Ear Center: Auditory Processing

About Auditory Processing

Auditory processing refers to our central nervous system's ability to process sound once the ear has transmitted sound signals to the brain. The ear itself is the organ that receives sound and changes it from an "air signal" to a "fluid signal". This is called "auditory reception". Once the brain receives sound signals from the ear, the brain processes sound signal and converts them into understandable sound. This is called "auditory perception". In the end, the brain is actually the "Master Ear".

Some patients, especially children, may have difficulty with auditory perception. Their ears are anatomically and medically fine, but their brains are not able to process sound properly. Often, parents and teachers begin to noticethat the child is not hearing well and begin to question whether the child might have a "hearing loss". Symptoms include:

  • appearing not to hear
  • asking to have words repeated
  • appearing not to pay attention
  • having difficulty performing sequential commands
  • not being able to follow verbal directions in school

Auditory processing is not completely understood as a science. Auditory perceptual testing includes tests for auditory memory, auditory sequential memory, hearing in noise, and how the ears are interacting with each other (binaural fusion testing).

Auditory processing testing takes approximately one hour. The testing is performed in the office setting. Testing is scored in a similar fashion to psychological tests. Normative data are available for children 7 years or older.

Guidelines for Auditory Processing Evaluations

  1. Children must be age 7 or older for testing in order to permit us to score the test with normative data. Children younger than 7 years old are not able to be tested. The AP testing process takes approximately one hour and requires separation between parent and child. Children must be mature enough to understand the test directions, be willing to cooperate, and be able to focus for one hour.
  2. If your child has a history of ear infections or other early childhood ear disease, we recommend a medical evaluation before testing to document that ear fluid and infections have resolved. If infection or fluid are present, your child will be appropriately treated and testing will be postponed until resolution has been achieved.
  3. If your child is ill (cold, flu, allergies, etc.), testing will be postponed. Pediatric illnesses may cause temporary hearing loss and lead to poor performance. It is best to test your child when they are refreshed and motivated.
  4. If your child has a documented history of hearing loss, a current hearing evaluation will be necessary just prior to the AP testing. A hearing test (audiogram) will be administered at the beginning of the appointment. If any significant changes in hearing are measured, your child will be referred to one of our ear specialists for a proper evaluation.


After AP testing is completed, you will receive a comprehensive report and recommendations. If an auditory processing issue is diagnosed, we recommend that you schedule a conference with your school counselor, teacher, audiologist,and speech pathologist to explore available options.

Because we are not affiliated with the various local school systems, detailed questions regarding auditory processing services available to your child at his/her individual school are better directed to your school's audiologist.


  1. Earobics, a computer habilitation program, may be purchased for in-home use from www.earobics.com or by calling 1-888-328-8199.
  2. FM Auditory Trainers, such as the iSense by Phonak, may be purchased through our office or may be available through your school system.
  3. The following is a partial list of Greensboro Speech/Language pathologists who work with auditory processing disorders:
    1. Sheri Bonner, CCC-SLP, 912 N. Elm St, Greensboro, (336) 275-2400
    2. Cheshire Center, 319 W. Wendover, Greensboro, (336) 373-1099
    3. Ling & Kerr, 1313 Carolina St, Greensboro, (336) 370-4070
    4. Karen Parish, CCC-SLP, (336) 275-0386
    5. Emily Berry, CCC-SLP, (336) 312-6221

Please feel free to contact our office at (336) 273-9932 if you have any questions concerning Auditory Processing or AP testing. You may also visit Phonak's website to learn more about the iSense.


1. Gates GA, Anderson ML, et al. Central auditory dysfunction as a harbinger of Alzheimer Dementia. Arch Otolaryngol Head Neck Surg 2011;137 (April):390-395.

Last revised January 1, 2012