Being autistic, adhd and random stuff

[PMarky2]

LOL, that reminds me of my childhood. I found that 'no response' worked with teachers as well as playground yobs. They could make me stand in the corner, but they couldn't make me answer and my willpower was a lot stronger than theirs. They never labelled me as backward due to some psychiatrist finding that I had a high IQ and consequently I was placed in the year above in junior school. But dumb insolence or failing to engage, whatever label was placed on it absolutely worked.

Not responding was my weapon too. On occasion, though, I would thump a bully HARD. Strangely, I never got into serious trouble so perhaps I was doing what the teachers secretly wished they could do. My mum did have to school the education system a couple of times on how to get me to do something. If I found something uninteresting or unrewarding I'd ignore it - which included the standardized reading scheme. Mum got hauled in, questions were asked, and she eventually said, "Tell him he can read whatever he wants once he gets through the reading scheme, and he will get it done." She was correct, and I got the run of the library, even of material way above my grade level.

 

[stickygirl]

In fact, the hearing test may pass with flying colours... Mine resulted in excellent hearing. Even on the sensitive side. That doesn't helpful with the processing at all, though.

Noisy environments. Being even slightly tired. Not seeing the one talking. Etc etc.

My hearing is quite good, but my ability to make sense of things deteriorates swiftly with increasing background noise. I just cannot filter the crap out and hear what I want/need to hear. Lip-reading helps a little, but bring tired makes that more difficult. If you are walking away from me and there is background noise - forget about it. I also cannot hear phone conversations if there is background noise, so I leave the room of the radio or TV is on. My wife accused me of being secretive quite a few times before she finally twigged it is due to the fact I find it difficult to process out background noise.

We're on the same page here and I agree that's it's processing of sound by the brain not the 'mechanical ability' of the ears to hear it that is commonly experienced by autistic people. The first linked article from goldytheGoldfish appeared to cover every type of hearing problem in infants and I found the term APD a bit broad to be of much help in distinguishing between NDs and NTs.

On a different theme, I'd take a guess and say the processing of sound into meaningful communication involves a quite different part of the brain to the widely experienced pain and distress created by for eg ambulance sirens, small-penis-motorbikes or babies crying.

 

[Strixaluco]

I just cannot filter the crap out and hear what I want/need to hear.

And with accurate hearing, you mainly hear more of the crap that needs to be filtered.

My late husband had a habit of starting to talk out of the blue ( = I was concentrating on something else) while climbing up behind the corner in the concrete stairwell ( = awful echo) coming up to living quarters. In 10 years he didn't learn that he will have to repeat everything that he said once his up. Or worse - he spoke while going down, not hearing how I asked him to repeat.

Whereas my current partner learned quite fast that my brain takes a marvelling pause when looking in his eyes.

 

[goldytheGoldfish]

If this is supposedly so common, I don't understand why the diagnostic criteria hasn't been updated and standardized. If you search for "CAPD" (central auditory processing disorder) you get different results.

https://www.mayoclinic.org/diseases...cessing-disorder/symptoms-causes/syc-20555261

Many conditions can affect how well a person understands what they hear, such as attention-deficit/hyperactivity disorder (ADHD) or autism. But these conditions are different from auditory processing disorder, although they can appear with APD.

https://www.ncbi.nlm.nih.gov/books/NBK587357/

Central auditory processing disorder is a rare, poorly understood condition that affects the central auditory nervous system. Patients are classically young children presenting with hearing difficulties but may have other learning disorders, such as attention deficit hyperactivity disorder.

https://www.asha.org/practice-porta...c9fA7-xyYjmKeC_pJEgb_Spal0tlkdkZ4E1hR0fDYS7HQ

• CAPD may co-occur with (and necessitate differentiation from) other disorders (e.g., attention-deficit/hyperactivity disorder, language delay or disorder, and learning disability).
• CAPD is not due to peripheral hearing loss, whether conductive (i.e., involving the outer or middle ear) or sensorineural (i.e., involving the cochlea or auditory nerve).

https://www.aetna.com/cpb/medical/data/600_699/0668.html

Auditory processing disorder (APD), also known as central auditory processing disorder, supposedly interferes with both the input and integration of verbal information, and results in a potentially permanent cognitive dysfunction during the developmental period of acquisition of language. The prevalence of APD in the general population has not been firmly established. Chermak and Musiek (1997) estimated that APD occurs in 2 to 3 % of children, with a 2-to-1 ratio between boys and girls, while Cooper and Gates (1991) estimated the prevalence of adult APD to be 10 to 20 %. Neurological disorders, diseases, and insults, including neurodegenerative diseases, probably account for most acquired APD in adults; however, such disorders probably account for 5 % or fewer of diagnosed cases of APD in children, especially as APD relates to learning disability (Musiek et al, 1985, 1992).

 

[goldytheGoldfish]

We're on the same page here and I agree that's it's processing of sound by the brain not the 'mechanical ability' of the ears to hear it that is commonly experienced by autistic people. The first linked article from goldytheGoldfish appeared to cover every type of hearing problem in infants and I found the term APD a bit broad to be of much help in distinguishing between NDs and NTs.

On a different theme, I'd take a guess and say the processing of sound into meaningful communication involves a quite different part of the brain to the widely experienced pain and distress created by for eg ambulance sirens, small-penis-motorbikes or babies crying.

Again, I'm not an expert in this, but it looks like testing for APD starts around age 7. The key word to differentiate seems to be "peripheral" hearing loss (physical) vs. "central" hearing loss (processing).

https://sphs.osu.edu/clinic/audiology-services/auditory-processing-disorders

Auditory processing disorders (APD) can be observed in both children and adults. Simply put, these are disorders in which the person appears as if they have a peripheral hearing loss but have normal hearing on the audiogram, or pure tone test. People with auditory processing disorders may have deficits in processing of auditory information in a number of ways: they may have difficulty listening when background noise is present, difficulty with “filling in” missing auditory information, problems with combining information between the two ears (called dichotic listening), and issues with the timing of auditory information, just to provide a few examples. These types of problems may result in the listener struggling to hear in less than optimal situations, not being able to understand non-native speakers of their language, and struggling with people who speak rapidly, among other deficits. Auditory processing disorders can be the result of a developmental delay, a disorder of the central auditory nervous system (e.g. related to a head injury or illness), or a “wiring” issue thought to have a genetic component.

Auditory processing disorders are assessed by audiologists as part of an interdisciplinary team approach. The diagnosis of auditory processing disorder is under the scope of practice of the profession of audiology. It is a low-incidence diagnosis and other types of causes for the suspected auditory difficulties should be ruled out prior to implementing an auditory processing evaluation. In children, testing is most effective at age 7 or older. Prior to testing, peripheral hearing loss should be ruled out. In addition, children that have been identified as being on the autism spectrum are not appropriate for this type of testing. Normal cognitive functioning should be established prior to seeking an auditory processing assessment.

Of course, there goes my theory. "Not appropriate"? Those are the people who should be screened for it the most I thought.

https://www.nationwidechildrens.org/conditions/auditory-processing-disorder

Often times a child is identified by their parent or school teacher with concerns for auditory processing difficulties, and a referral to audiology can be placed by the child’s pediatrician to begin the evaluation process. Once the referral is received, a team of audiologists carefully collect and review information about the child to determine if the child meets the requirements for testing.

Due to the complexity of APD, there are several factors that are REQUIRED for a child to be eligible for testing.

A child must:

• Be at least 7 years old
• Have normal hearing, normal speech and language skills
• Have normal (or at least near-normal) intelligence

In addition, there are some co-occurring conditions that prevent a child from qualifying for testing.

Common reasons that a child may not be eligible for APD testing include:

• Autism Spectrum Disorder
• Down Syndrome
• Developmental delay/disorder
• Intellectual disability or below average IQ
• Significant speech/language disorders, such as apraxia of speech, stuttering, etc.
• Hearing loss of any degree or type

Because of the similarities of APD with other disorders, determining if a child is eligible for testing requires a very comprehensive review of the child’s past medical, educational, and developmental history. Testing for APD requires a child to participate in several listening tests that assess different areas of the auditory system. This testing can last for up to two hours, and requires a significant amount of attention and effort from the child. The results of each test are compiled and reviewed to determine if a diagnosis of APD is appropriate.

So... in conclusion: it's extremely common for children with autism to (additionally) have an auditory processing disorder. However, they can't be screened for auditory processing disorder because they have autism. Case closed. Brilliant. Perhaps I'm missing something.

 

[goldytheGoldfish]

Alright, ChatGPT:

https://chatgpt.com/

Why can't people with autism be screened for auditory processing disorder?

That’s an excellent and nuanced question — and one that reflects an issue professionals in audiology and neurodevelopmental care still debate.


People with autism spectrum disorder (ASD) often show behaviors that overlap with auditory processing disorder (APD) — difficulty understanding speech in noisy environments, following spoken directions, or processing subtle differences in sound. However, there are reasons why clinicians often don’t screen or formally diagnose APD in autistic individuals:

---

1. Overlap in symptoms makes results unreliable​

APD and autism share many similar outward behaviors:

• Difficulty following verbal instructions
• Sensitivity to sounds
• Seeming not to “hear” or respond when spoken to
• Trouble in noisy environments

Because these behaviors can stem from social communication differences, attention differences, or sensory sensitivities in autism, it’s hard to tell what’s due to auditory processing itself versus broader neurodevelopmental processing.

---

2. Current APD tests rely on cooperation and typical language skills​

Most APD assessments use tasks like:

• Repeating words presented with background noise
• Discriminating small timing or pitch differences
• Following complex spoken patterns

These tests assume typical attention, language comprehension, and motivation — areas that can be affected in autism. This can make test results invalid or misleading, since poor performance may reflect something other than true auditory pathway issues.

---

3. Lack of standardized diagnostic criteria​

APD itself is a controversial and inconsistently defined condition. Different clinics and professional groups (like ASHA or the American Academy of Audiology) use varying definitions and test batteries.
Because of this, clinicians are cautious about assigning a second label (APD) when there’s already a complex developmental diagnosis like autism — especially when management strategies (like environmental supports and speech therapy) overlap.

---

4. Clinical focus on functional support, not dual labeling​

Even when an autistic person shows auditory processing challenges, professionals may focus on practical interventions — e.g.:

• Using visual supports
• Reducing background noise
• Preferential seating
• Speech-language therapy for listening comprehension

Rather than assigning a separate APD diagnosis, care plans often target the underlying difficulty directly.

---

Would you like me to explain how some audiologists still approach auditory processing testing in autistic individuals (i.e., modified or adapted assessments that can be done in some cases)?

 

[goldytheGoldfish]

ChatGPT continued:

Excellent — let’s go over both parts: how APD testing could be adapted for autistic people, and what supports or accommodations are usually recommended even if they don’t get an official APD diagnosis.

---

1. Adapted APD Testing for Autistic Individuals​

While standard APD tests (like the SCAN-3 or dichotic listening tasks) often aren’t reliable for autistic people, some clinicians modify their approach to better fit neurodivergent needs.
Here’s how they adapt:

a. Simplify verbal demands​

• Use non-verbal auditory tests (tones, frequency patterns) instead of language-heavy tasks.
• Allow visual supports (e.g., pointing to pictures instead of speaking answers).

b. Adjust attention and sensory load​

• Test in a quiet, low-stimulus environment with flexible breaks.
• Shorten testing sessions or spread them over multiple visits.
• Allow sensory tools (weighted lap pad, stim toy, etc.) to help regulate focus.

c. Focus on functional listening​

• Instead of diagnosing “APD,” measure real-world listening challenges (like understanding speech in noise, following multi-step instructions).
• Use questionnaires and observations, such as:
  • The Children’s Auditory Performance Scale (CHAPS)
  • The Listening Inventory for Education (LIFE)
  • Parent/teacher listening behavior checklists

d. Combine with a multidisciplinary team​

Because autism, ADHD, and language disorders can overlap with auditory issues, best practice is a joint evaluation:

• Audiologist (for auditory processing or hearing)
• Speech-language pathologist (for language and auditory comprehension)
• Occupational therapist (for sensory integration)
• Psychologist or developmental specialist (for attention, cognitive factors)

Together, they look for patterns instead of relying on a single test score.

---

2. Supports and Accommodations (With or Without an APD Diagnosis)​

Even without a formal APD label, listening and comprehension challenges can be addressed effectively.


Here are the most common supports used in schools and daily life:

Environmental and classroom supports​

• Preferential seating (close to the teacher, away from noise)
• FM or remote microphone systems (teacher’s voice transmitted directly to headphones)
• Sound-field amplification for the classroom
• Acoustic improvements (carpet, curtains, felt chair pads to reduce echo)

Communication strategies​

• Use clear, slower speech and check for understanding.
• Give written or visual instructions along with spoken ones.
• Allow extra processing time before expecting a response.
• Repeat or rephrase instructions rather than just saying them again.

Educational supports​

• Break multi-step directions into smaller parts.
• Use visual schedules or checklists.
• Provide lecture notes or recordings.
• Pair listening tasks with hands-on or visual activities.

Sensory and self-regulation strategies​

• Allow breaks from noisy environments.
• Offer noise-reducing headphones when not in instruction.
• Teach self-advocacy (“Can you repeat that?” “It’s too noisy for me right now.”)

---

3. The Big Idea​

Even though formal APD testing isn’t always valid for autistic individuals, their listening struggles are very real.
Clinicians and educators are increasingly moving toward a “functional listening profile” approach — understanding how a person listens, what environments make it harder, and what supports make it easier.


This approach is often more useful than the diagnostic label itself.

---

Would you like me to show you what an example adapted listening assessment plan for an autistic child or adult might look like (step-by-step, including tools and professionals involved)?

 

[Strixaluco]

Sigh.

 

[goldytheGoldfish]

You think you're funny?

 

[Strixaluco]

You think you're funny?

Funny? Why? How???

I was sighing at them not testing for APD in autistic people.

(edit typo, I'm too exhausted to even think/write properly)

 

[goldytheGoldfish]

Yes, well... let's all take a break and think about what we've learned.

 

[stickygirl]

Again, I'm not an expert in this, ~snip~

Thank you for going to so much trouble over this, but I was still struggling with the 'Why?' until I dug a little deeper.

i/ So the first cited article from 2023 is a lengthy scientific report on autistic children with cohorts 3,6,9 yrs who have observed auditory processing differences .
It concludes, after laudable statistical testing, with this:-

In conclusion, results from this study demonstrate (1) auditory processing differences are common in autistic children aged 3 to 9 years, (2) the prevalence of auditory processing differences high from 3 to 9 years of age, greater than 70% in this sample, (3) reported auditory processing differences at ages 3 and 9 years are associated with increased disruptive/concerning behaviors and difficulty with adaptive functioning and (4) auditory processing differences at age 3 years predict disruptive/concerning behaviors and difficulty with adaptive behaviors at age 9 years. These findings suggest the potential benefit of incorporating measures of auditory processing during clinical evaluations conducted in autistic children and developing interventions targeting auditory processing differences in early childhood.

ii/ The second article 2021 refers to a longer study of auditory processing disorder in groups that include autistic children through to veterans with blast exposure.

iii/ The third link, from Ohio State Dept of Speech & Auditory Science, acknowledges that adults and children can report hearing problems but are shown to have normal periphery hearing. It goes on to suggest a repeatable test to determine if an individual has APD, but with the exclusions you've highlighted - that they are not ASD and are over 7yrs.

iv/ Sorry, I'm not interested in the fourth link.

Throughout I found myself asking 'Why? What is the purpose of providing an assessment?' However the final paragraph of the iii/ third link answers this: -

Recommendations are generated from the assessment that helps to link the diagnosis to treatment and management. The management of auditory processing disorders can be categorised in three areas: modification of the listening environment, often with the use of assistive listening technology; direct treatment for the disorder; and development of compensatory strategies and techniques.

Aha! So we're there! To paraphrase the recommendation ( management ) in (iii) - Sit them at the front, remove background noise. The 'direct treatment for the disorder' is not explained and in any case none of this is relevant to autistic people who would be screened out.
Their target group is NT children over 7yrs who show signs of auditory challenge. One might hope that a teacher would recognise that 'Sarah/Timmy struggles when there's background noise' and make accommodations. It's good to know that auditory colleges have a diagnostic procedure for kids with a less perceptive teacher, and can report back with a diagnosis and a management plan: Sit them at the front, remove background noise.

It's a shame the diagnostic procedure of iii/ necessarily excludes autistic children, but the suggested management is likely to be the same for both NT and NT children. I hope that the recommendations from i/ would inform the caring team for autistic children to make those same accommodations.

Thanks - it's been an interesting dip into the topic

 

[xXxplorher]

I just Googled 'how to cope with neurotypicals doing stupid things?' and Reddit came up with a nice, supportive thread with loads of RL examples.

Don't bother to search but I posted in a thread recently in which someone drew a false conclusion from a YT they'd watched. The premise of the YT was light-hearted, but they took it as gospel to support a vague pet notion. I bailed out after a couple of posts, but it's so frustrating. I do, double, triple check my facts, but in the end realise I'm being gaslit. NTs like to play at expert, purely for small-talk discussion.

I could cite RL examples but they'd be too close to home. The trick I need to practise is walking away from stupidity that's masked as small-talk. Small-talk for them takes up the uncomfortable silence we welcome as peace.

It's always us that have to make the accommodation for their stupidity. It wears you down. Where's my fidget? Where's my man and his calm chest and strong arms?

I just googled "random idiot" and it not only came back with my name but yours as well.

What now?

 

[Strixaluco]

And now we walk away from the stupidity right above me and don't feed the bullying troll.

 

[PMarky2]

It was one of those weekends. Friday I got to hang out doing stuff with a dear female friend and her son, so that was cool, but Saturday and Sunday both involved serious socializing. Saturday went OK, but Sunday was a dumpster fire, and I am frightened I might have upset someone. Yesterday was definitely an anxious day even though I had good news on the work front (yet another disrupted day off!) and nothing went wrong. Currently, I am hunting around for my executive function and can't find it.

 

[Noor]

My hearing is quite good, but my ability to make sense of things deteriorates swiftly with increasing background noise. I just cannot filter the crap out and hear what I want/need to hear. Lip-reading helps a little, but bring tired makes that more difficult. If you are walking away from me and there is background noise - forget about it. I also cannot hear phone conversations if there is background noise, so I leave the room of the radio or TV is on. My wife accused me of being secretive quite a few times before she finally twigged it is due to the fact I find it difficult to process out background noise.

Restaurants or bars with the chatter and tv on can be the worst!

 

[Statius]

ADHD here. I get so impatient when my wife and I go to a restaurant because of the noise. I can't deal or focus at all. Stresses me out. I have my card ready to be billed before we're even done eating. Get me the fuck out of there!

Side note: Thanks @stickygirl for opening the thread up to ADHD people, you're cool as fuck!

 

[stickygirl]

ADHD here. I get so impatient when my wife and I go to a restaurant because of the noise. I can't deal or focus at all. Stresses me out. I have my card ready to be billed before we're even done eating. Get me the fuck out of there!

Side note: Thanks @stickygirl for opening the thread up to ADHD people, you're cool as fuck!

My gran used to complain the lights were too dim in restaurants but I’d be stressed by the noise too. We ate at home mostly !! with nice lights, no noise and often ice cream for pud!

 

[Statius]

My gran used to complain the lights were too dim in restaurants but I’d be stressed by the noise too. We ate at home mostly !! with nice lights, no noise and often ice cream for pud!

It's much better definitely. But sometimes she wants something that I just can't cook lol, or she can't. So we bite the bullet and go. Of course I always forget my readers too then I can't read the damn menu!