Virtual APD and Sound Sensitivity Care That Fits

Why Brick-and-Mortar Clinics Are Not Always the Best Fit

Some children and adults need listening evaluations and support in spaces that look nothing like a clinic booth. The hum of fluorescent lights, the long drive, the new building full of echoes—all of it can make testing harder and results less accurate.

When we meet people where they are, in environments that feel familiar and safe, the listening picture changes.

The Value of Virtual Care

Virtual care, when it is an option, makes that possible. It can happen at a kitchen table, in a quiet bedroom, or in a favorite chair by the window. The setting is already theirs, which means the energy that would have gone into navigating a new space can go toward listening, learning, and problem solving.

The Burden of Travel and Inconvenience

For many families, the alternative is hours of travel just to reach a clinic, sometimes for programming adjustments and sometimes for full testing, with the added cost of time away from work or school. Being away from a familiar environment can raise stress levels, and sterile clinic rooms rarely reflect the real-world listening situations where strategies and devices will actually be used. The inconvenience can also lead people to put off necessary adjustments or testing, allowing small problems to grow into bigger ones.

Access Beyond Local Options

Working in a virtual model also makes it possible to meet with an expert who truly matches your needs, not just whoever happens to be nearby. You can always go to a local professional, but in many areas, especially rural or underserved ones, there is a resource desert. Virtual care gives you the chance to choose between several professionals who are licensed to work in your area but may not actually be located there.

Shifting Away from the Medical Model

Going to a brick-and-mortar clinic can also feel a lot like the traditional medical model, where you are being labeled and processed in a way that may feel clinical or even threatening. In your own home, that same process can feel more collaborative, more personal, and less like something being “done to you.” The comfort of a familiar environment can make it easier to focus on what you are hearing and learning, rather than on the pressure of the setting itself.

Flexibility in Appointments

Working virtually also allows a child or adult to step away from an appointment if they truly need to, without the stress of a long trip or a jarring change of scenery. At the same time, being in a comfortable environment may make it possible for them to stay in the appointment longer, simply because they feel safe enough to continue.

Preventing Small Problems from Growing

This approach often allows for faster follow-ups and much shorter wait times, reducing the chance of small problems festering into larger ones. It also lowers the risk of a good treatment failing because of poor implementation, such as when a program cannot be followed consistently due to long commutes or difficulty getting to appointments. In many cases, the issue is not the quality of the treatment at all, but the barriers that prevent it from being used as intended.

Real-World Listening Support

Treatments can also fail when they are not tailored to the real environment where a person needs support. I once joined a basketball game remotely for an autistic child with hyperacusis so we could work through the layered sounds of the experience. That included the sharp thump of basketballs hitting the floor, the echo inside a large gymnasium, the crowd cheering, and the piercing whistles from referees.

Because we were connected virtually, I could guide him in real time as each sound happened. I was also able to make adjustments to his hearing aids on the spot, then immediately test those changes while he was still in that environment. This meant we could fine-tune his comfort and clarity exactly for the situation he was facing, rather than guessing from his description, which was difficult since he was autistic and not particularly able to express his feelings in detail. That kind of targeted, in the moment support would not have been possible in a clinic.

Stories from Families

One teenage client had struggled through multiple in-person appointments in the past, often leaving exhausted before the testing was complete. We met online, worked in short segments over several days, and used her own school laptop to run the speech in noise tasks. For the first time, she was able to finish the full evaluation without shutting down, and her parents got to watch each step, asking questions as they came up.

A younger child came into a session holding his favorite toy car. His parents kept his snacks nearby, and the family dog stayed curled up on the couch. We were able to take listening breaks to race the car across the coffee table, then return to the activity without losing focus. The results were more accurate than what they had seen before because the child was not worn out from the environment before we even began.

The Power of Pacing

One of the biggest benefits of virtual care is pacing. If someone needs a sensory break, we take it. If a child needs to move or listen in shorter bursts, we adapt. Appointments can be spread out to reduce fatigue, and follow up sessions happen right where the strategies will be used.

Meeting People in Their Reality

Earlier today, I met with someone who has both auditory processing disorder and misophonia. In their last testing experience, they were told there was nothing that could be done. They walked away feeling broken, like their struggles were fixed and permanent.

As a neurodivergent audiologist, I could meet them in that space of frustration and self-doubt, not as an outsider but as someone who understands the weight of being dismissed. We talked about how misophonia can develop, how it shapes the way the brain processes sound, and how it can magnify the challenges of APD.
I explained how the two conditions can feed into each other, but also how targeted support, from tailored sound management strategies to amplification and environmental changes, can turn down the daily sensory load.

By the end of our conversation, they were not feeling broken. They were feeling equipped. They could see a path forward with interventions designed for their needs rather than one size fits all recommendations.

The Real Work of This Profession

That shift, from being labeled as untreatable to being recognized as capable and resourceful, is the real work of this profession. It is the difference between leaving an appointment defeated and leaving it with hope.