If a child has difficulty understanding instructions, mixes up words with similar enunciations, or appears disoriented in loud surroundings, parents may presume that a hearing issue is to blame. However, in certain circumstances, the issue may not lie with the ears themselves, but instead with a condition called auditory processing disorder (APD), which affects the way the brain processes sound.

Although hearing loss and Auditory Processing Disorder (APD) often present with similar signs, they are distinct conditions that necessitate unique analyses and interventions. Below, we’ll break down the key differences to help you support your child’s distinct needs.

Understanding Hearing Loss: A Definition.

Hearing loss describes a decreased ability to detect sound, often a result of problems in the outer, middle, or inner ear.

Three primary classifications:

• Conductive hearing loss: Happens as a result of blockages or injury in the outer or middle ear, including ear infections or accumulation of earwax
• Sensorineural hearing loss: Occurs when there is damage to the inner ear or the auditory nerve, which is commonly triggered by variables including aging, exposure to loud noise, or genetic predisposition
• Mixed hearing loss: A combination of conductive and sensorineural types

Physicians usually make a diagnosis via standard hearing assessments like audiograms, otoacoustic emissions, or auditory brainstem response (ABR) testing. When a child experiences hearing loss, the issue is with their ability to perceive sound at all.

What Does Auditory Processing Disorder Mean?

APD, conversely, is not a hearing issue; it’s a brain-based issue with interpreting sounds. Kids with APD can hear perfectly fine, but they have trouble making sense of what they hear.
It’s often referred to as “perceiving sounds without grasping their meaning.”

Some common challenges include:

• Difficulty following multi-step verbal instructions
• Trouble distinguishing similar sounds or words
• Struggling in loud settings (like classrooms or restaurants)
• Having trouble recognizing humor, irony, or expressions that aren’t meant to be taken literally

A standard hearing exam might indicate no problems because the ears are functioning normally. But that doesn’t mean everything is functioning as it should. In APD, the breakdown occurs after sound is sensed, during processing in the central auditory nervous system.

Distinguishing Between Testing and Diagnosis

In order to diagnose hearing loss, audiologists use conventional hearing tests that measure sound detection. Pinpointing Auditory Processing Disorder involves more in-depth evaluations that extend beyond standard hearing tests.

Evaluations often involve a multidisciplinary team, including:

• A hearing specialist to assess how the brain interprets sound
• A specialist in speech and language to assess understanding and expression skills
• A psychologist should be consulted to determine any underlying attention or learning disorders that may imitate the symptoms of Auditory Processing Disorder (APD)

Approaches for Treatment and Assistance

If your child is diagnosed with hearing loss, treatment might include:

• Hearing aids
• Cochlear implants
• Assistive listening devices
• Medical or surgical interventions

Or, if your child is diagnosed with APD, assistance usually involves:

• Speech-language therapy
• Classroom accommodations (e.g., seating changes, written directions)
• Environmental modifications to reduce background noise
• Auditory processing therapy

Some Concluding Thoughts About Hearing Loss vs. APD

It’s essential to differentiate between hearing loss and auditory processing disorder in order to provide your child with the most reliable assistance and accommodations. If your child seems to have a hard time listening but their hearing test is normal, don’t stop there. The real problem might only be pinpointed by more in-depth evaluations. With the correct diagnosis and tailored treatment plan, kids with either condition can do well in the classroom, at home, and beyond.

For more information, give us a call.

Sources:.
About Hearing Loss in Children|Hearing Loss in Children|CDC.
Auditory processing disorder (APD)– Symptoms and causes– Mayo Clinic.
Auditory Processing Disorder vs. Hearing Loss: Key Differences.
Understanding the Differences: Auditory Processing Disorder vs. Hearing Loss|Hearing.
Associates of Las Vegas.
Auditory Processing Disorder (for Parents)|Nemours KidsHealth.