A communication problem that makes it difficult for people to understand speech can affect a person's education, career, and relationships, but they might not realize what's going on because the condition is underdiagnosed.
It's called auditory processing disorder, and it means the brain has trouble interpreting speech.
Austen Beaird first noticed he was experiencing this during the COVID-19 pandemic, when people began wearing masks.
"I realized I was not able to understand anyone, and I thought, 'Well, that is super weird, because I know I have normal hearing,'" Beaird said.
He knew his hearing was normal because he was studying to become an audiologist. Still, during class, he found it difficult to grasp some of the details his instructors were verbalizing.
"That first kind of spark was really realizing that I had been relying so much on reading lips," he said.
Beaird thinks he has had the condition his entire life, but because he always performed well in school, it was never detected.
An estimated 2% to 5% of school-aged children and 23% to 76% of adults are believed to have an auditory processing disorder, or APD. Some people are born with the condition. And sometimes, it emerges later in life, or following a traumatic brain injury.
"I very commonly see individuals about 40 to 50 years old. It's usually women," said Tela Katz, director of audiological services at Rochester Hearing and Speech Center. "They'll come in and they'll say, 'You know, my teenage kids are getting on me that I'm not hearing. I feel like I'm not hearing as well as I used to.'"
Katz said she treats a client with APD about once a week.
One form of treatment is a low-gain hearing aid. The device itself is no different than a typical hearing aid; it's the way it's programmed that sets it apart. It's calibrated to provide a small amount of amplification.
Beaird, who is now an audiologist and Katz's colleague at the hearing and speech center, has been using this device himself for about two and a half years and said it's changed his life.
"I mean, it's honestly night and day," he said. "I truly can't function without my hearing aids. On days I forget them, it is so drastically different."
The slight amplification is believed to reduce sensory overload or fatigue for people with normal hearing who struggle to process sounds.
Remote microphones are another technology that can help people with APD. These typically wireless systems connect earbuds worn by the user to a small microphone worn by the speaker. They are often used in classrooms, lecture halls, places of worship, and during one-on-one conversations in restaurants or other noisy settings.
But the first step is recognizing that there's a problem and getting a diagnosis. Sometimes the signs are subtle and can be attributed to other disorders.
"For adults and children, they might retreat from a social situation, because maybe they're not hearing very well, so they cannot respond and engage in the conversation," explained Katz. "Sometimes they can even appear bored, looking around, looking at other individuals to see what they're doing for instruction if they didn't hear the instruction."
Beaird, who is autistic, added that APD is often diagnosed in people with neurodivergences, such as autism and attention deficit disorder.
Experts say more research is needed, but some studies have shown that low-gain hearing aids significantly improved speech perception and boosted self-esteem for people with auditory processing disorder.
According to Katz, teachers are often the first to detect a possible auditory processing disorder in a student, which often shows up when the child begins to learn to read and write. That is an advantage that many adults did not have when they were younger, she said. They might have been accused of not paying attention or not caring about their education.
If they're lucky enough to get a diagnosis years later, it can be a powerful emotional experience.
"It's a significant relief that they're validated," Katz said.
This story is part of WXXI's Dialogue on Disability Week, a partnership between WXXI and Al Sigl Community of Agencies - in conjunction with the Herman and Margaret Schwartz Community Series. It is supported by the Fred L. Emerson Foundation with additional support from The Golisano Foundation.
