The Adults with APD We Never See (And Why I Wish We Did)
Why the Most Underserved Population Stays Hidden – Despite Being My Favorite to Work With
I need to be honest about something: I almost never see adults seeking help specifically for auditory processing disorder. This isn’t because I don’t want to work with them – I actually love working with adults and am more comfortable with them than children. With kids, I generally work through their parents. Adults can advocate for themselves, describe their experiences clearly, and collaborate in their own care.
I especially love working with autistic and ADHD adults with sound sensitivities and auditory processing issues because I get it. I’m one of them.
But adults are scared to come to me, while children (through their parents) are desperate for help.
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The Fear vs. Desperation Dynamic
Here’s what I see: Parents are desperate to get their kids “fixed” because they’re terrified of what will happen when they become adults. They probably went through the same struggles themselves and survived, but they don’t know if their kids will. They’ve lived with decades of exhaustion, social challenges, and feeling “not quite right” – and they’ll do anything to spare their children that experience.
Adults, meanwhile, have learned to survive. They’ve built coping mechanisms, found ways to function, and convinced themselves they’re “fine.” The fear of appearing weak or disabled often outweighs their desire for relief.
Humans are pack animals, and hearing aids signal weakness. Even if the technology would make you stronger, give you more access, help your brain function in noise – the fear of visual stigma and what it will do to your social standing means people would rather suffer in silence.
This is especially true for adults with APD who don’t have “real” hearing loss. They’re caught in an impossible bind: their brain can’t function properly in noise, but they fear admitting this “weakness” more than they want relief from their struggles.
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How Adults Actually End Up Getting Help (By Accident)
Despite these barriers, some adults with APD do end up in my practice through these pathways:
Misophonia crisis: They’re desperate about sound sensitivities that trigger panic attacks. During evaluation, I discover significant APD – difficulty understanding speech in noise, problems with accents, trouble following rapid speech. When I mention these findings, the response is always: “Oh, that? Yeah, I’ve learned to deal with that. I just get really tired.”
Family recognition: A parent or grandparent sees their child’s transformation with hearing aids and recognizes their own lifelong struggles. When they trace back through family history, they finally understand what they’ve dealt with for decades. They decide to try the technology – either to model for the child or because they wonder if it could help them too.
Older adults through family connections: I often see them because they recognize their struggles in their grandchild’s or child’s APD diagnosis. These older adults are often the most accepting of hearing technology – less stigma, more willingness to try devices. But they’re almost never given auditory processing testing anywhere else. We assume their listening difficulties are “normal aging” or cognitive decline.
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The Hidden Struggle They All Share
These adults describe lives shaped by exhaustion they’ve accepted as normal. They avoid social events because listening is too hard, come home from work drained from understanding colleagues, miss information in meetings despite trying their best, feel inadequate when they can’t follow restaurant conversations, and experience constant mental fatigue from processing unclear auditory input.
The effects spill over into everything: memory issues, organizational problems, difficulty enjoying new music or unfamiliar TV shows because they can’t handle anything requiring mental effort. They forget things they’re told, get lost more often, and seem like they have ADHD – it’s all the same symptoms we see in children with APD.
The difference is they’ve developed sophisticated coping strategies using phones, computers, and administrative assistants. Because they CAN function – they have jobs, relationships, responsibilities – they don’t feel they deserve technological help.
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The Transformation When They Do Get Help
When I fit these adults with low-gain hearing aids, the transformation is remarkable. They discover their “normal” listening effort wasn’t normal at all. Conversations don’t have to be exhausting. They can understand people without intense concentration. Background noise doesn’t have to be overwhelming. Social situations can be enjoyable rather than draining.
But here’s the problem: once they feel “good enough,” they disappear. Adults don’t advocate for follow-up care the way they do for their children. As soon as they’re doing better, they go back to their daily lives, even if they could benefit from additional help. They accept “some improvement” rather than pursuing optimal function.
These adults always position themselves as secondary. Even when they’re struggling with the same symptoms we readily treat in children, they focus entirely on the importance of helping the child. They see their own improvement as just a “side effect” – as if they don’t deserve help themselves or it’s “too late” for them.
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The Veteran Exception That Proves What’s Possible
The data on veterans shows what happens when adults ARE prioritized. A VA Health Care System study found that 69% of veterans provided low-gain hearing aids continued wearing them for at least 2 years. Walter Reed reported “surprisingly high levels of patient benefit” from these devices.
But veterans don’t always have it easy either. The waitlists can be long, the system itself isn’t always well controlled, and not every veteran gets timely or consistent support. What makes a difference is that they at least have some resources, and their auditory processing needs are viewed through a more legitimate medical lens.
Another reason veterans receive more attention is because they are a much easier group to study. Their shared backgrounds and relative homogeneity make research cleaner and more publishable. That research then feeds back into professional awareness and acceptance. Civilian adults, by contrast, remain overlooked, even though they share many of the same struggles.
Why do veterans succeed more often? Because the VA system recognizes their auditory processing needs as real medical concerns deserving of ongoing support and follow-up care. Military culture also reframes hearing aids as performance equipment rather than disability markers.
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The Visibility Myth and the Power of Openness
Here’s what’s funny about the stigma: these hearing aids aren’t even that visible. I’ve had bald patients who wear glasses, and nobody even notices the hearing aids. Or if they do, they don’t say anything about it.
But if people would just be a little more okay with saying “hey, it helps me hear in background noise,” it would change the world for other people. It’s one of the reasons I’m open about my autism and ADHD and my auditory processing issues and bipolar – it’s for the next person who’s not ready to admit those things yet. I want them to hear that I’m okay with it, that I function and thrive.
I know I come from a place of privilege at this point. I can afford my lifestyle because I live simply and my husband works. My family sold us our home at a level we could afford. My kids are in good public schools so we don’t need as much money to function. We vacation nearby, we buy from thrift stores instead of buying new clothing – we do everything we can to maintain this freedom. I’m able to work on my own without worrying about how a boss might react or what coworkers might think.
But I spent 15 years in 11 jobs getting bullied, so I get it. Having this privilege now means I’m able to be open in ways other people can’t, and I don’t take that responsibility lightly.
When we hide our accommodations, we reinforce the shame. When we normalize them – especially those of us who have the safety to do so – we create permission for others to seek help.
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The Former Children We’ve Abandoned
These adults are the former children we helped. We readily provided accommodations, technology, and support when they were in school. We understood their brains needed assistance to function optimally. Yet the moment they became adults, we decided they should “cope” without technological help.
Adults don’t believe they deserve help – they believe they should keep pouring resources into helping their children instead. The only difference between a veteran getting APD coverage through the VA and a civilian adult with identical symptoms is that our society decided veterans’ needs are legitimate medical concerns, while civilian adults’ needs are character deficits they should overcome through willpower.
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What We’re Really Missing
Every adult suffering in silence with APD represents years of unnecessary cognitive fatigue, reduced work performance, higher burnout rates, and lost potential. Research shows that when adults get proper auditory support, the benefits are substantial and lasting – when the system actually follows up with them.
The irony is that I genuinely prefer working with adults – they can articulate their experiences, collaborate in treatment decisions, and provide detailed feedback about what’s working. But the very people I’m most equipped to help are the least likely to seek that help.
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The Bottom Line
If you’re an adult who gets exhausted from listening even when you can technically hear, avoids social situations because conversations are too hard, has learned to cope but wonders why everything feels effortful, or would seek help for emotional sound reactions but not processing fatigue – you deserve the same technological support we readily provide children.
Adults with auditory processing difficulties deserve recognition that compensation isn’t the same as optimal function, managing isn’t the same as thriving, being tired all the time isn’t normal, and accommodations are optimization, not failure.
The research shows the interventions work. The technology exists. What’s missing is a system that values adult auditory processing needs, provides ongoing support for optimal outcomes, and addresses the social stigma that keeps adults from seeking help even when their brains are struggling to function.
Until we recognize that the fear of appearing “weak” often outweighs the desire for better hearing, we’ll continue to miss the vast majority of adults who could benefit from auditory processing support.
That’s not science. That’s stigma.
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References:
• Papesh, M. A., Fowler, L., Pesa, S. R., & Frederick, M. T. (2023). Functional Hearing Difficulties in Veterans: Retrospective Chart Review of Auditory Processing Assessments in the VA Health Care System. American Journal of Audiology, 32(1), 101-118.
• Tepe, V., Guillory, L., Boudin-George, A., Cantelmo, T., & Murphy, S. (2023). Central Auditory Processing Dysfunction in Service Members and Veterans: Treatment Considerations and Strategies. Journal of Speech, Language, and Hearing Research, 66(, 2922-2949.
• Davidson, A. J., Ellis, G. M., Jenkins, K., Kokx-Ryan, M., & Brungart, D. S. (2024). Examining the Use and Benefits of Low-/Mild-Gain Hearing Aids in Service Members with Normal Hearing Thresholds and Self-Reported Hearing Difficulties. Healthcare (Basel), 12(5), 578.
• Singh, J., & Doherty, K. A. (2020). Mild-Gain Hearing Aids as a Treatment for Adults with Self-Reported Hearing Difficulties. American Journal of Audiology, 29(3), 419-428.
• Roup, C. M., et al. (2018). Evaluation of Low-Gain Hearing Aids as Treatment for Auditory Processing Deficits in Service Members with Normal Hearing Thresholds and History of mTBI.
• Gordon-Salant, S., & Fitzgibbons, P. J. (2019). Overview of Central Auditory Processing Deficits in Older Adults. PMC.
• Clinical observations from Dr. Rae, LLC’s family-centered auditory processing practice (2017-2025)
#AdultAPD #AuditoryProcessing #Misophonia #VeteranBenefits #FamilyPatterns #HiddenDisability #ListeningFatigue #SystemicBarriers #OlderAdults #Neurodivergent #AutisticAdvocacy
