The Link Between ADHD and APD

man and woman talking

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APD, or auditory processing disorder, affects a person’s ability to correctly interpret what they’re hearing. This can make it hard to follow conversations, listen to music, remember spoken instructions, or just plain understand what people are saying. While it can be a problem in any setting, it’s usually worse in loud places or in environments with multiple sources of sound—like a living room where people are talking while the TV is on.

While researchers aren’t sure what causes it, they do know that it’s not a learning disorder or a result of hearing loss. In other words, people with APD can hear just fine and they understand what words mean. In fact, the problem may not even be with auditory processes at all, but with other cognitive functions that the brain needs in order to interpret what it’s hearing.

One systematic review of the studies done on auditory processing disorder found a high rate of comorbidity between APD and other developmental disorders, like dyslexia and speech or language impairments. Another common comorbid diagnosis: ADHD.

What Is the Relationship Between ADHD and APD?

There are a surprising number of overlaps between these two neurological disorders: struggling to follow conversations or remember spoken instructions, for example, are two APD symptoms that someone with ADHD can often relate to.

In fact, there is so much overlap that the researchers behind that same systematic review cited earlier wondered whether APD is a distinct clinical diagnosis or simply a symptom of ADHD and the other disorders that it’s so often linked to.

Whether APD is its own independent disorder or not, studies do show that the measures used to assess APD also happen to be strong indicators of ADHD—meaning people whose test results suggest they have APD might also need to be evaluated for ADHD because the two disorders can be extremely difficult to distinguish from each other.

This is likely because listening is not just the physical process involved in hearing. It also requires attention and memory so that the listener can piece together all the information encoded in a sound.

If you struggle to focus your attention on the person speaking to you while tuning out background noise, you might mishear or fail to hear every word. With the working memory deficits associated with ADHD, you might find it hard to keep track of everything being said and put it all together.

With both of those ADHD-related deficits, you might be both missing bits and pieces of information altogether while also struggling to keep track of the pieces you are getting. Those challenges can look a lot like APD.

How to Tell the Difference Between ADHD and APD

Both disorders can make it difficult to tune out background noise, follow conversations, or remember spoken information—but that doesn’t mean ADHD and APD are the same or impossible to differentiate.

In the study showing the usefulness of auditory processing tests as a tool for assessing ADHD, researchers suggested that a key way to distinguish ADHD and APD would be additional testing that doesn’t involve auditory processing.

That means patients whose auditory processing test results suggest they might have APD should then be given other tests that measure visual processing, attention, and memory to rule out ADHD and other disorders.

Patients who test positive for both auditory processing deficits and attention or memory deficits, for example, might be more accurately diagnosed as having ADHD rather than APD (or having both). Those who only show difficulties with auditory processing, on the other hand, are more likely to have APD.

If you’re doing a self-assessment to decide whether it’s worthwhile to talk to your doctor about a possible misdiagnosis or comorbid condition, here’s a quick rundown of the unique symptoms of each to help you figure out if you might fit the criteria for one or the other—or both.

The unique symptoms of APD that aren’t typically shared by ADHD include:

  • Difficulty identifying where a sound is coming from, or isolating a particular sound in a noisy environment (such as focusing on just the guitar in a musical recording featuring multiple instruments).
  • Sound discrimination problems, especially mixing up words that sound similar to each other (e.g. – “free” and “three”). Most notably, people with APD often have difficulties with this both in listening (causing them to mishear what was said) and in their own speech (causing them to speak less clearly).
  • Language processing problems. Even without competing noises or voices, someone with APD can struggle to translate the sound of speech into words that have meaning. The delayed processing can make holding conversations frustrating as it takes more time to process words and then formulate a response.

The unique symptoms of ADHD that aren’t typically shared by APD include:

  • Inattention, which can look like mind wandering, being easily distracted, or struggling to focus on a task even when you’re trying your hardest to concentrate.
  • Forgetfulness, which can look like misplacing important things, missing appointments and deadlines, or forgetting what you were doing even while you’re in the middle of doing it.
  • Impulsiveness, which can look like interrupting people during conversations, making rash decisions, and struggling to resist impulses.
  • Hyperactivity (if you have the hyperactive subtype) which can look like fidgeting, explosive energy, and difficulty sitting still or staying in one place.

Accommodations and Methods for Coping with Auditory Processing Issues

Whether you have ADHD, APD, or both, here are some tricks and tips for managing your symptoms and avoiding some of the problems that come with auditory processing challenges.

Minimize Background Noise

Close windows, shut doors, turn off machinery or appliances that don’t need to be on. Getting rid of competing noise can make it much easier to focus on and process what you need to listen to, whether that’s a teacher, a coworker, or your friend.

If you’re finding it difficult to follow a conversation, pause and ask them to wait while you get rid of background noise or, if possible, move to a less noisy location.

Use Noise-Canceling Headphones

For virtual meetings or phone conversations, connecting your computer or phone to noise canceling headphones with a microphone can make it much easier to hear and understand the person on the other end. You can also use them to shut out irritating or distracting noises while working or studying.

Turn on Subtitles

When watching a show or video, subtitles can help you catch the things you might have missed or clarify things you might have misheard. Similarly, finding the lyrics to your favorite songs so you can read them as you listen can help gain new understanding and appreciation of the song. Both are also useful training as your brain starts to match the written words with the spoken dialogue or lyrics.

Face the People You’re Listening To

For in-person conversations, face the person speaking and watch their mouth as they talk. Pairing the visual of mouth movements with the sound of their voice can help you focus more fully on what they’re saying and decode their speech more accurately.

Ask People to Repeat or Speak More Slowly

While it might be embarrassing or frustrating to need someone to repeat what they just said, it’s often worse to get caught not understanding or following what they said.

If you’ve ever tried to pretend you’re following a conversation, only to give a response that doesn’t fit, you know that pain. As awkward as it can be, it’s better to ask someone to repeat something in the moment than it is to risk misunderstanding or forgetting it later.

Write Down Spoken Instructions or Information

Take notes during your classes or meetings to aid in your processing of the spoken information and to prevent you from forgetting it. Write down anything and everything that might be important to know or remember later.

Likewise, you might record meetings, lectures, or phone calls so you can replay them later to catch any parts you might have misheard or just missed altogether.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Riccio CA, Cohen MJ, Garrison T, Smith B. Auditory processing measures: correlation with neuropsychological measures of attention, memory, and behavior. Child Neuropsychology. 2005;11(4):363-372. Doi:10.1080/09297040490916956.

  3. Lenartowicz A, Truong H, Salgari GC, et al. Alpha modulation during working memory encoding predicts neurocognitive impairment in ADHD. J Child Psychol Psychiatry. 2019;60(8):917-926. Doi:10.1111/jcpp.13042.

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By Rachael Green
Rachael is a New York-based writer and freelance writer for Verywell Mind, where she leverages her decades of personal experience with and research on mental illness—particularly ADHD and depression—to help readers better understand how their mind works and how to manage their mental health.