Following Instructions and Auditory Processing Difficulties
Psychologists | Speech Language Pathologists | Occupational Therapists | Exercise Physiologists | Therapy Assistants
Psychologists | Speech Language Pathologists | Occupational Therapists | Exercise Physiologists | Therapy Assistants |
What are auditory processing difficulties?
Auditory processing difficulties occur when the brain has trouble making sense of what the ears are hearing, particularly in noisy environments, or when information is presented quickly or in complex sentences.
Children with auditory processing difficulties typically have normal hearing on a standard hearing test. The challenge isn't in detecting sound, it's in processing, organising, and making meaning from what they hear.
This can make it genuinely hard for children to follow instructions, keep up in classroom settings, listen to stories, or respond accurately when multiple things are being said at once. It can be exhausting, frustrating, and is often mistaken for inattention, non-compliance, or a language delay.
What does this look like day to day?
- Often ask for things to be repeated
- Follow instructions inconsistently — getting some steps right but missing others
- Struggle to follow multi-step directions
- Seem 'in their own world' or take a long time to respond
- Have particular difficulty in noisy environments like classrooms, shopping centres, or playgrounds
- Find it hard to follow along in group instruction situations
- Mishear words — especially when sounds are similar
- Have difficulty remembering verbal information or sequences
- Appear to be listening but not retaining what was said
These challenges can have a real impact on learning, classroom participation, and everyday family life. It's also worth noting that many children with ADHD, language difficulties, or anxiety show similar signs, which is why a thorough assessment is so important.
What causes auditory processing difficulties?
- Differences in how the brain processes auditory information at a neurological level
- A history of frequent ear infections (otitis media) in early childhood, which can affect the development of auditory processing pathways
- Language and listening skill differences
- ADHD or attention differences, which affect the ability to sustain listening
- Autism and other neurodivergent profiles
Because many conditions can affect a child's ability to listen and follow instructions, assessment by a speech pathologist, and sometimes an audiologist and/or psychologist, helps identify what's driving the difficulty.
How can speech therapy help?
- Assessment of your child's language comprehension and listening skills
- Targeted therapy to build listening skills, verbal memory, and the ability to follow instructions
- Strategies to help children manage in noisy or fast-paced environments
- Home and school strategies that reduce the listening burden without reducing expectations
- Collaboration with audiologists, teachers, and other professionals
- Recommendations for classroom accommodations that help your child access learning more easily
Auditory processing difficulties are often much more noticeable in busy, noisy environments like classrooms. The quieter, more predictable home environment naturally reduces the processing load. This contrast is actually a useful clue that auditory processing may be involved.
A standard hearing test checks whether the ears can detect sound at different frequencies, it doesn't assess how the brain processes that sound. Normal hearing doesn't rule out an auditory processing difficulty.
"They understand everything at home, it must be a behaviour issue at school."
FACT
FACT
Myth
"Their hearing test was fine, so there's no problem."
Myth
Children with auditory processing difficulties are often trying very hard to listen, it just requires much more effort for them than for their peers. What looks like inattention is often genuine processing difficulty. This distinction matters, because the response that helps is very different.
FACT
"They're just not listening."
Myth
Myths and facts about auditory processing difficulties
Ideally, both. An audiologist can assess hearing and auditory processing from an ear and brain-pathway perspective. A speech pathologist assesses the language and listening comprehension skills that are affected by these difficulties. Both perspectives together give the fullest picture. We're happy to help coordinate care.
Should my child see an audiologist or a speech pathologist?
APD is a recognised condition, but diagnosis can be complex and is usually made by an audiologist following specialised testing. Speech pathologists assess the listening and language comprehension difficulties associated with APD and provide targeted support, regardless of whether a formal diagnosis has been made.
What can teachers do to help?
Is auditory processing disorder (APD) a formal diagnosis?
There are many simple, effective strategies teachers can use, like reducing background noise, giving instructions one step at a time, checking in for understanding, and using visual supports alongside verbal information. Your speech pathologist can provide specific recommendations tailored to your child.
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