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APD, ADD, ADHD and AD/HD: Personal and Scientific Reflections

APD, ADD, ADHD and AD/HD: Personal and Scientific Reflections
Katherine A. O'Neill, PhD
March 21, 2005


I'm not a stranger to research or behavioral conditions based in physiology. I am the mother of a 9 year old child with an auditory processing disorder, and I have a Ph.D. in Physiological Psychology.

As a mom, I wanted to educate myself to better understand my 9 year old son's auditory processing disorder, to better provide him with helpful treatments and activities. However, prior to arriving at his diagnosis, one of the steps along the way was to "rule out" attention deficit disorder/attention deficit hyperactivity disorder. The term "rule out" is common in medicine. It is used by physicians and others while trying to establish a differential diagnosis while eliminating other possibilities. Hence, things to be "ruled out" are often similar to, or indeed are the actual diagnosis, but are as of yet undetermined.

Our experience while "ruling out" took us through an enormous amount of information regarding the prevalence, diagnosis and treatment of neuropsychological conditions, many of which potentially cause us to medicate children who are physically and emotionally developing. This is a significant issue for all parents, professionals, and children too.

Many diagnostic terms and acronyms used in 2005, which describe specific patterns of behavior, were unheard of twenty or thirty years ago. Of course, that doesn't mean these problems didn't exist previously, maybe they did...but these terms were strangers to most moms, dads, teachers, and professionals!

I believe decisions regarding the management and treatment of children should be based on solid scientific evidence, good clinical judgment and excellent parenting skills, none of which can be assumed.


  1. Auditory Processing Disorders (APD) is a term used to describe what happens when your brain recognizes and interprets sound. It has been said that auditory processing is "What you do with what you hear." The "disorder" part of APD indicates something is adversely affecting the processing of sound. APD is typically more apparent and more of a problem in noisy environments or while listening to complex or difficult information. APD is also referred to as central auditory processing disorders (CAPD).

    Symptoms of APD:

    Children with APD often have difficulty paying attention to and remembering information presented to them verbally. Children with APD often have difficulty executing multi-step directions, they have poor listening skills and may need more time to process information. Children with APD may have low academic performance and may have behavior problems. They may demonstrate language difficulties and they often have difficulty with reading, comprehension, spelling, and vocabulary (adapted from www.nidcd.nih.gov/health/voice/auditory.asp).

  2. Attention Deficit Disorder (ADD), Attention Deficit Hyperactivity Disorder (ADHD), and ADD/ADHD, and Attention Deficit/Hyperactivity Disorder (AD/HD).

    While many people use these diagnostic terms rather loosely, it is important to note that there are in fact, specific diagnostic criteria and guidelines for making a diagnosis. ADD is the more general term, referring to Attention Deficit Disorder. ADD can be present with or without hyperactivity, hence the terms ADHD ADD/ADHD and AD/HD.

    It has been estimated that about 5 percent of the U.S. population (children and adults) has AD/HD.

    Symptoms of AD/HD behaviors include:

    • distractibility (poor sustained attention to tasks)

    • impulsivity (impaired impulse control and delay of gratification)

    • hyperactivity (excessive activity and physical restlessness)

    Of course, at one time or another, virtually everyone experiences some of these behaviors. However, specific diagnostic criteria (below) identifies AD/HD from "normal" distractibility and/or occasional impulsive behavior of childhood (adapted from www.add.org/).

    Therefore, to be diagnosed with AD/HD, symptomatic behaviors must be present prior to age 7 years and have lasted more than 6 months. The behaviors must create a significant handicap in at least two areas of a person's life, such as school, home, work, or social settings. We tend to associate hyperactivity with attention deficits, but they are not always present in tandem.

Katherine A. O'Neill, PhD

Related Courses

20Q: A Continuum Approach for Sorting Out Processing Disorders
Presented by Gail J. Richard, PhD, CCC-SLP
Course: #10008Level: Intermediate1 Hour
There is a good deal of confusion among audiologists and speech-language pathologists when a diagnosis of “processing disorder” is introduced. This course presents a continuum model to differentiate processing disorders into acoustic, phonemic, or linguistic aspects so that assessment and treatment can become more focused and effective. The roles of audiologists and SLPs in relation to processing disorders are described, and compensatory strategies for differing aspects of processing are presented.

Back to Basics: Practical Aspects of Auditory Processing Disorders
Presented by Gail M. Whitelaw, PhD
Course: #9294Level: Introductory1 Hour
This course will provide an overview of assessment and management of auditory processing disorders (APD) in children. Interdisciplinary aspects of working with school-age children will be highlighted.

Improving Visual and Auditory Processing in Preschoolers with ASD, presented in Partnership with Thieme Publishers
Presented by Kelly Vess, MA, CCC-SLP
Course: #9116Level: Advanced1 Hour
This is Part 4 of a four-part series, Incorporating Movement to Comprehensively Treat Preschoolers with ASD. This course examines the impact of visual and auditory processing challenges for preschoolers with autism spectrum disorders (ASD). Participants will be able to identify deficits and describe evidence-based intervention strategies that improve auditory and visual processing to improve outcomes globally for this population, while developing critical motor skills. This course is presented in partnership with Thieme Publishers. (Part 1 - Course 9096, Part 2 - Course 9103, Part 3 - Course 9115)

ApPARENTly This Is Not Going Well: Difficult Conversations with Parents
Presented by Marva Mount, MA, CCC-SLP
Course: #9726Level: Intermediate1 Hour
This course explores emotional intelligence (EQ) and how to "plug in" and use it in situations that go awry with parents of clients. Specific strategies for handling difficult situations and de-escalating arguments are discussed.

The Art of Debriefing: Key Elements in CSD Simulation Education
Presented by Carol Szymanski, PhD, CCC-SLP, CHSE
Course: #8704Level: Intermediate1.5 Hours
This course defines and describes the types of simulations utilized for clinical education in communication sciences and disorders (CSD). The learning theory behind simulation education will be presented, with the process and examples of debriefing specifically highlighted.
Please note: This course uses a different recorded format from most of our courses; arrows on the playbar must be used to progress through the course. When playback stops after the course introduction, use the right arrow key to progress to the second slide, where you can read the full playback instructions. Due to the nature of the development of this content, this course is best viewed on a tablet-sized screen or larger. Please plan your viewing experience accordingly.

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