The difference between auditory processing disorder and ADHD

Lagging behind at school. Not following directions properly. Seeming “out of the loop” in social situations. These can be signs of both ADHD and auditory processing disorder (APD), two very different issues that sometimes can look so similar, they may be mistaken for each other and misdiagnosed.

This chart shows some of the similarities and differences between APD and ADHD.

 Auditory processing disorderADHD
What is it?

A brain-based condition that makes it hard to process what the ear hears, such as recognizing subtle differences in the sounds that make up words.

APD impacts language-related skills, such as receptive and expressive language.

A brain-based condition that makes it hard for kids to pay attention and stay focused. They may also be impulsive, hyperactive, and have trouble with self-control.

Kids with ADHD often struggle with executive functions, including working memory. They may also have trouble managing emotions.

Signs you may notice
  • Seems “tuned out” due to not understanding what’s being said
  • Seems forgetful
  • Struggles to follow conversations and respond to spoken questions
  • Frequently asks people to repeat what they’ve said; often responds with “huh?” or “what?”
  • Has trouble following directions and spoken instructions
  • May not speak clearly, confuses similar sounds, such as “three” instead of “free”
  • Has trouble with rhyming
  • Is easily distracted by background noise or loud and sudden noises
  • Struggles with activities that involve listening comprehension
  • May prefer to read stories independently rather than listen to them read aloud
  • Seems “tuned out” due to inattention
  • Seems forgetful
  • Struggles to focus during conversation and when responding to spoken questions
  • Frequently doesn’t react or respond when spoken to; when pressed, might say “I didn’t hear you!” or “What?”
  • Has trouble following directions
  • Finds it hard to stay organized and on task
  • Interrupts people and blurts out things inappropriately
  • Is easily distracted by whatever’s going on — sounds, sights, activity
  • Struggles to sit still during quiet activities
  • Is constantly fidgeting and moving and gets bored easily unless an activity is very enjoyable
Possible social and emotional impact

Kids with APD may miss social cues because they have to focus so hard on understanding the actual words being said. They may not pick up on sarcasm and nonverbal forms of conversation.

As a result, they may avoid socializing, or want to be alone during gatherings, because keeping up with conversation can be exhausting and stressful.

Kids with ADHD may have trouble following social rules, which can make it hard to make and keep friends.

They may get a lot of negative feedback for acting out or not paying attention. This can result in feeling excluded or like the “bad kid.” As a result, kids with ADHD may struggle with low self-esteem.

Professionals who can help
  • Pediatricians, developmental-behavioral pediatricians, nurse practitioners: May suspect an issue and refer child to a specialist.
  • Clinical child psychologists: Provide cognitive behavioral therapy (CBT) to help with emotional issues related to APD. Diagnose mental health issues that may co-occur, like anxiety and depression. May also evaluate for learning differences and ADHD, which often co-occur with APD.
  • Audiologists: Some audiologists can evaluate for APD along with hearing issues.
  • Educational therapists or reading specialists: Work on reading skills impacted by APD.
  • Speech-language pathologists: Work on sound discrimination (understanding the difference between certain sounds), active listening skills and using appropriate language in social situations.
  • Pediatricians, developmental-behavioral pediatricians, nurse practitioners, psychiatrists: Diagnose ADHD and may prescribe ADHD medication. Psychiatrists will look for other issues like anxiety.
  • Clinical child psychologists: Provide behavior therapy to teach kids skills to manage their actions and interactions. Provide CBT to help with emotional issues related to their ADHD. Diagnose ADHD and mental health issues that may co-occur, like anxiety and depression. May also evaluate for learning differences.
  • Pediatric neuropsychologists: Diagnose ADHD and common mental health issues that may co-occur. May also evaluate for learning differences.
  • Educational therapists and organizational coaches: Work on organization and time management skills.
What the school may provide

Accommodations under an IEP or a 504 plan. Examples of accommodations may include:

  • Getting extended time for reading and writing
  • Being seated near the teacher and away from noisy distractions
  • Having teachers make eye contact before giving instructions and check in frequently to make sure a child understands
  • Use of pictures, gestures and symbols to enhance spoken lessons
  • Use of a quiet work space to do independent work
  • Being provided with prepared classroom notes or copies of another student’s notes

Accommodations under a 504 plan or an IEP. Kids might be eligible for an IEP under the category of “other health impairment.”

Examples of accommodations might include:

  • Getting extended time on tests, including standardized tests
  • Being seated near the teacher and away from distractions
  • Having an agreed-upon signal the teacher can use to get the child’s attention
  • Use of picture or written schedules for the day’s activities
  • Use of a quiet area to do independent work
  • Having longer assignments broken down into smaller chunks; being given worksheets with fewer questions
What you can do at home
  • Set up a quiet place where your child can do homework with minimal distractions.
  • Use visual prompts like visual schedules, checklists and sticky notes to help your child stay on task and get things done.
  • Give instructions one step at a time, since multi-step directions can be harder to process and remember.
  • Establish eye contact before giving instructions.
  • Shut off the radio and TV when talking to your child.
  • Try apps and games that build reading and listening skills.
  • Use closed captions to help your child follow dialogue on TV.

Learn more ways to help kids with APD at home from a mom who’s been there.

  • Set up an organized homework area that is quiet and free of distractions.
  • Use visual prompts like visual schedules, checklists and sticky notes to help your child stay on task and get things done.
  • Set rules and stick by them to help your child think before acting.
  • Provide structure by creating daily rituals and routines.
  • Break chores and tasks into smaller chunks; encourage breaks during study and homework time.
  • Give advance warning about schedule changes, and explain what to expect in new situations.

Learn about more strategies to help kids with ADHD at home.


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