Auditory Processing Disorder (also known as Central Auditory Processing Disorder) is a condition that affects how the brain processes sound, rather than how the ears hear it.
Parents, teachers, and healthcare professionals are asking whether auditory processing disorder (APD) is linked with autism and/or ADHD, particularly when children present with overlapping listening, communication or attention difficulties.
In this article, we’re exploring the current understanding of the relationship between APD, Autism Spectrum Disorder and ADHD, highlighting shared symptoms that children can present, and explaining how to best support children in and out of school.
Understanding Auditory Processing Disorder (APD)
In short, auditory processing disorder is a condition that affects the brain’s interpretation of sounds, rather than the ear’s ability to receive and process sounds. Children with APD may hear sounds clearly, but struggle to make sense of them, especially in environments such as classrooms.
Common signs that a child is experiencing difficulties include:
- Understanding speech in noisy settings
- Following verbal instructions
- Distinguishing between similar sounds
- Remembering spoken information
- Listening fatigue and frustration
APD is a recognised neurodevelopmental condition and should always be assessed by appropriately trained hearing professionals using evidence-based clinical protocols.
At Harley Street Hearing, we provide the clinical expertise and specialist resources required to accurately assess and diagnose APD. Jordon Thompson, one of our Clinical Leads, oversees the assessment and management of APD in both children and adults, with a particular clinical interest in auditory processing in bilingual populations.
Is Auditory Processing Disorder Linked to Autism?
From a clinical perspective, there is a clear and well-recognised overlap between auditory processing disorder and autism, but it’s important to remember that they are not the same condition.
Autistic children often experience differences in sensory processing, including how they respond to sound. In practice, we frequently see children on the autism spectrum who:
- Are highly sensitive to certain sounds
- Struggle to filter out background noise
- Take longer to process spoken language
- Find verbal communication particularly demanding
Some autistic children also meet the diagnostic criteria for APD when formally assessed. Others may show listening difficulties that resemble APD but are better explained by broader sensory or communication differences associated with autism.
This is why a thorough, individualised assessment is essential; APD should never be assumed based on an autism spectrum disorder diagnosis alone.
Is Auditory Processing Disorder Linked to ADHD?
The link between auditory processing disorder and ADHD is another frequent topic of discussion in clinic, as both conditions present with symptoms that include:
- Poor listening skills
- Difficulty following instructions
- Apparent inattention
- Academic underachievement
However, the underlying cause differs widely. In ADHD, the primary difficulty lies in attention regulation and impulse control. Whereas in APD, the difficulty is specific to how auditory information is processed by the brain.
Some children present with both ADHD and APD, and this combination can intensify listening and learning challenges. Accurate differentiation is vital, as management strategies and recommendations can differ.
APD vs ADHD vs ASD: The Overlapping Symptoms
APD, Autism Spectrum Disorder, and ADHD can share symptoms such as:
- Difficulty coping in noisy environments
- Delayed responses to spoken language
- Problems with literacy and classroom learning
- Frustration, anxiety, or behavioural difficulties
Without appropriate assessment, auditory processing difficulties may be misattributed or overlooked. From a clinical standpoint, identifying APD where it exists allows for targeted, evidence-based support rather than generic strategies that may not address the root cause.
The Importance of Accurate APD Assessment
We regularly assess children who have already been identified as autistic, have ADHD, or are currently undergoing neurodevelopmental assessment.
A recurring theme in our clinical work is that listening difficulties are often attributed solely to attention, behaviour, or sensory sensitivity, when in some cases there is also a measurable auditory processing difficulty present.
One of the challenges with auditory processing disorder is that it is not immediately visible. Children may be articulate, cognitively able, and present with a normal hearing test result, yet still experience significant difficulty in environments such as classrooms.
Families often describe situations where a child appears to hear but struggles to take information in, or copes well in one-to-one conversations but becomes overwhelmed in noisy environments. These are commonly reported patterns when auditory processing difficulties are part of the clinical picture.
When APD co-occurs with autism or ADHD, listening demands can become particularly exhausting for a child. Without appropriate recognition, this can affect learning, self-esteem, and emotional well-being.
From a clinical perspective, this highlights the importance of evidence-based auditory processing assessments when listening difficulties persist, rather than assuming all challenges are purely behavioural or attentional.
A clear diagnosis is not about labelling a child; it is about understanding how they process auditory information and identifying the most effective ways to support them.
In our experience, families often report a significant sense of reassurance once their child’s difficulties are clearly explained and appropriate, targeted strategies are put in place.
How to Support Children with APD
Children with auditory processing disorder often experience the greatest challenges in environments with high listening demands. Effective support therefore relies on consistent strategies across both school and home settings.
When adjustments are aligned and reinforced, children are better able to manage listening fatigue, process spoken information, and build confidence in their communication and language skills.
Supporting Children with APD in School
In educational settings, children with auditory processing difficulties often benefit from structured, evidence-based adjustments that reduce listening strain and improve access to spoken information. These may include:
- Preferential seating to minimise background noise and improve access to the teacher’s voice
- Clear, concise verbal instructions supported by visual aids
- Repetition or rephrasing of key information
- Additional processing time before a response is expected
- Assistive listening technology where clinically indicated
Collaboration between families, schools, Special Educational Needs Coordinators (SENCOs), and healthcare professionals is essential to ensure that support strategies are consistent, appropriate, and responsive to the child’s individual needs.
Supporting Children with APD at Home
Support at home plays a vital role in reinforcing listening strategies and reducing daily communication challenges. Families are often encouraged to:
- Minimise background noise during conversations
- Ensure the child’s attention before speaking
- Break instructions into smaller, manageable steps
- Use visual cues alongside spoken language
- Maintain predictable routines and clear structure
When these strategies are used consistently across school and home environments, many children report reduced listening fatigue and greater confidence in everyday communication, both at home and in social situations.
How to Know When an APD Assessment is Necessary
If your child’s hearing test results have determined they have normal hearing but continues to struggle with listening, understanding speech, or functioning in noisy environments, particularly when autism or ADHD is also present, an APD assessment should be considered.
At Harley Street Hearing, APD assessments are conducted by our clinical lead, Jordon Thompson using recognised, evidence-based protocols. Testing is generally suitable for children aged 7 years and above and includes a detailed clinical history alongside specialised auditory processing tests.
If you think your child would benefit from an auditory processing assessment, you can find out more information about our APD testing service or contact us to arrange an appointment.
This article has been written with clinical input from Jordon Thompson, Clinical Lead at Harley Street Hearing.
