“My hearing test is normal… so why can’t I understand people?”
This is one of the most common things we hear at The Audiology Place. After nearly 20 years working in the Auditory Processing Disorder (APD) space, Dr. Signe Steers has seen firsthand how often these concerns are misunderstood or dismissed. Many adults come to us convinced they have hearing loss because they’re struggling to follow conversations, especially in noisy places. They’ve often had a hearing test elsewhere and been told their hearing is “normal”, yet they still feel like they’re missing half of what’s being said.
If this sounds familiar, you may be experiencing Auditory Processing Disorder (APD). APD isn’t a hearing loss in the traditional sense. Your ears can hear the sounds, but your brain has difficulty making sense of them. Think of it like having excellent internet signal but a computer that’s taking longer to process the information. The result? You can hear people talking, but understanding what they’re saying can be a completely different story.
What Does APD Actually Feel Like?
Many adults with APD describe it as feeling like everyone around them is mumbling.
You might find yourself saying:
- “I can hear people talking, but I can’t work out the words.”
- “I do much better one-on-one than in groups.”
- “Restaurants are exhausting.”
- “I spend all day pretending I understood conversations.”
- “I need subtitles, even when the volume is loud enough.”
For some people, listening feels like a full-time job. By the end of a busy workday, social event, or family gathering, they feel mentally drained from concentrating so hard on following conversations.
Common Signs of APD in Adults
Adults with APD may experience:
- Difficulty understanding speech in background noise
- Frequently asking people to repeat themselves
- Trouble following verbal instructions
- Confusing similar-sounding words or numbers
- Slower responses in conversations
- Listening fatigue or “brain fog”
- Sensitivity to competing sounds
- Difficulty keeping up in meetings or group discussions
- Feeling overwhelmed in busy environments
These challenges can affect work performance, confidence, relationships, and social participation.
Unfortunately, many adults spend years believing they’re simply bad listeners, inattentive, anxious, or “getting older” before discovering there’s an actual explanation for what they’re experiencing.
Why Does APD Happen?
There isn’t one single cause.
Some adults have had APD since childhood but were never diagnosed. Others develop auditory processing difficulties later in life due to:
- Head injuries
- Stroke
- Neurological conditions
- Age-related changes in how the brain processes sound
- Co-existing conditions such as ADHD, dyslexia, or language-based difficulties
It’s also important to understand that APD and hearing loss can occur together. In fact, many older adults experience a combination of both peripheral hearing changes and auditory processing difficulties.
Why a Standard Hearing Test Doesn’t Pick It Up
A standard hearing test measures whether your ears can detect sounds. APD assessments look at something different: what your brain does with those sounds once it receives them. This is why someone can have completely normal hearing thresholds yet still struggle enormously in real-world listening situations.
How We Assess APD at The Audiology Place
If we suspect APD, we start by getting a thorough understanding of your listening difficulties and how they’re affecting your daily life.
We then complete a range of assessments, which may include:
- Comprehensive hearing testing
- Speech understanding in background noise
- Auditory discrimination testing
- Temporal processing assessments
- Dichotic listening tasks
- Binaural integration testing
- Spatial processing assessments
Sometimes we also work alongside psychologists, speech pathologists, or other health professionals if ADHD, language difficulties, or cognitive factors may be contributing to the picture. The goal isn’t simply to put a label on the problem. It’s to understand why you’re struggling and develop practical strategies that actually help.
What can we do about APD?
There are many effective ways to improve communication and reduce listening effort.
Auditory Training
Just like physical therapy helps strengthen muscles, auditory training can help strengthen listening skills. This may involve structured listening exercises, computer-based programs, or targeted therapy with an Audiologist specialised in auditory training.
Environmental Changes
Small adjustments can make a surprisingly big difference.
These include:
- Reducing background noise where possible
- Choosing quieter venues
- Sitting closer to speakers
- Using visual cues such as lip-reading and facial expressions
- Improving room acoustics at home or work
Assistive Listening Technology
For many adults, technology can be life-changing.
Options may include:
- Remote microphone systems
- Low-gain hearing technology
- Communication accessories
- Noise-cancelling headphones for concentration tasks
Communication Strategies
Learning how to advocate for yourself is incredibly important. Simple strategies such as requesting written meeting notes, asking people to face you when speaking, or choosing quieter environments can dramatically reduce listening fatigue.
The Impact on Mental Wellbeing
One of the most overlooked aspects of APD is the emotional impact. When understanding conversations requires constant effort, people often begin avoiding situations they once enjoyed.
They may withdraw socially, lose confidence at work, or feel anxious in group settings. Many adults tell us the greatest relief comes from finally understanding that they’re not imagining the problem – and that they’re certainly not alone.
What Does the Research Tell Us?
Research continues to show that auditory processing difficulties are common, particularly as we age.
Studies have found that:
- Central auditory processing changes become more common in older adults
- Remote microphone technology can significantly improve speech understanding
- Personalised auditory training programs can improve listening performance
- Appropriate intervention can reduce listening fatigue and improve quality of life
When Should You Seek Help?
If you’ve ever been told your hearing is normal but you still struggle to understand people, it’s worth investigating further.
You don’t need to simply “put up with it.”
At The Audiology Place, APD assessment and management has been a key area of clinical interest for almost two decades. During that time, Dr. Signe Steers had the privilege of helping hundreds of adults and children and families better understand the challenges associated with auditory processing difficulties. We know that listening challenges can have a profound impact on confidence, relationships, education, workplace performance, and overall wellbeing. Our goal is not simply to provide a diagnosis. It’s to help people understand why listening feels so difficult and provide practical, evidence-based strategies that make communication easier. Because hearing isn’t just about what your ears can detect—it’s about what your brain can do with the information once it gets there.
