Written in June 2025
Auditory Processing Disorder (APD) often occurs as part of other neurotypes (such as autism and ADHD), but it can also occur in people who don’t have any other neurodivergent conditions. The sensory processing differences that are part of autism mean that the majority of autistic people have APD, although it may be given as an additional diagnosis.
It’s also a form of neurodivergence that can also be acquired – stroke, traumatic brain injuries and other neurological conditions can lead to APD.
When you have APD, you’ll often say “what?”, “pardon?”, “I didn’t get that, can you repeat it?” when someone talks to you. It’s especially noticeable when it’s someone you haven’t heard speak before, especially if they have an accent or a particular tonal quality to their voice. For me, it’s deep bassy voices. While I actually like the sensory experience of listening to a deep voice, my brain really struggles to process those sounds into words and language.
It’s nothing to do with being able to hear the voice clearly (although noisy places and people who mumble don’t help matters), but to do with processing the sounds into recognisable words, from which we can derive meaning.
From the outside, it looks like we have a hearing problem, or that we’re not paying attention. I know I’ve been told I need to get my hearing checked (my hearing is acute) and that request is something that everyone with APD will hear throughout their life, pun intended.
What are some of the challenges of APD?
APD can make it hard to socialise – if you’re in a busy place and you are trying to listen to a conversation involving more than one person, the brain can’t ignore the background noise. Our brains are also trying to process that, along with the sounds we want to hear, making it hard to focus on the words of the people who are speaking.
We often end up with a backlog of sounds to process, so we appear to be a bit slow in following the conversation. It’s like trying to feed 20 sheets of paper into a shredder at the same time – it jams and we end up behind. This processing backlog, along with a slower speed, means we miss parts of conversations and we might miss important information.
As you can imagine, it’s also a significant barrier in the workplace. In-person meetings with multiple people talking present the same kind of challenges as a social environment, but the stakes might be much higher if we’re at an important meeting.
It’s even more difficult if we have to take notes or minutes, because not only do we have to process all the sounds, we also have to synthesise the information into written words. Then, inevitably, the discussion leads to a change of approach and we have to backtrack on what we’ve written, sometimes while we are still processing it.
How do I know if I have it?
Assessment for APD usually starts with ruling out any actual hearing problem, so an audiologist is the person you’ll see. Assuming there’s no mechanical problem with your hearing, the audiologist will give you more tests designed to check for sound processing. A neurologist or speech and language therapist may be involved to assess for processing and learning differences.
Is APD protected by the Equality Act?
The Equality Act defines disability as “a physical or mental impairment that has a substantial and long-term negative impact on daily activities”. Under these guidelines, APD can be considered to be a disability if it is interfering with work, social and family life to the extent that the difficulties are noticeable compared to someone without APD.
If someone needs subtitles, quiet places for conversations and other adjustments in order to participate in work and in society, then the APD is clearly having a substantial impact on daily activities.
As APD often co-occurs with neurodevelopmental conditions like ADHD, dyslexia and autism, the combined effect on someone’s language processing in work and social contexts can be considerable. The challenge we often face is that APD is invisible, and perceived to be a problem with attention or hearing, so our difficulties and needs are not taken seriously.
What can help manage APD?
Socialising in smaller groups, or 1-on-1 can really help. Doing this in quiet places (not a loud pub, coffee shop or soft place centre) also makes a big difference. Allowing us to ask clarifying questions when we’ve missed some of the words is really important – let us ask for a repeat of what you said without treating us like we weren’t paying attention.
Sitting face to face with someone, or at least at an angle where we can lip read a little, is also helpful. A lot of us didn’t realise how much we rely on lipreading until the covid times of masks when suddenly we had no idea what anyone was saying! Having the visual cues of body language can help (if we use and understand this non-verbal communication method), and having the dual attention on the person and the words can help with maintaining attention and processing.
This is really different for everyone – I appreciate the dual processing for social conversations, but when I have to process more complex ideas, or longer pieces of auditory input, I need to switch all my processing to that and not try to process visual input at the same time. Some autistic people with APD find the eye contact and body language (that many allistic people rely on) to be too much to process at the same time.
In the workplace, having smaller meetings in quiet spaces is important. It’s helpful to summarise points for the minute taker, whoever that is, to ensure consensus. It’s also helpful for those with APD to join meetings virtually so they can use the captioning feature. An AI transcript or recording of the meeting can also be really helpful so someone can re-experience the meeting and listen again to bits they may have missed.
Time spent in a quiet place after periods of auditory processing helps our brains and nervous systems to regulate and to process any backlog. This also gives us space to properly think about the conversation or meeting we have just had. While almost everyone else can process the sounds into language and process that language into thoughts, we don’t have time to do both in the moment. It’s important for us to have the time (in the right sensory environment) to do that extra processing.