Left to right: Melissa Baily, Dr Bill Keith, Professor Suzanne Purdy and Flora McKay (not pictured) wrote the New Zealand Guidelines for Auditory Processing Disorder.


Guidelines for identifying and treating auditory processing disorder are set to become a key resource for clinicians here and overseas, and are a major milestone in dealing with a condition that affects tens of thousands of New Zealand children.

The New Zealand Guidelines on Auditory Processing Disorder, launched on August 29 by the New Zealand Audiological Society and the Eisdell Moore Centre at the University of Auckland, have been more than three years in the making.

Co-author Dr Bill Keith says the comprehensive and detailed guidelines will be distributed to clinicians and professional groups in New Zealand and overseas, and will also be a resource for those with the condition and their families.

Auditory processing disorder (APD) affects our ability to understand and process what we are hearing, and was described in a recent research grant application as “the most neglected and under-funded area of hearing and deafness services in New Zealand”.

A 2014 report on APD, commissioned by the Ministries of Health and Education, estimated 6.2 per cent of children – 60,000 based on 2019 Department of Statistics population figures – are affected, as well as adults (it’s a common consequence of head injury) and the elderly.

Dr Keith says its prevalence among children means “there’s one in every classroom”.

APD has also been linked to dyslexia and other reading and language disabilities, and treatment of APD could potentially benefit people with those conditions as well.

Dr Keith, one of the four authors of the guidelines and a leader in researching and treating the condition, says the state of APD services in New Zealand is “appalling”.

Because it affects a child’s ability to learn, funding for treatment comes from the Ministry of Education, and it’s the only hearing condition whose treatment falls outside the aegis of the Ministry of Health.

“Education doesn’t have the expertise for this,” Dr Keith says. “It’s a health issue – a whole of life issue – not an education issue.”

The impact of APD on children can be profound with researchers preparing the ministry-funded report describing how parents saw their children’s confidence and self-esteem being undermined.

One parent described how her daughter “sat in the toilets at school all day crying”, while another said her son “sits with his hands over his ears in class”. For many parents, the only option was to take their children out of school and teach them at home.

But Dr Keith says that because of the brain’s plasticity, auditory processing disorder is “very treatable”, and that’s where the guidelines hold the key.

The guidelines recommend three main approaches – auditory training, amplification with remote microphone hearing aid systems, and language therapy.

“Through neuroplasticity, auditory training and amplification can engender permanent improvements in auditory skills,” the guidelines say.

The New Zealand Guidelines on Auditory Processing Disorder are the result of work by areference group on APD established by the Ministries of Health and Education following the Sapere report on APD released in February 2014.

Dr Keith said the ministries decided no further work on APD treatment policy would be done until a set of guidelines was prepared, and four authors set to work – Dr Keith who established the SoundSkills APD Clinic a decade ago to build a base of knowledge and research; Professor Suzanne Purdy, an international expert on APD and now head of the School of Psychology at the University of Auckland; Melissa Baily, an audiologist at the Ministry of Health; and Flora Kay, the public hospital representative of the NZ Audiological Society.

The draft guidelines were completed in 2017, then went out for review in the sector and by four international peer reviewers in Britain, the United States, Canada and Australia.

Now the guidelines have been launched, Dr Keith says the next step is to go back to the ministries to address the key element in dealing with APD – funding for treatment and support for children with the condition, as well as adults, and the elderly

“The guidelines are essential in themselves, but they are also a step towards the goal of reconvening the reference group, developing policy, and getting funding for treatment.”

A copy of the guidelines is available for download here