Auditory Processing Disorder (APD) in Children: Guide

Campbell, N., Grant, P., Moore, D,R. and Rosen, S. | View as single page | Feedback/Impact

Audiogram and baseline tests

Prior to considering administering any tests of auditory processing it is important to do ear specific audiometry (250-8000Hz) and, if possible, up to 12,000Hz and immittance (tympanometry and reflexes) to rule out peripheral hearing loss and middle ear dysfunction.

There is some evidence to suggest that contralateral acoustic reflexes can be absent for some children with APD although this has recently been challenged by Kunze et al (2017).

There is also some evidence to suggest that while children with APD show normal Oto-Acoustic Emissions (OAEs) in quiet, examination of emissions in the presence of contralateral broadband noise may have greater diagnostic utility, although findings have been equivocal (Iliadou et al, 2018).

When there is suspicion of Auditory Neuropathy Spectrum Disorder (ANSD) ABR together with oto-acoustic emissions and/or cochlear microphonic potentials is indicated to either identify or rule out ANSD (BSA, 2018).

There are also screening tests for APD, such as the SCAN:3-C.  The SCAN:3-C comprises of screening (gap detection, auditory figure ground, competing words), diagnostic (filtered words, competing words (directed ear), competing sentences) and supplementary (further auditory figure ground conditions and time compressed sentences) tests.  The tests are similar to many of the ‘traditional’ APD tests, which carry a high language, attention and memory load.  Moore et al (2013) highlighted that children with language impairment do poorly on the SCAN:3-C for reasons unrelated to an auditory processing problem.  Further concerns around traditional APD tests are discussed in greater depth under the section ‘APD tests and criteria’.


British Society of Audiology APD SIG. (2018). APD Position Statement and Practice Guidance.

Iliadou, V., Weihing, J., Chermak, G.D., & Bamiou, D-E. (2018). Otoacoustic emission suppression in children diagnosed with central auditory processing disorder and speech in noise perception deficits. International Journal of Pediatric Otorhinolaryingology 111, 39-46.

Kunze, S., Nickisch. A., von Voss, H., & Mall, V. (2017). Acoustic reflexes in children with and without central auditory processing disorder. HNO, 65(4), 328-336.

Moore, D.R., Rosen, S., Bamiou, D-E., Campbell, N., & Sirimanna, T. (2013). Evolving concepts of developmental auditory processing disorder (APD): A British Society of Audiology
APD Special Interest Group ‘white paper’. International Journal of Audiology, 52, 3–13.