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Auditory Processing Disorder (APD) Symptoms
APD Checklists by Age
Does your child ask for things to be repeated? Is their reading slow and labored? These are signs of an auditory processing disorder, or at least an auditory processing deficit, that can be remediated with cognitive training.
APD is a neurodevelopmental delay in how the brain interprets sounds. It’s not a physical hearing issue; it’s a cognitive delay. More about APD types and causes here.
Should I have my child evaluated for APD?
Before sending your child to an audiologist, use the checklist of auditory processing disorder symptoms below for an initial screening. If your child has 2-3 signs on one of the lists, you should consider the next steps. If not, your child may simply be a slower developer, or the source of the difficulty may be elsewhere.
If you do see signs of auditory processing disorder in your child, though, you should act. Auditory processing delays impact almost every aspect of a child’s life – in class, listening to the coach, in the playground, doing homework, and at reading time. It’s exhausting and a little soul-destroying, all of it.
As long as your child has auditory processing difficulties, life will be an uphill climb. Progress will be made, but the challenges change; the difficulties and signs of APD in a 6-year-old or 7-year-old are quite different from the difficulties and APD symptoms teenagers face. But difficulties, nevertheless.
If you have concerns, take our APD screening for symptoms and risk factors, and we will send you our findings.
“It’s as if a switch in her brain went on. She is finally making connections between letters, sounds, and words. She has started writing letters to family and friends (which she never did). She also joined a soccer team and was able to follow the coach. She has way more confidence. Thank you for helping our daughter finally start to find her way!”
“He has made a remarkable transformation in just a few months of 10th grade. First, he noticed he was following instructions at a summer sports camp far more easily. He said that he wished he had done the program years ago. Now at school, he is much happier and has more confidence. His school day is so much more productive as now he catches everything the teacher says.”
READING ASSESSMENT
Free nationally-leveled online test.
APDReading
Georgia
Age: 11
Location: California
Diagnosis: APD
Results
Georgia’s reading progressed significantly, from leveled readers to chapter books. She now participates comfortably in conversations with adults and her friends.
APD Symptom Checklists by Age
Because there is generally no hearing loss or evidence of neurological disorders associated with auditory processing disorder, it often goes undetected. Another complication is that symptoms of APD often overlap with specific language impairment, ADD/ADHD, developmental dyslexia, or delayed learning.
Difficulties related to APD
Auditory processing disorder has been likened to listening to sound through water. This creates these areas of APD-related difficulty:
- Sound discrimination. Temporal auditory processing determines how well a child can distinguish between rapidly changing syllables where the sound changes in milliseconds. “Thrill” is heard as “frill.”
- Auditory memory. If the language sounds muddy, it does not always make sense, making it hard to organize and memorize. This impacts math facts, following directions, etc.
- Background noise. Difficulty separating out one source of sound, e.g., a teacher, over others, e.g., class noise (called dichotic listening)
- Language processing. This is where auditory processing disorder causes the most havoc. It impacts the ability to understand and think about language, spoken and written. This has academic and social consequences.
The checklists below are primarily age-related symptoms caused by one of these difficulties. Of course, auditory processing needs change as a child grows – early language delays might fade, but academic and social hurdles come into view. Having said that, there are persistent universal signs of APD that affect all ages:
- Listening difficulty with background noise
- Trouble following verbal multi-step instructions or long explanations
- An inability to read with automaticity
Review the age-specific lists below to see if your child is at risk.
APD Checklist – Early Childhood
Speech delays are most often a language-processing issue; your child isn’t hearing longer words or word blends well enough to use them when talking. Signs of a specific auditory processing disorder in toddlers include:
- Difficulty rhyming – this is considered the single most important indicator of future reading skills
- Delay in learning to speak
- Leaves the last letter off words – “ca” instead of “cat”
- Difficulty listening with background noise – this sign of APD persists through life
- Slow start to recognizing letter sounds in words (as opposed to the alphabet)
APD Checklist – 5-Year-Old Milestones
This is the age that parents start to wonder if their child is being held back by auditory processing disorder. Signs of auditory processing delays in 5-year-olds include:
- Difficulty with similar-sounding words or letter sounds – /ma/ versus /na/
- Difficulty listening with background noise (or dichotic listening)
- Delayed response to questions
- Inability to take in or remember two-step spoken directions.
- Pronunciation errors – leaving off the final consonant or garbling longer words
APD Checklist – 6-Year-Old Milestones
This is the most common age for an APD diagnosis, as this is when a child’s listening in class and learning to read become priorities – for the parents, and for the child. If there are any difficulties here at all, parents are aware and start looking for signs of APD.
- Phonics difficulty – this is the most important tell of upcoming reading difficulty
- Difficulty sounding out phonetic words, like “band”
- Consistently mishearing song lyrics
- Inattentiveness in class or while reading – a possible sign of exhaustion
- Frustration or acting out to avoid reading or in reaction to multi-step verbal instructions
Note: symptoms of auditory processing disorder in 7-year-olds are similar to those on this list, as 7 years of age is a key point of biological maturation when auditory processing skills generally click into place. If your 7-year-old has been a little behind peers in all aspects, then this checklist of APD for 6-year-olds is relevant.
However, if your child is otherwise on schedule or ahead, and not meeting these milestones, there is more reason for concern.
APD Checklist – Elementary Age
Many aspects of auditory processing dysfunction only surface in elementary school when multitasking comes into play. For instance, reading comprehension requires both decoding and understanding the content simultaneously. This requires processing efficiency that is beyond the reach of most children with APD.
By third or fourth grade, academic demands pivot from “learning to read” to “reading to learn.” Lost time in late elementary grades is hard to make up, making the need to identify signs of APD in your 7- or 8-year-old a priority. Signs include:
- A lack of progress with reading comprehension and/or reading reluctance
- Difficulty listening with background noise – in the playground and in class
- Difficulty following verbal multi-step directions
- Inattentiveness in class
- Mishearing words of songs
- Spends too much time on homework or disappointing test results
- Difficulty with word retrieval or rapid automatized naming (knowing the word but struggling to pull it from memory).
APD Checklist – Teenagers and Adults
By high school, speech issues are mainly resolved, but APD still impacts listening, reading, and thinking (we think in our native language). Tracking auditory processing disorder symptoms in teenagers focuses more on executive function and test performance.
Common signs of auditory processing disorder in teenagers and adults include:
- Difficulty listening with background noise – in the playground and in class
- Reading comprehension stalls and/or reading reluctance develops
- Disappointing performance in high-stakes tests
- Slow worker in tests and/or homework
- Struggles to remember a list or sequence
- Social anxiety due to difficulty in tracking conversations in noisy peer environments.
APD vs. ADHD, Dyslexia, and Speech Delays
Because APD causes delays in reading, and the exhaustion from listening with APD causes inattentiveness, APD symptoms overlap with other learning differences. It is common for APD to be misdiagnosed or to co-occur with:
- Developmental Dyslexia: Phonological awareness is the foundation of reading. If a child cannot map sounds accurately due to APD, they will almost always display symptoms of dyslexia.
- ADD/ADHD: A child who cannot process what a teacher is saying will naturally drift off, appearing inattentive or hyperactive.
- Specific Language Impairments: Delays in expressive and receptive vocabulary often stem directly from poor sound discrimination.
If any of these symptoms resonate with you, take a look at our APD solutions here.
Signs of APD in Daily Life
Auditory Processing Disorder impacts all aspects of life, from the ability to communicate at the family dinner table, interactions in the playground, while reading, and in class. 9 consequences of APD here.
1. APD Symptoms in the Classroom
The first signs of APD in 6-year-old students typically appear when they start school. Language is coming at them from all directions, the classroom is noisy, and learning to read is a new priority:
- Dichotic Listening Failure: This is the ability for the brain to focus on one source of sound, hopefully the teacher!, to the exclusion of all others. Young children in particular with APD struggle to do that. More on dichotic listening here.
- Slow Response Times: Slow and inefficient language processing slows down how quickly a child can take in a verbal question, attach meaning, and then form a response. This delay, demonstrated with frightening clarity in the F.A.T. City video, is a source of frustration, embarrassment, and a loss of self-esteem for so many children with APD.
- Drifting Off: Processing a teacher’s fast-paced explanations is exhausting, so children naturally tire. Or they are not able to process fast enough to keep up and so lose track. Either way, children with APD are prone to tuning out in class.
- Multi-Step Instuctions: The instructions around homework assignments or changes in what the class does next include a sequence of steps that many children with APD cannot follow. In class, they can follow what the other kids do, but at home, it can create problems with the actual assignment.
- Note-Taking: One aspect of APD is that auditory input is not well integrated with non-auditory function in the brain – more on Auditory Integration here. And so, simple tasks like converting verbal information into written text can be much more of a burden than you might imagine.
- Anxiety: Testing in particular exposes inefficient processing, inefficient reading, and working memory deficits often caused by APD. Test-result disappointments and failures can be an accumulating source of anxiety about school and learning, becoming somewhat self-fulfilling. More on our cognitive training for test-taking here.
2. APD Symptoms At Home and in Social Settings
Unfortunately, life outside school hours is not much easier. Signs of APD in 6- and 7-year-olds are everywhere, but even as your child ages, APD presents difficulties in unexpected places:
- Can’t Get Beyond Literal: Signs of social difficulties caused by APD in 5-year-olds and 6-year-olds may not be obvious, as play tends to be more physical and interactions are simple and transactional. Literal language comprehension is good enough. However, around age 7, conversations with friends start to include nuances, clumsy sarcasm, and other complexities that a child who is working hard just to make out the words will miss. That can start to cause social issues.
- Playground Issues: Dichotic listening issues (not being able to hone in on a speaker) can make it hard for a child to follow conversations or the rules of a new game in a noisy playground. This can lead to embarrassing episodes, and then, depending on the child, social withdrawal
- Meltdowns at Home: Working double time to keep up with the teacher and managing a challenging school day is exhausting and can lead to a short fuse in the safety of home. Similarly, embarrassment over not having fully understood the homework assignment or the frustration of knowing it’s beyond you can lead to a shutdown – part avoidance and self-preservation, and part frustration and self-doubt – what’s wrong with me. This is particularly true of 5, 6, and 7-year-olds with signs of APD.
3. APD Symptoms When Reading
Reading is oral language in a visual format. If a child cannot process oral language perfectly, of course there will be reading issues. In reading, the symptoms change. Signs of APD in a 5-year-old center around letter sounds; for 7-year-olds, focus is on fluency; and by 9 and 10 years of age, APD affects comprehension.
- Phonemic Awareness Delays: Arguably, most APD is detected when a child who learned to speak on time and can follow directions struggles with phonics. The inability to pick out the sounds inside words – phonemes – is a classic sign of APD in 5- and 6-year-old children. As children age, they do start to hear the sounds, but then the challenge is that they can’t do it without concentrating, which makes reading aloud slow and laborious. Eventually, that lack of automaticity in decoding undermines reading comprehension in 8- and 9-year-olds, a deficit that can be traced to an auditory processing deficit.
- Erratic Spelling: If a child can hear the sounds inside words, spelling phonetic words – like “band” – should be easy. The fact that it isn’t for many young children often leads to investigation that ends up in an APD diagnosis. If your child misspells phonetically pure words like /band/ as often as they misspell irregular words like /enough/, they are likely to be carrying an auditory processing delay.
- Weak Reading Comprehension: Some children with APD can learn phonics and spell, but struggle with comprehension. Comprehension requires automatic decoding, recognizing every sound in every word subconsciously and without needing to concentrate. It’s a classic sign of APD in 8- and 9-year-olds when comprehension falls short due to automaticity in decoding.
4. APD Symptoms in Advanced Academics
We have quite a few students who get through to high school but then hit a wall. The signs of APD in teenagers related to academic shortfalls are most obvious in delayed development of higher-level skills such as executive function and metacognition:
- Homework Inefficiency: The age-old problem for all children with APD of not being able to follow the teacher in class and accurately understand the homework assignment is present for all ages. APD causes difficulty understanding the assignment, slow reading and writing at home to complete homework, and poor organizational skills and planning (or procrastination) in managing homework.
- Disappointing Test Results: Testing requires a range of learning skills compromised by APD – working memory, reading speed, reading accuracy, and executive function. Knowing the material and failing the test might lead back to APD.
“She received her first trimester 1st grade report yesterday. Her subject grades were as follows: Language Arts 97%, Reading 96%, Math 99%, Science 100%, Social Studies 100%. Plus her Diebels reading scores were OFF THE CHARTS! Based on this report card Rachel no longer needs any special intervention for her auditory processing issues as she continues to advance at a higher level than her peer group… So it was wonderful to use your service but I do not anticipate we will need Gemm Learning in the future. Thanks for all your help.”
“I am now really seeing the positive effects the program has had with his language. He is using language that I have never heard him use before, much more natural language, like instead of saying to me “I want the shrek toy”, he is saying “mum where is the shrek toy, I can’t find it, I think it was in here” etc. So a vast improvement for him.”
What to Do With Your Observations of APD Symptoms
The Tension Between Natural Maturation vs Early Intervention
It is important to understand that auditory processing for language clicks into place around 7 years of age. This is why some countries don’t teach reading until 7, as only then will most of the class be able to manage letter sounds and phonics.
This makes signs of APD in 7-year-olds particularly pertinent.
While early speech delays can indicate that your child is behind the curve, your child’s maturation cycle is unique, and late development is always possible. And so, looking for signs of APD in a 7-year-old is more about where your child stands, understanding there’s still maturation to come.
However, the other side of the coin is the value of early intervention. Learning is sequential, and so any lost time early on is hard to make up.
If you see signs of APD in your 8-year-old, we would recommend an intervention. Most of the natural maturation of auditory processing skills has occurred, and so there’s much less value in waiting.
However, if you see symptoms of APD in your 6-year-old, it’s a matter of deciding how severe the symptoms are and assessing current progress. If recent momentum is slow, then you might want to seek an evaluation or an intervention.
Here is an Infographic – APD by Age
Note on Child Development: Always compare your child’s abilities to their direct peers. For example, auditory discrimination between close phonemes (like /na/ and /ma/) does not fully mature until ages 6 or 7. Not hearing those phonemes is not necessarily a sign of APD for a 5-year-old.
Next Steps: Taking Action
If your child displays 2 or 3 symptoms on an APD checklist, it is important to take action. Even a mild case of Auditory Processing Disorder interferes with all aspects of your child’s learning, reading, and social life.
You have two primary paths forward:
Seek a Formal Diagnosis. You can consult the American Speech-Language-Hearing Association (ASHA) to find a local audiologist or speech-language pathologist equipped to run behavioral auditory processing tests.
Targeted Cognitive Training. Fast ForWord is the most recognized brain training software for APD in the world. It trains and improves processing and related cognitive skill gaps through targeted exercise. Most children develop these neural pathways naturally, but those with APD require more language stimulation than daily language immersion provides.
‘Gemm Learning uses clinical-grade Fast ForWord® software to address the root causes of APD at home. Read more about our programs for APD here.
Infographic of Auditory Processing Symptoms By Age
This visual summary of APD symptoms shows how significantly the signs of auditory processing disorder in 6-year-olds and 7-year-olds morph in just a year or two as the reading and academic demands escalate dramatically.
Each child is unique, and so maturation varies. However, as you observe your child, be realistic. A classic definition of a disability is a lag in one area relative to other abilities. And so if your child is progressing well in most areas but is not hitting the auditory processing milestones, that is probably not a maturation issue.
