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Notification on Auditory Processing Disorder (APD)

Evaluation of Auditory Processing Disorder (APD), also termed "Central Auditory Processing Disorder" (CAPD), is an assessment of an individual's perception of speech and non-speech sounds. It is not a standard "hearing test," but rather an assessment of how the brain recognizes and interprets what it hears. APD has been defined as a "deficit in the neural processing of auditory stimuli that is not due to higher-order language, cognitive or related factors" (ASHA, 2005). However, although there is not unanimity on the definition.

Recently (2005), the American Speech-Language-Hearing Association (ASHA) and the California Speech-Language-Hearing Association (CSHA) have produced documents reviewing the assessment, diagnosis and treatment of APD. Additionally, the California Department of Education has issued a Position Statement on CAPD (2003).

Taken together, these documents make the following points:

  1. The area of APD is controversial and changing rapidly; the nature of APD is still somewhat unclear.
  2. There is lack of consensus regarding the validity and reliability of some commercially marketed products to treat APD, and minimal evidence of valid and reliable studies to support therapeutic interventions for APD. As such, some treatments must be viewed as experimental and should not be included in a student's Individual Education Plan, except as suggested experimental options available at no charge. However, should the parents wish to pursue such an option privately, it should be done so with the understanding of its experimental nature.
  3. The audiologist is the professional who diagnoses APD. However, speech-language pathologists and other professionals collaborate with the audiologist both in assessment and in development of intervention.
  4. Evaluation of certain children is not recommended (e.g., those with mental age below 7 years, significant intellectual deficit, or severe hearing loss), and a diagnosis of APD in children with autism or Attention Deficit Hyperactivity Disorder should only be made when it is clear that APD is a comorbid deficit in the central auditory nervous system.
  5. Evaluation of children for APD should be preceded by a complete audiological assessment to assure normal hearing sensitivity.

It is incumbent upon the licensed audiologist and licensed speech-language pathologist to use only diagnostic assessments and therapies that are supported by rigorous empirical evidence. While it is important to conduct research studies on new and emerging assessment tools, such studies should take place within the confines of an approved experimental protocol, and it should be clear to consumers that assessment with such tools is experimental only and provided at no cost. In keeping with B & P Code 651(b)(7), licensees are prohibited from making scientific claims that cannot be substantiated by reliable, peer-reviewed, published scientific studies.

Below is related information on Auditory Processing Disorder and/or Auditory Integration Training: