Dyslexia Awareness Month
Dyslexia and Auditory Processing: Understanding the Overlap
Is there a relationship between dyslexia and auditory processing difficulties? The answer is that there can be overlap — but they are not the same thing.
During Dyslexia Awareness Month, we often talk about reading, spelling and written language. But for children, much of learning begins with something else: listening.
Children spend a significant part of their school day listening to teachers, following spoken instructions, learning new vocabulary, participating in discussions and trying to understand speech in busy classrooms. For some children with dyslexia, listening can also be difficult.
What is dyslexia?
Dyslexia is a learning difficulty that primarily affects the development of reading and spelling.
The current British Dyslexia Association definition recognises that difficulties may occur across a continuum. Phonological processing difficulties — including phonological awareness, phonological memory and phonological processing speed — are commonly associated with dyslexia, although they do not explain every person's individual profile.
A child with dyslexia may therefore experience difficulties with skills such as recognising and manipulating the sounds within words, developing fluent reading, spelling, remembering information or processing information efficiently.
Importantly, every dyslexic child is different and may also have significant areas of strength.
What is auditory processing?
Hearing and listening are related, but they are not quite the same thing. A standard hearing assessment primarily tells us about a person's ability to detect sound across different frequencies. Auditory processing assessment explores different aspects of what happens when the brain has to make sense of auditory information.
For example, we may explore how someone manages when:
- Speech is presented with competing information
- Auditory information needs to be remembered or sequenced
- Sounds or patterns need to be distinguished
- Information is presented quickly
- Different information reaches the two ears
- Speech needs to be understood in more challenging listening situations
This is one reason someone can have hearing sensitivity within normal limits on a standard audiogram while still reporting significant difficulty listening in everyday life.
Where do dyslexia and auditory processing difficulties overlap?
This is where the picture becomes more complex. Children referred with listening difficulties frequently have difficulties in other areas including language, attention, memory and learning.
Research comparing children diagnosed with APD with children who have developmental conditions such as dyslexia, language disorders and ADHD has found considerable overlap between these groups. That does not mean that dyslexia is caused by APD, nor does it mean that a child with dyslexia automatically requires an APD assessment.
Instead, it reminds us that children's development does not always fit neatly into separate diagnostic boxes. A child may have dyslexia and have no significant everyday listening difficulties. Another child may have dyslexia alongside significant difficulties understanding speech in noise, following spoken information or remembering auditory sequences. For that second child, understanding their listening profile may provide useful additional information.
What might parents or teachers notice?
A child experiencing listening difficulties might:
- Frequently ask for repetition
- Find multi-step spoken instructions difficult
- Struggle more in noisy classrooms than in quiet one-to-one situations
- Appear to hear but not always understand what has been said
- Lose track during lengthy verbal explanations
- Have difficulty remembering spoken information
- Become tired after sustained listening
- Have difficulty distinguishing or manipulating speech sounds
These behaviours are not specific to APD. Similar difficulties may occur with hearing loss, language difficulties, attention differences, dyslexia and other developmental or learning differences. That is why careful assessment — rather than simply matching symptoms to a diagnosis — is important.
Start with hearing
When a child is experiencing difficulties with listening, communication or learning, it is important that peripheral hearing is considered.
Temporary conductive hearing difficulties such as otitis media with effusion (glue ear), as well as permanent hearing loss, can affect a child's access to speech. A comprehensive hearing assessment therefore provides an important foundation before interpreting more complex listening difficulties.
Does an auditory processing assessment diagnose dyslexia?
An auditory processing assessment is not a dyslexia assessment and should not be used to diagnose dyslexia. Formal dyslexia assessment is undertaken by appropriately qualified professionals and considers literacy together with relevant underlying learning and processing skills.
Similarly, an auditory processing assessment investigates hearing and listening abilities; it should not be used to explain every difficulty experienced by a child with dyslexia. In many cases the most useful approach is multidisciplinary, bringing together information from audiology, education, speech and language therapy, psychology and other professionals where appropriate.
What about younger children?
Not every child reporting listening difficulties is ready for a formal APD test battery. For younger children, it may be more appropriate to explore whether their listening and auditory skills are developing as expected for their age, alongside a comprehensive assessment of peripheral hearing.
At Hearing Pathways, this distinction is important. A developmental listening assessment is not intended to label a young child with APD. Instead, it can help build a picture of their current listening strengths and areas of difficulty and consider whether practical management, monitoring or input from other professionals may be helpful.
When might further assessment be useful?
Further investigation may be worth considering when a child has persistent listening difficulties that seem greater than expected — particularly when they are affecting learning, communication or participation at school or at home.
The purpose should not simply be to find another diagnosis. The more useful question is: what is making listening difficult for this particular child, and what can we do to make listening and learning easier?
Sometimes the answer lies in hearing. Sometimes language, attention, memory or literacy plays an important role. Sometimes several factors overlap. Understanding that individual profile can help parents, teachers and professionals make more informed decisions about support.
Unsure which assessment is right?
Hearing Pathways provides specialist hearing, listening and auditory processing assessments for children and adults. If you are unsure which type of assessment may be appropriate, please contact us to discuss your concerns before booking.
Further reading
You may also find these pages and articles helpful.
Evidence & Further Reading
This resource has been developed using current research and professional guidance.
Concerned about your child's listening?
We can help you understand whether a hearing assessment, developmental listening assessment or APD assessment may be the right starting point.