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  • Writer's pictureDr. Lisa Marnell, OTD, MBA

Support Auditory Processing in Autistic Children

Updated: Dec 9, 2022

Did you know that autistic children and teens frequently present with auditory processing challenges?

Too often, I meet with clients or speak with teachers and I hear comments like these about students:

"Sometimes he listens. Sometimes he doesn't. It makes no sense whatsoever!"

"Her ability to listen depends on her mood. You know, she can be stubborn and do what she wants."

Or, one comment I heard recently which truly made me stop in my tracks . . .

"They had his hearing tested. He's fine. His problem has nothing to do with listening."

Yet, if a child presents with an auditory processing disorder, he's not fine. He is struggling. He is missing information on a daily, hourly, and likely minute by minute basis. His abilities vary in relationship with so many other factors, such as the environment, the time of day, and his interoceptive state (is he hungry, tired, needing to go to the bathroom?)

But what is "auditory processing" exactly?

Auditory processing is the ability to interpret the sounds that a person hears. Contrary to popular belief, it has nothing to do with hearing. A child can have his or her hearing tested and perform fine, but still have difficulty processing sounds.

In a 2015 study, researchers at the Children's Hospital of Philadelphia compared structural and functional abilities of sound processing in 63 typically developing and 52 autistic children aged 6 to 14. What did they discover? Their findings suggested that the auditory cortex of the brain develops slower in children with autism. This affects children's ability to process language and learn to speak. (See this study HERE.)

Other research has demonstrated that auditory processing challenges are common in kids with autism.

So, what are other specific challenges our kids face?

Autistic children may have difficulty localizing sound or differentiating between sounds (such as vowel sounds and consonants or short and long sounds). They may struggle with auditory memory and may have a hard time making sense of sounds when there are competing background noises. We cannot assume that a child isn't listening to us, as they may simply be having difficulty processing what we are saying.

So . . . what can you do to support a child with auditory processing challenges?

1- Wait it Out

Instead of immediately repeating a question that a child struggles to answer, give them time. Wait 10 to 15 seconds (which is longer than we imagine!).

2- Movement Can Be Calming and Organizing

Allow and even encourage children to fidget. This may seem counterintuitive, but don't force kids with autism to follow the rules for Whole Body Listening. This often does not work for them given that they process information differently. Also, the hearing and vestibular systems are closely tied, so optimal function for hearing may be linked to movement.

3- A New Perspective Regarding Eye Contact

Do not require eye contact. Today many adults with autism describe that forcing themselves to make eye contact is physically painful to them. Eye contact can increase anxiety and decrease their ability to listen well.

4- Reduce Background Noise

Trying to process more than one sound at a time can be disorienting to children and teens with autism. So, turn off the TV. Ensure the child's learning environment is quiet, with no music playing, for example.

5- Use Visual Supports

Offer visual supports when giving instructions to a child with autism. This is becoming more and more common in many environments, but it is not always used. Ensure that the child understands the visuals as well since some individuals may do better with pictures of real objects rather than with images or clip art.

6- Offer Breaks

Provide children with breaks from listening. Yes, complete breaks! Allow them to work or play silently for 10 to 20 minute periods of time. This allows their working brains to shut down for a bit and recharge!

As always, feel welcome to touch base with me, Dr. Lisa Marnell, OT, by e-mail at

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