Auditory Processing Disorder Subtypes

When diagnosing auditory processing disorder (APD), the audiologist will check for the most common form of APD (auditory decoding subtype). There are a total of 5 subtypes of auditory processing disorder, each with specific symptoms. It is important to know which subtype is present so the proper therapy can be applied to improve auditory function. An individual can have more than one subtype.

Auditory Decoding Subtype (most common):

  • May behave like there is a hearing loss even when hearing is normal.
  • Mishears often, but does not realize it has been misheard and may even argue about what was heard.
  • Individual has difficulty with auditory discrimination, especially in the presence of competing noises.
  • Cannot follow along well when speaker talks quickly and may often say, “What?”
  • Has difficulty distinguishing similar sounds, which may initially show up as difficulty learning to read.
  • May have issues with: speech delay, reading, spelling, writing, understanding words that have multiple meanings, understanding ‘wh’ questions (who, what, when, where and why).

Integration Subtype:

  • Difficulty synthesizing information that is heard. For example, listening to a group of instructions to perform one task, may not know how to take all the information and apply it to the one task.
  • Difficulty with tasks that require right/left brain integration, such as listening to a lecture and writing notes at the same time.
  • Often has significant issues learning to read, and even if reading is achieved, comprehension is poor.
  • May have coordination or fine motor issues.
  • May have poor visual-motor abilities.
  • May have difficulty with rhythm
  • May have difficulty with phonics, spelling, writing.

Prosodic Subtype:

  • Difficulty understanding the unspoken aspects of conversation, such as tone, intonation, pitch, emphasis.
  • May have monotone speech pattern.
  • Pragmatics of speech may be disorganized which can effect communication and social skills.
  • Has difficulty summarizing large pieces of information and may have difficulty understanding cause and effect.
  • May be diagnosed as a non-verbal learning disability.

Associative Subtype:

  • Has receptive language difficulties, especially with meaning of speech (semantics). May be diagnosed as receptive language disorder.
  • Interprets words literally and may not understand sarcasm, jokes or metaphors.
  • Difficulty applying rules of language to spoken speech.
  • May have significant issues with pragmatics of speech.
  • Has difficulty understanding long, complex sentences.
  • Will often say “I don’t understand”.
  • Maybe be okay with phonics, but very poor reading comprehension.
  • Difficulty with relationships between words such as synonyms and antonyms.
  • Difficulty with words that more than one meaning.

Output-Organization Subtype:

  • Difficulty with pragmatics (organization) of speech.
  • Difficulty hearing in noisy situations.
  • Struggles with expressive language and may be diagnosed as expressive language disorder.
  • May have speech articulation issues.
  • Difficulty recalling proper sequence of information.
  • Difficulty remembering groups of information, especially if it must be recalled in a specific order.
  • Difficulty organizing and prioritizing assignments.
  • Difficulty with long or multi-step directions.

Not all audiologists assess for all 5 subtypes of auditory processing disorder. At APCenters we have expertise at assessing for each subtypes so we can provide a clear profile on the auditory deficits that need to be remedied. Contact us today to schedule an auditory processing assessment.