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What is the difference between ADHD and APD?

October is ADHD Awareness Month. But what is the difference between ADHD and Auditory Processing Disorder (APD)?

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common mental health condition which can affect children and adults. The aim during ADHD Month is to raise awareness of the disorder, as well as educate and share experiences with others. 

What is ADHD?

ADHD is a neurodevelopmental disorder which often presents as patterns of behaviour including inattention and/or hyperactivity-impulsivity that can interfere with daily life or general development. People with ADHD often have problems paying attention, beginning an activity, organising themselves or with remembering things. While there is no single test to diagnose ADHD, specialist healthcare professionals are able to rule out depression or anxiety, which often present with similar symptoms. 

The three main presentations of ADHD include: 

  • Inattention
  • Hyperactive-impulsive behaviour
  • Combined inattentive & hyperactive-impulsive

The main symptoms for determining a diagnosis of ADHD include:

  • Failure to pay close attention or makes silly mistakes
  • Difficulty in staying attentive 
  • Doesn’t seem to be listening 
  • Struggles to follow instructions
  • Difficulty with organisation 
  • Dislikes tasks that need ongoing mental concentration 
  • Loses things
  • Easily distracted
  • Forgetful about daily activities
  • Fidgets or squirms when seated (and difficulty remaining seated)
  • Extreme restlessness or in children, frequently running around or climbing 
  • Difficulty engaging in quiet tasks 
  • Talks excessively
  • Impatient and interrupts other people

People with ADHD may have trouble processing information received from each of their senses, including auditory sounds and noises. In a 2017 study, children with ADHD were found not to perform as well on auditory processing and hearing tests. Because ADHD affects function, attention and impulse control, it may be difficult for people to process sounds or distinguish one sound from another, particularly in distracting environments. Research also suggests that people with ADHD may have other sensory processing issues, such as needing sensory stimulation such as chewing or they may be less responsive to loud noises or bright lights.

So, what is Auditory Processing Disorder (APD)?

Auditory Processing Disorder (APD) has similar symptoms to ADHD. Someone with APD  may be struggling to interpret sound and seem inattentive, as their difficulty with processing sound can affect their behaviour. A 2018 systematic review found that children with APD have similar characteristics to children with ADHD – and it is also possible for someone to have both ADHD and APD.

People with any learning disability, developmental diagnosis or psychological condition (such as ADHD or autism), may need screenings for Auditory Processing Disorder and additional support. This is because APD may affect attention and functionality, which could include learning disabilities, language impairment and dyslexia. The main difference between ADHD and APD is that people with APD will be more likely to struggle with activities that involve sound. 

Symptoms that can help distinguish APD from ADHD include:

  • It’s harder to locate the source of a sound
  • Difficulty in remembering songs or lyrics
  • Problems with understanding spoken language 
  • May appear to have hearing loss 

Tests for Auditory Processing Disorder may help distinguish ADHD from APD. Once diagnosed, the primary treatment for APD is therapy. This way, they can work towards improvements including:

  • Identifying and reducing auditory distractions
  • Using auditory training to help identify sounds
  • Learning new skills to help reduce distractions and confusion 

People with APD and ADHD may be able to help manage their diagnosis in the following ways:

  • Reducing distractions by working in a quiet environment
  • Learning about their diagnosis
  • Educating others about their diagnosis 
  • Finding suitable assistance at work or school
  • Self-help strategies such as making organisational notes or a calendar 

If you think that your child is struggling to block out background noises, follow conversations, pronounce words correctly or is highly sensitive to sound, they may have APD and it may be worth getting an APD assessment. Increasingly common, it is thought that around 7% of children have some form of hypersensitivity or difficulty processing sensory information, which can often be attributed to APD.

Generally speaking, APD is a fault with the brain’s ability to process sounds and words. Although a child’s hearing may be fine, the brain makes it difficult for them to distinguish between certain sounds. Some children with APD may also find it hard to block out background noise – an echo or the hum of an air conditioning unit within a school classroom can be an issue when they are trying to concentrate on lessons. Children with APD don’t usually have problems with paying attention in a quiet space but certain sounds can be highly distracting or even painful (such as a blender, a train engine or police sirens). 

While the cause of APD isn’t currently known, experts continue to debate whether it is a hereditary or environmental condition – or both. Although our auditory system is already developed when we are born, our auditory pathways don’t mature until we are around ten to twelve years old. This means that any negative early influences (poor nutrition, exposure to cigarettes or alcohol, untreated ear infections) may have an impact on the development of auditory processes. Occasionally, a premature birth, Lyme disease or a brain infection can also contribute to auditory processing issues. Thankfully, APD responds well to treatment when there is an early intervention.  

The only way to diagnose APD is by undertaking a series of tests performed by a trained audiologist. The tests involve listening to words and sentences while background sounds are increased and instructions are spoken at faster speeds. When testing children for APD, they should be at least five years old. 

Nadia Abbott, Paediatric Audiologist at angli-EAR Hearing says: “In order to assess for Auditory Processing Disorder we need to carry out a series of tests, requiring the child to listen to words and sounds and to respond to them in a certain way. By school age APD may begin to have a negative impact on a child’s academic performance, so if a child has suspected ADHD it’s also worth getting an assessment for APD too. The good news is that APD can be treated from childhood through adolescence and into adulthood. Treatment may include a range of exercises that target specific auditory problems, such as using software programmes or one to one training with an audiologist. 

If you need advice regarding your child’s hearing ability or information about an APD test, please visit our Paediatric page or call 01223 661 399.

Find out more about ADHD Awareness Month at ADHD Awareness Month. 

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