Similarities and Differences Between ADHD and Auditory Processing Disorder
More than 20 years ago, a small study showed that attention deficit hyperactivity disorder (ADHD) and auditory processing disorder (APD) were closely related. The two conditions share several symptoms – including distraction and inattention, however, today there is still debate as to what the connection between the two really means.
What is APD?
APD, also known as central auditory processing disorder (CAPD) is when a child with normal hearing has difficulty processing the sounds or hearing in areas where there is background noise. He or she sometimes cannot distinguish similar sounds, such as b and v or c and g.
Some of the common symptoms of CAPD are:
- Difficulty hearing when there is background noise
- Difficulty processing spoken words quickly making it hard to follow along in conversations
- Poor auditory memory
- Difficulty following oral instructions, especially multi-step instructions
- Speech delays when young
- Can misinterpret things that are said without realizing they misinterpreted it
- Difficulty with phonics causing a delay in learning to read
- Consistently asks for things to be repeated
- Difficulty with unspoken social cues
APD is diagnosed through a battery of tests where a child’s hearing is monitored. The child listens and interprets sounds as background noise is slowly increased. Only specialized audiologists can diagnose APD.
APD vs. ADHD
APD and ADHD are considered separate disorders, however, it is possible for someone to have both at the same time and they do share similar symptoms, making diagnosis more difficult. Both have inattention and distractibility in common. Both can cause problems with following conversations or following directions (although the underlying cause would be different.) Despite the similarities, there are some differences to help differentiate the conditions:
- With APD, children don’t usually have as many problems paying attention or focusing when they are in a quiet environment. It is the background noise that causes difficulty. In ADHD, inattention and lack of focus appear in any environment.
- Both conditions can cause difficulty with recall and memory of auditory information. However, children with ADHD usually have short-term memory issues with more than auditory information.
- Children with APD show characteristics similar to hearing loss, even though they can hear normally. Their difficulties with listening, following directions and academic work stem from the inability to distinguish and interpret the sounds they hear. Children with ADHD have difficulties with listening, following directions and sometimes academic work because of inattention, distraction and hyperactivity.
Different medical professionals diagnose these conditions. Family doctors and mental health professionals diagnose ADHD but cannot diagnose APD – that must be done by a specialized audiologist.
Another concern is that there were some reports that methylphenidate, a stimulant medication commonly prescribed for ADHD, also helped reduce symptoms of APD. However, research has shown that this is not the case but that individuals who were diagnosed with both ADHD and APD did show improvement when taking this medication. It is thought that the improvement in ADHD symptoms, such as better focus, improved some of the common symptoms. Further studies showed the APD symptoms did not improve.
A note about insurance
If you believe your child might have APD or APD, talk with your health insurance company before going for testing. Some insurance companies consider diagnosis and treatment of APD to be experimental and do not pay. Aetna, for example, states, “Aetna considers any diagnostic tests or treatments for the management of auditory processing disorder (APD) (previously known as central auditory processing disorder (CAPD)) experimental and investigational because there is insufficient scientific evidence to support the validity of any diagnostic tests and the effectiveness of any treatment for APD.”
For more information on diagnosing ADHD in children:
What Is CAPD?: CAPD Support