Poor Hearing: ADHD, Inattentive Type or Auditory Processing Disorder?

Reader’s Question

My hearing has always been bad. I am constantly repeating “what?” in a lot of conversations and I don’t interpret (and misinterpret) what’s being said to me often times. I have struggled with this issue as a child. I have always thought I had hearing loss until I finally got examined by a physician and was told my hearing was perfect. To add a puzzling element, I never have problems detecting sound. In fact, I can pick up (and even confuse) a lot of sounds I hear, or think someone said something to me and they didn’t. I have decided to look around for some information and the closest thing I have found was something regarding Auditory Processing Disorders. I have also read that other problems are almost always associated with APD. My question is should I seek an audiologist first or should I find a psychologist? And if I do see a psychologist, should I look for a specific sub-specialist? Thank you for any answers in advance.

Our Consulting Clinical Psychologist’s Reply

There is a difference between physically hearing and attending. As you mention, you don’t have a hearing problem. It sounds like you’ve got a problem attending, listening, and focusing. If the issue has been present since childhood, I would suspect it’s associated with an Attention-Deficit Hyperactivity Disorder, Inattentive Type. In this childhood disorder, problems are noted in the following areas (source: DSM-IV):

• Failure to pay close attention and carelessness,
• Difficulty sustaining/keeping attention during tasks and activities,
• Does not seem to listen when spoken to directly,
• Often doesn’t follow through with assignments or projects,
• Has difficulty organizing tasks,
• Is reluctant to engage in tasks that require sustained effort,
• Often loses and misplaces items,
• Is easily distracted by irrelevant items in the environment, and
• Is often forgetful in daily activities.

In my experience, children and adults with ADHD-Inattentive often have delayed auditory awareness. In other words, the instant someone begins to speak, most people immediately engage their hearing and concentration. For an individual with ADHD-Inattentive or Hyperactive Type, their brain is running so fast that they must “switch gears” and refocus when someone calls their name or speaks to them, producing the automatic “What?” The brain is so busy that it doesn’t engage fast enough.

I’d recommend reviewing information on ADHD on this website — take a few of the ADHD tests on this website and available on the Internet for ADHD, Inattentive Type. If your research makes sense to you, seek a psychological consultation to clarify the diagnosis. If you feel ADHD is not the issue, an examination by an audiologist can be considered.