ASHA’s (  Definition for Auditory Processing:

(Central) auditory processing disorder (C)APD refers to difficulties in the processing of auditory information in the central nervous system (CNS) as demonstrated by poor performance in one or more of the following skills: sound localization and lateralization; auditory discrimination; auditory pattern recognition; temporal aspects of audition, including temporal integration, temporal discrimination (e.g., temporal gap detection), temporal ordering, and temporal masking; auditory performance in competing acoustic signals (including dichotic listening); and auditory performance with degraded acoustic signals. Non-modality-specific cognitive processing and language problems may manifest themselves in auditory tasks (i.e., as listening problems); however, diagnosis of (C)APD requires demonstration of a deficit in the neural processing of auditory stimuli that is not due to higher order language, cognitive, or related factors.

When to Refer for (C)APD Testing

by Laura Polich, Ph.D, CCC of Portland Auditory Processing Diagnostics

Children or adults merit consideration for (Central) Auditory Processing testing if some or all of the characteristics below are present:

AGE: Child is seven years of age or older.  (In severe cases, some testing can be done at age five.)


  • Hearing is “within normal limits” (per audiogram) and Word Discrimination is above 88% in a quiet environment.
  • Hearing is normal and symmetrical, but Word Discrimination scores are asymmetrical (more than a 10% difference).
  • Mild symmetrical hearing loss is present, but client shows difficulty hearing in noise beyond that typical for someone with such a level of hearing loss.

At Home Behavior:

  • When given a multi-part instruction, only does first part, then gets distracted or “forgets.”
  • Family comments include: “Sometimes I think there is a hearing loss”; “hears what s/he wants to hear”; “acts like s/he doesn’t hear me sometimes”; “I know s/he has heard me, but s/he just sits there looking at me like s/he didn’t understand”
  • Parent reports: “the school thinks there is an attention problem, but s/he can play video games for hours so I don’t see the lack of attention so much at home.”
  • Has friends, but often complains that his/her feelings are hurt by playmates
  • Often doesn’t get humor (jokes) or sarcasm
  • Often asks for repetition or clarification
  • May not be good at telling where a sound is coming from or who is talking in noisy situation
  • Prone to temper tantrums or arguments when in a noisy situation
  • Poor at understanding people who have a heavy accent or whose speech is not clear

School Behavior:

  • Experiencing academic problems
  • Characterized by teacher as acting “spacey”, “dreamy”, “on another planet” or “lights on but no one home” during class
  • Difficulty learning to read or do calculations
  • Rarely completes seatwork during school hours, even if time deadline is extended
  • Easily distracted by antics of children in near proximity
  • Teacher wonders if a hearing loss is present
  • Poor at carrying out multi-step instructions
  • May do first step, but then cannot say what other parts are
  • Has difficulty auditorially discriminating minimal-pairs (like “bed” and “said”)
  • Works better in quiet room (such as detention) than in regular classroom
  • Does better in classes not dependent on oral language
  • Needs more clarification of an oral assignment than other children
  • Hardest classes rest on reading for content

For more information on Auditory Processing and/or Portland Auditory Processing Diagnostics, click here




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