Attention deficit hyperactivity disorder (ADHD) and auditory processing disorder (APD) often occur together. People with any learning disability, developmental diagnosis, or psychological condition — especially ADHD and autism — may need screenings for auditory processing disorder and additional support for APD symptoms.
Auditory processing disorder may affect attention, as well as executive function. This can make it difficult to accurately diagnosis people with ADHD and auditory processing disorder symptoms since one diagnosis can masquerade as another.
When APD masquerades as another syndrome, such as ADHD, a person may receive the wrong diagnosis. The two disorders are very similar, and treating the symptoms of either may offer some relief from both. A 2017 study found the ADHD medication methylphenidate could ease ADHD-related sensory issues.
Keep reading to learn more about ADHD and auditory processing disorder, including the key differences, diagnosis, and treatment and management for both conditions.
What’s the link?
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People with ADHD may have trouble processing sensory input, including auditory information. For example, a 2017 study notes that children with ADHD do not perform as well on auditory processing tests. However, they perform similarly to neurotypical children after treatment with methylphenidate. This suggests that auditory processing issues may be an ADHD symptom.
ADHD affects executive functioning, attention, and impulse control. This may make it more difficult for people to process sensory input, including sounds. It may be difficult or impossible for a person with ADHD to interpret sounds or distinguish one sound from another, particularly in distracting environments.
Research also suggests that people with ADHD may have other sensory processing issues. They might crave sensory stimulation through chewing or be less responsive than typical to sensory input, such as loud noises or bright lights.
Similarly, symptoms of APD may mimic those of ADHD. This is because a person who cannot correctly interpret sound may appear to be inattentive. Their sensory difficulties can also affect behavior. A 2018 systematic review emphasizes that children with APD have similar characteristics, including behaviors and test scores, to children with ADHD.
It is also possible for a person to have both ADHD and APD.
Key differences
There is significant overlap between ADHD and auditory processing disorder. A 2018 systematic review found that children with APD have similar learning difficulties to children with ADHD, learning disabilities, specific language impairment, and dyslexia.
They perform equally poorly on tests of language, memory, intelligence, and attention. So these tests alone cannot distinguish ADHD from APD. Children may also have behavioral issues and trouble concentrating.
The main difference between ADHD and APD is that people with APD will show more difficulties with tasks involving sound.
For example, they may not be able to do a task that requires listening to a teacher but will struggle less with a test of the same skill that requires reading. However, distinguishing one condition from another becomes even more difficult if a person has other learning disabilities, such as dyslexia. This poses a similar difficulty in diagnosis for ADHD and APD because both can often co-occur.
Some symptoms that may help distinguish APD from ADHD include:
- APD makes it more difficult to localize the source of a sound.
- People with APD may struggle to learn songs.
- APD can make it difficult for people to understand spoken language or decode complex verbal communications.
- People with APD may appear to have hearing difficulties, even when they listen attentively.
Tests for auditory processing disorder may help distinguish ADHD from APD.
Diagnosis
No lab test can diagnose a person with ADHD or auditory processing disorder. Instead, clinicians rely on symptoms.
To get an accurate, reliable diagnosis and correctly quantify symptoms, some healthcare professionals use validated scales. For example, the Sensory Processing 3-Dimensions Scale can detect sensory processing issues, including auditory processing challenges.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not list sensory or auditory processing disorders. The DSM-5 criteria for ADHD include:
- Inattentive behaviors: A person might have trouble listening, extracting important information when reading, or remembering deadlines. They may struggle to keep track of their work or frequently forget things.
- Hyperactive behaviors: A person may fidget, struggle to sit still, frequently interrupt, or talk excessively.
- Impulsive behaviors: A person may make rash decisions, behave in self-destructive ways, or have trouble controlling their emotions or reactions.
Can someone have both conditions?
It is possible to have both auditory processing disorder and ADHD. One of the most popularly cited statistics suggests that 50% of people with APD also have ADHD. However, it is important to note that this statistic dates back to a 1994 study of just 30 children with APD.
While newer research does not give a specific prevalence rate, it does show that many people with ADHD have auditory processing concerns.
A 2018 systematic review found similarities in test scores and behavior between children with APD and other neurodevelopmental disorders, including ADHD. A 2017 study notes high rates of auditory processing issues among people with ADHD. The same research also suggests that ADHD medications may ease sensory processing issues.
Treatment and management
Healthcare providers may opt to treat both APD from ADHD because it is difficult to distinguish the symptoms. A 2017 study found that treating ADHD with methylphenidate could also ease auditory processing symptoms. Medication is a mainstay of ADHD treatment. Other treatment options include:
- therapy for an individual or their family
- training for organization and study skills
- trigeminal nerve stimulation, which uses low-level electrical activity to stimulate the brain and reduce hyperactivity
Therapy is the primary treatment for auditory processing disorder. A person might enroll in speech or occupational therapy. During treatment, a person usually works on several strategies, including:
- identifying and reducing auditory distractions
- using auditory training to improve auditory processing ability
- cultivating other skills to overcome auditory distractions and confusion
People with both conditions may find the following strategies help to manage their diagnosis:
- reducing distractions and working in a quiet environment
- learning about their diagnosis
- educating others about their diagnosis and needs
- seeking accommodations at work and school
- using self-help strategies, such as an organizer, a reminder list by the door, or an accessible calendar of deadlines
Summary
The link between ADHD and APD goes in both directions. People with ADHD may experience sensory processing issues, while those with APD may have ADHD or symptoms similar to ADHD.
Distinguishing one diagnosis from the other can be difficult, even for clinicians with extensive training. Rather than trying to determine which diagnosis is the “right” one, the better strategy may be to focus on treatment and management.
People who think they might have ADHD, APD, or both, should visit a doctor or therapist. A multifaceted treatment approach that focuses both on improving symptoms and managing distractions in everyday life may help.
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