as glue ear, especially in the first few years of life. Sometimes APD can occur alongside other neurodevelopmental disorders, such as dyslexia and autism. How is it diagnosed? Studies have suggested that up to 5% of children may have some level of APD. There are a number of hearing and listening tests to diagnose APD and currently these are available to children at least 6 years of age in a small number of specialist centres across the country, although some centres prefer to wait until the children are at least 7 years of age. If there are suspicions of a language disorder or cognitive difficulty, these should be assessed before requesting an APD assessment. How is it treated? There is usually no cure for APD but there are a number of strategies that would help an affected child. Also, Auditory training software could improve certain specific types of APD (e.g. Spatial Processing Disorder) Audiologists, teachers of the deaf and speech and language therapists can offer advice about: auditory training programmes, exercises and strategies to help the child become a better listenerminimising the effects of APD at home and school. General suggestions to help at school: the child should sit close to the teacher to hear better, lip read and use other cues to aid understandingprovide written information to consolidate verbal instructionscreate a more favourable listening environment by adding carpet and soft furnishings (bean bags for example) and replace worn rubber feet on table and chair legs. These simple adjustments that will minimise the background noise level and reverberationassisted FM listening devices make it easier to hear the teacher (e.g. iSense, Phonak Roger devices, ReSound minimicrophone) by making the teacher’s voice level relatively louder than the background noise (improving speech to noise ratio)dynamic class soundfield systems can help to keep speech to noise ratio at a favourable constant level, but quality of soundfield speakers need to be very good, otherwise sound from the room speakers simply can add to the ‘noise’listening to good quality recorded material through personal headphones with good acoustic output in mental maths tests and foreign language aural lessons and examinationsyounger children will be helped by a visual material and other visuals to support spoken instruction. In the home: encourage the child to do listening and learning exercises at a regular timecheck that the child is looking and listening when necessaryreduce background noise (such as TV or radio) when speaking. Inheritance patterns and prenatal diagnosis Inheritance patternsThere is a possibility that APD may run in families, but further studies are required in this area. Prenatal diagnosisNone. Is there support? APD Support UK Email: firstname.lastname@example.orgWebsite:https://apdsupportuk.yolasite.com/ APD Support UK is the only organisation providing UK-wide support to individuals and families affected by Auditory Processing Disorder (APD). Their website contains free, printable information about APD, coping strategies/management, strategies for support at school and at work, current research projects and more. It also provides details of where to find specialist testing and diagnosis for children and adults. and links to support groups for adults with APD, parents and loved ones. Group details added December 2021.