Is it Autism or Auditory Processing Disorder (APD)? What's the Difference?Q: My 4 year old daughter’s pediatrician noted some developmental delays and referred us to a psychologist for a full assessment. She had 14 ear infections form 6 months to 3 years of age, and our family has a history of auditory processing disorder (APD) and I believe my daughter may have that. The psychologist who did the assessment insists that it is very rare and she fits the symptoms of autism better. How can I know if the psychologist is right?

A: First, I am not trained to assess autism or APD, so my answer comes from the point of view of a mom observing similar situations.

Assessing autism is such a broad area with a large subjective component, it is difficult to know if the diagnosis is accurate or not. One thing I have learned in this special ed process is that mother’s intuition is almost always right. If you do not believe your daughter is autistic, you need to keep searching for answers until you find something that feels right.

APD can only be assessed and diagnosed by an audiologist. So the psychologist is not qualified to say her auditory processing is normal. The challenge is that auditory processing is not usually assessed until a child is 7, so you need to find an audiologist who can use screening tools to determine the likelihood of APD.

Right now your daughter fits the diagnosis of autism. My son fit the diagnosis at 2-1/2, and I refused the label because in my gut I didn’t believe he had it. I turned out to be right, but in the meantime we lost out on a lot of services. So try not to think about it like she has it or doesn’t, just use the label as a tool to get her some help.

I have an acquaintance who has a son who is now 22. He was diagnosed severely autistic at age 2. He did all kinds of therapies and such, and by age 9 they said he didn’t have it anymore, maybe he was just PDD (which at that time was not considered full-blown autism). By age 12 they said he had Aspberger’s. At age 15 they said he had nothing, he was just a quirky kid. The mom did not do gluten free diet or any really intense therapies. She just did the regular speech, social skills and OT therapy that the school offered. So is he or was he autistic? It’s difficult to answer that question, but since theoretically you can’t grow out of it, it looks like his earlier challenges were caused by something else. Yet he fit the diagnosis very well when he was young, and he got services that helped. 

If you want another way to look at it, you could get a QEEG brainmap done. It can show autism, APD, as well as many of the other diagnosis. It rules in or out many conditions that are neurological in nature. It will tell you if this is MTBI (mild traumatic brain injury). That history of tons of ear infections by itself can cause many of these issues.

I would also recommend you check in with Vickie Bockenkamp at Tools for Learning. She has some powerful diagnostic tools that would tell you what is going on in the brain. She also has simple exercises to heal the issues so the child will progress. Those ear infections cause massive vestibular problems, and that by itself can cause a lot of the symptoms that are confusing to pin down.

And I’m sorry to say that the search for the answer goes on until your gut tells you that you found the right answer. When my son was diagnosed with post-concussive syndrome, everything made sense. That’s when I knew we had the right diagnosis. Then it was a matter of finding the therapies that would help. And I can tell you once we applied therapies for brain injuries, that is when we saw the best progress. So figuring out the cause can help you find the right solutions. 

Bonnie Landau
Bonnie Landau
Bonnie Landau is a special education advocate and educational consultant in Ventura County, California. Her goal is to help parents find strategies and solutions to help their children succeed in school and in life. Bonnie is the author of Special Ed Mom Survival Guide: How to Prevail in the Special Education Process and Find Life-long Strategies for You and Your Child.