What does it mean when an autistic person has an auditory processing disorder?

Auditory processing is the ability to interpret the sounds that we hear. It has nothing to do with the ability to hear, but rather making sense out of—or perceiving—what is heard. A person with auditory processing disorder may have their hearing tested and perform fine, but will still struggle to process sounds. They hear speech sounds, but don’t perceive the meaning of the sounds. Sometimes the lack of speech comprehension is interpreted by others as an unwillingness to comply or follow directions, when in reality the person simply isn’t able to retrieve the meaning in that moment.

Autistic people can present with sensory processing difficulties, auditory processing being one of them. The causes of auditory processing disorder is unknown, but there are several theories as to why. One theory is that brain’s hippocampus, which is responsible for processing auditory information, could be less developed in autistic people. Another one is autistic children are hearing normally, but are processing sound more slowly than non-autistic children because the auditory cortex of the brain develops slower in autistic children. This affects the ability to process language and learn speech.

Finnish and American researchers think another possibility might be that autistic children do not pay attention to certain sounds, and that their attention shifts slowly. These researchers also mentioned autistic children preferred odd sounds to the sound of their mother’s voice. At the same time, they paid attention to and understood music well. (Have a look at my post on monotropism. The monotropic style of processing explains many features of autistic experience.)

Alan Heath, UK psychologist, says another area that research shows can be a challenge is that of steady beat and rhythm. This not only affects our ability to listen and concentrate, but also affects movement.

The sound that reaches our ears has 4 components that can change. These are:

1. Where is the sound coming from? – sound localization

2. How loud is it? – volume

3. Can I process the tiny timing differences in sound? – temporal processing

4. Is it a high or low sound and can I process the changes? – pitch or frequency

Heath says if your brain can’t work out where a sound is coming from, this leads to problems processing sound. Research shows that an unstable brain response to sound is a feature for many autistic people so it’s no surprise that seeking out music and beat is something that helps.

What does auditory processing disorder look like?

While audiologists diagnose auditory processing disorders, a multidisciplinary team is usually required for assessment, which may include physicians, speech-language pathologists, occupational therapists, educators, psychologists and other professionals. Here are some signs of auditory processing disorder:

• asks for multiple repetitions, or frequently asking “Huh?” or “What?”
• difficulty remembering names, nursery rhymes and the words to familiar songs
• can’t follow conversations
• appears distracted
• muddles up sounds and pronounces words incorrectly
• struggles to pay attention when information is presented verbally, but well-developed concentration is displayed when instructed visually or while reading
• requires more processing time
• inability to block out background noise
• difficulty following verbal instruction, especially multi-step instructions

Autistic adults describe auditory processing difficulties as:

• garbled sound when someone is talking, especially while loud noises are playing in the background
• they hear perfectly, but sometimes speech sounds blurry, muffled, garbled, or like gibberish
• some say they want subtitles when listening to spoken conversations (my son and daughter often like to have the subtitles visible when watching a movie)
• if there are no background sounds, one-to-one conversation is possible

Autistic adults would appreciate more understanding and for people to realize their struggles in processing sounds and speech have nothing to do with intelligence or motivation.

How can we help?

There are several things you can do to help an autistic person who has auditory processing difficulties.

1. Allow time for processing – Give a person 10 – 15 seconds time to answer. While this may seem like a long time, jumping in too soon will cause the person to have to start their processing all over again.
2. Movement can be organizing – Allow a person to move while listening because the hearing and vestibular systems are closely tied, so optimal function for hearing may be linked to movement.
3. Reduce background noise – Processing multiple sounds at a time may be impossible. Music, TV, fans, and even clocks may cause additional challenges for a person listening to instructions.
4. Use visual supports – Visual information is fixed and permanent, not fleeting like sound is.
5. Offer breaks – There should be breaks from listening and quiet periods offered throughout the day. Brains need a chance to recharge.

Two autistic adults have written about their experience using specially programmed hearing aids to help with auditory processing issues and sound sensitivity, which they found life changing. They said:

Specially programmed low-gain hearing aids can help people with auditory processing problems, even when they don’t have other difficulty hearing. They work by enhancing the sounds that help people understand spoken words. They can also make sounds less painful.

Auditory processing is part of the sensory processing profile. It is important for anyone supporting an autistic person to understand auditory processing disorder and the accommodations we need to make in order to support comfort and success.

References

Berke, J. (June 2021) Autism and Auditory Processing Disorders. Very Well Health
https://www.verywellhealth.com/autism-and-auditory-processing-disorders-1048796

Heath, A. (February 12, 2020) Autism and auditory processing. reThinking Autism
https://www.thinkingautism.org.uk/autism-and-auditory-processing/

Loftus, Y. (October 3, 2023) What is Auditory (Sensory) Processing Disorder? Autism Parenting Magazine

What is Auditory (Sensory) Processing Disorder?

Marnell, L. (December 9, 2022) Support Auditory Processing in Autistic Children. Kids Master Skills
https://www.kidsmasterskills.com/post/support-auditory-processing-in-children-with-autism