Do you struggle to hear your spouse talk across the room when watching television at night?

Do you have to ask a friend to repeat themselves multiple times when in a loud restaurant?

You could have Auditory Processing Disorder (APD) and not even realize it. APD is not a commonly known condition and its symptoms are often confused with hearing loss or ADHD.

Dr. Laura Fragomeni has worked for the Ball State Interprofessional Community Clinics twice now and most recently returned in August of 2025. Fragomeni was drawn to the ICCs as she enjoys not only supervising and guiding students but also getting to work directly with those in the community. Fragomeni’s main areas of practice include auditory processing evaluations and treatment for all ages, diagnostic hearing evaluations, hearing aids, and tinnitus evaluations and treatment. Overall, she believes that the ICCs give the community an option for evaluation and treatment of hearing concerns without having to travel far.

“Auditory Processing Disorder is the dysfunction of what the brain understands from what the ear hears,” clarified Fragomeni. APD is different from hearing loss or ADHD because it is not a fault in the ear itself or an attention issue, but rather a processing issue where the brain struggles to put the auditory information together. Fragomeni explains that APD “typically is present in childhood but sometimes doesn’t manifest until adulthood when life becomes more demanding”. APD can also arise from brain injury, menopause, long COVID, and other demyelinating or neurological disorders.

 

“It’s Not Just Background Noise” (Consider “I’m Not Just Ignoring You”)

“One of the most common and notable symptom is struggling to understand conversation in an environment with a lot of background noise” shared Fragomeni.

She further explained that those who experience this oftentimes notice real-life impacts that begin to lessen their quality of life. Within work and professional life, those with APD may notice that they struggle to understand colleagues and begin to feel distant from their work and connections. At home, their spouse or significant other  may mistake their difficulty processing speech for ignoring them, which can lead to arguments. Fragomeni explained that all of this can cause distress, heighten anxiety, and contribute to burnout as those impacted experience constant listening fatigue due to the cognitive effort required when constantly trying to listen and understand. Fragomeni further shares that many “don’t feel in tune with their surroundings, experience impatience from others, and deal with others misunderstanding their processing disorder”.

Getting Answers: Diagnosis in Adulthood

If any of these symptoms apply to you, it is not too late for an APD assessment.
“APD assessments for adults are fairly simple, and they take less than an hour,” explains Fragomeni, “patients fill out questionnaires, discuss areas of struggles, complete a baseline hearing test if not done before, and complete three core APD tests which only take 10-15 minutes each. These tests are very laid back and interactive.”

APD is not widely known about and there is a slim amount of knowledge surrounding the disorder within healthcare, resulting in the lack of referrals for testing. Fragomeni discussed that “many clinicians are unfamiliar with APD as it is likely only glazed over in their education. Pediatricians may be more likely to have some awareness of it  as it is more commonly a concern in children because it tends to show up academically with reading, spelling, and reading comprehension difficulties.”

Finding Solutions

Various treatment options are offered for APD, though treatment outcomes may vary depending on the patient and their conditions/symptoms. Dr. Fragomeni typically first recommends Buffalo Model Auditory Processing Training, which is a 12-week program where patients work with a speech-language pathologist or audiologist for 1 hour per week and do exercises to strengthen areas of the brain that are not processing sound and speech the way they should be.

If auditory processing training does not sufficiently improve the patient’s day-to-day functioning, they could consider options such as low gain amplification/hearing aids or remote microphone systems. This technology can help provide patients with improved speech clarity and understanding in noise, and lessen the effort used in listening, all which causes less strain on the brain.

As for daily living, Fragomeni shared activities  that patients can do at home to enhance their processing abilities and personal lives: “Simply have a loved one read some words or sentences to them while playing background noise and have them repeat back what they heard; or they can even just converse with background noise playing.  If someone gives you a piece of information, for example, a phone number, try to remember it first by repeating it in your head before writing it down.” This helps with building short-term auditory memory, another area of APD. There are also some apps that can help maintain good auditory processing skills.

Finally, advocating for yourself when struggling with APD is crucial. Fragomeni explained ways you can do this like: “Utilizing devices such as remote microphones in a classroom/meeting setting, sitting closer to the speaker where both volume and visual cues are better, telling others that you struggle with the disorder and offering suggestions on how they can help, and writing things down that you will need to recall later.”

Final Thoughts from Dr. Fragomeni 

If you think you or someone you know is struggling with APD, Dr Fragomeni advises to “reach out to an audiologist that is trained and knows how to assess for it. It is absolutely a real thing and can be very limiting to a person’s quality of life. However, it is definitely able to be improved significantly with the right treatment.”

Our clinic offers resources and audiologists who can help you if you believe you are struggling with Auditory Processing Disorder and are seeking help. To access these resources call 765-285-4422 or visit bsu.edu/icc.