Anxiety and (Central) Auditory Processing Disorder

Few things makes me anxious. I may be a little high-strung and afraid of a lot of things, but there’s only one thing that brings out an irrational and disproportionate emotional response – not being able to communicate properly. I have a combination of APD, intermittent CHL as a result of hypermobility of the bones in my inner ear, hyperacousis and tinnitus. None of these are actually treatable or curable, but there are, as always, ways of coping that makes things better than before, but far from perfect. Communication remains an anxiety provoking obstacle. Here’s how I manage:

  • Context is everything. The more I can anticipate and predict what people are about to say, the easier it is to infer what was said in the gaps where I heard Gllah gahr allahhgrl ghallagl gah.
  • Scripts are heaven. I can go to a busy restaurant and order a meal without issue when I can hear less than 5% of the conversation. I know what is suppose to happen next. Get a table first, order drinks, order food, nod through a few ‘is everything okay’ checks, ask for the bill, pay, leave. Warcraft raiding is pretty similar. It follows a predictable script and I can guess what the meaning of words are if I know where in the script I happen to find myself.
  • Language and people are predictable.I spent a vast majority of my time at university on semantics, pragmatics and especially discourse analysis. Meaning is inferred from both linguistic and non-linguistic knowledge and the more I know about how language works and how specific people habitually string together words, the easier it becomes to guess correctly what they are saying. The more time I spend listening to a particular person, the easier it becomes to hear what they are saying.
  • Intonation, accent and familiarity. It’s easier to understand strangers who speak with familiar accents and enunciate well than those who do not. It’s even easier to understand family and friends who speak with familiar accents and phrases. It takes time to adjust to someone’s voice and vocabulary, but after spending hours listening to the same voice, it becomes easier and easier to follow.
  • Environmental control helps. I don’t tolerate background noise very well. My worst nightmare is going out with a large group of acquaintances to a busy place, i.e. office parties and family gatherings are best avoided. I keep social events small and private. My house for tea, their house for dinner, or a restaurant over lunch time on a week day when it’s quiet and unbusy.
  • Nothing beats a notepad and pen. I can sometimes repeat what someone has said to me without understanding what was said. The meaning is lost even if the words aren’t. Sometimes I can sidestep issues by simply writing down what I am hearing. It all makes sense when I read it afterwards. Sometimes it doesn’t and I have bizarre notes coursing through my notebook, but it’s worth a try. It’s a useful trick  when talking on the phone or listening to instructions through ventrilo, but less desirable when face to face. Most people don’t appreciate being kept waiting whilst I write down their question before answering it.
  • Ask for a rephrase rather than a repetition. The most anxiety escalating thing about APD is that I know there is no ‘out’. I can ask someone to say something again, but I know that the second time round will probably be just as incomprehensible as the first and so will the fifth time round. Repetition rarely  helps. Talking louder doesn’t help much.  Slowing down and speaking clearer may on occasion help me catch a word or two more, but when people slow down they tend to loose their natural speech tone and without that, it’s harder to guess at the bits I still can’t hear.  Rephrasing helps, but it’s a difficult request to make. It’s an odd request that makes the social awkardness that much more awkward. I usually ask for a repetition and hope that the request is executed in a slightly different way that makes it easier for me to discern meaning.

People make me anxious when they’re unpredictable. Small talk is an evil invention. Sometimes I realize that I am being talked to and are ready to make the effort to try and understand.

Other times speech simply fades into the background, it’s just noise and I neglect to notice that it is language and I am suppose to be interpreting it. I have always preferred books over people and characters over friends for the simple reason that the first is comforting and the latter is work.

I have learned over the years that once you overcome the initial social obstacles, people are worth the effort, but the obstacles remain despite the reward. Talking is hard. It gets easier and easier the more I talk to the same person, but it never quite gets to easy. Andrea does a much better job explaining what it’s like in Living with (C)APD [1].

1. Andrea. Andrea’s Buzzing About: Living With (Central) Auditory Processing Disorder [Internet]. San Francisco: Andrea’s Buzzing About: c2006-2008 – [cited 18 April 2009]. Available from:


5 thoughts on “Anxiety and (Central) Auditory Processing Disorder

  1. Thank you for that thorough, insightful piece. It reinfornces what we are already doing for our (9 year old) daughter. I am making copies of this to carry around for those teaching my daughter but don’t really understand. Many thanks.

  2. There is no cure for APD, but understanding and planning around it can make a tremendous difference. Glad I could help a little and best of luck with helping your daughter.

  3. Thanks for a great post. The more I read about APD, the more that I think I have it.

    I especially like the suggestion to rephrase rather than asking for a repetition. I find I usually rephrase when others ask me to repeat, probably because I want them to do that for me. Although a repeat often does help, because by then my brain has had more time to catch up and figure out more from the context.

    It also helps if the person is facing me when they talk, additional lip-reading and body language clues.

  4. APD is one of those invisible conditions that’s frequently misdiagnosed or undiagnosed. All of the things you’ve mentioned Jen I find very useful too. It’s an interesting quirk to live with that sometimes require very creative thinking to adapt to the challenges it raises.

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