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Auditory processing disorder

What’s the Difference Between Auditory Processing Disorder and ADHD?

By Joanne Restivo

I think my daughter might have auditory processing disorder, ADHD or both. What’s the difference between them? And how can experts tell them apart?

Joanne Restivo

Former Assistant Professor of Audiology, Columbia University Medical Center

Some of the symptoms of auditory processing disorder (APD) and attention-deficit hyperactivity disorder (ADHD) can look similar. Each of these conditions can make it hard for kids to understand what’s being said. This is especially true if they’re in a noisy room or if they’re being asked to follow multi-step directions.

Kids with APD may sometimes act the same way as kids with ADHD. But they’re behaving in these ways for very different reasons.

APD involves difficulty processing sound. It makes it difficult for the brain to make sense of what the ear hears. ADHD affects the brain’s ability to stay focused. But this lack of attention can lead to difficulty understanding what’s being heard.

Here’s a classroom example to highlight the differences between these two disorders. Let’s say the teacher tells the class, “OK, everyone, take out your math book and open to page 25.” A child with APD might be paying close attention but has trouble following the teacher’s directions. The child may become confused and take out the wrong book or turn to the wrong page.

Meanwhile, a classmate sitting in the next row who has ADHD might be so distracted by the itchy tag on his shirt or by the distant rumble of a school bus engine that he doesn’t focus on what the teacher is saying.

Both kids might respond to the teacher’s request in the same way: “Huh?”

APD and ADHD can look similar on the surface. They can also coexist. That’s why careful evaluation by a multidisciplinary team of professionals is needed to determine the correct diagnosis. Important areas to be evaluated are hearing, academic performance, cognitive function and speech-language development, including both written and oral communication.

Once the correct diagnosis is identified, the team can develop an effective treatment plan. Some classroom accommodations can help with APD and ADHD. For example, seating a child closer to the teacher and away from the hallway or other sources of distracting noise can be helpful.

Keep in mind that ADHD medication won’t benefit a child with APD. Talk to your child’s teacher or doctor about getting a comprehensive evaluation.

About the Author

Portrait of Joanne Restivo

Joanne Restivo

Joanne Restivo, Au.D., is an audiologist in Newport, California, and a former assistant professor of audiology at Columbia University Medical Center in New York City.

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