Hearing Loss vs Auditory Processing vs Inattention
A child who seems not to listen is showing you a behavior. Some children do not hear well. Some lose your voice in a busy room. Some cannot keep their attention on the task. No sign we hold has been shown to tell these apart. Ask your child's doctor whether hearing has been checked recently.
TL;DR
- A child who seems not to listen is showing you a behavior. The behavior alone does not tell you why. A child who cannot hear the teacher clearly cannot attend to what was said. Ask your child's doctor whether hearing has been checked recently.
- Some children do not hear well. Some lose your voice in a busy room. Some cannot keep their attention on the task. No sign we hold has been shown to tell these apart. Ask your child's doctor whether hearing has been checked recently.
- ICD-11 is the World Health Organization's list of medical codes. In it, auditory processing disorder is listed among hearing conditions. That listing is not a definition. A British audiology body describes auditory processing disorder as listening trouble with normal hearing (British Society of Audiology, 2018). One large UK study argued that auditory processing disorder is mainly an attention problem (Moore and colleagues, 2010). This is not settled. Ask your child's doctor whether hearing has been checked recently.
- One review looked at children diagnosed with auditory processing disorder (de Wit and colleagues, 2018). It compared them with children diagnosed with ADHD, dyslexia and other conditions. On tests of intelligence, memory, attention and language, the groups scored much the same. The ADHD comparison rested on one small study. The review's authors said poor research quality may have affected that result. Ask your child's doctor whether hearing has been checked recently.
- A 2025 schedule from the American Academy of Pediatrics has hearing checked at routine visits. We hold no figure for how often a hearing problem is mistaken for inattention. Ask your child's doctor whether hearing has been checked recently.
A behavior, not an answer
A child who seems not to listen is showing you a behavior. The behavior alone does not tell you why.
To us, whether the ears are doing their job is one question. What happens to the sound next is another. Ask your child's doctor whether hearing has been checked recently.
Three things that can look the same
Some children do not hear well. Some lose your voice in a busy room. Some cannot keep their attention on the task. No sign we hold has been shown to tell these apart. We hold no figure for how often a hearing problem is mistaken for inattention. Ask your child's doctor whether hearing has been checked recently.
Hearing
A child who cannot hear the teacher clearly cannot attend to what was said. A 2025 schedule from the American Academy of Pediatrics has hearing checked at routine visits. Have hearing and vision checked too. A child who cannot hear well needs that found. Ask your child's doctor whether hearing has been checked recently.
Auditory processing disorder
ICD-11 is the World Health Organization's list of medical codes. In it, auditory processing disorder is listed among hearing conditions. It is in the chapter on the ear, not with developmental conditions. That listing is not a definition. A British audiology body describes auditory processing disorder as listening trouble with normal hearing (British Society of Audiology, 2018). One large UK study argued that auditory processing disorder is mainly an attention problem (Moore and colleagues, 2010). This is not settled. A US audiology body says audiologists should diagnose auditory processing disorder (American Academy of Audiology, 2010). Ask your child's doctor whether hearing has been checked recently.
One review, several groups
One review looked at children diagnosed with auditory processing disorder (de Wit and colleagues, 2018). It compared them with children diagnosed with ADHD, dyslexia and other conditions. On tests of intelligence, memory, attention and language, the groups scored much the same. Its 13 studies were of moderate quality. The ADHD comparison rested on one small study. The review's authors said poor research quality may have affected that result. Ask your child's doctor whether hearing has been checked recently.
Our page on processing difficulties has more.
When to ask for help
Each of these is a reason to ask for help on its own.
- Little change, even with steady practice and good teaching.
- Schoolwork well below what school expects.
- A teacher who raises a concern about learning.
- Extreme upset about schoolwork.
- Complete avoidance of school or learning.
- Hopelessness about learning.
- Sadness or worry that lasts.
- Significant delays in speech, language or motor development.
- A skill that was there and has gone. Our position is that a lost skill goes to a doctor first, not a tutor.
If no skill has gone, start with the teacher. Say what you are seeing at home, and what you have tried. Beyond the teacher, the right person depends on what it turns out to be about. If the work is too hard, someone who works on that school skill. If worry or mood is the thing, someone who works with children's mental health. In our view, delays in speech, language or movement are worth raising with your child's doctor. In our view, if you are worried enough to ask, a professional evaluation is worth asking about.
Any talk of hurting themselves is a same-day call to your doctor or a crisis line.
In the classroom
A child may often seem not to listen. If so, the family can ask the child's doctor whether hearing has been checked.
Two sentences for an email home: "In class, your child often seems not to catch what I say. Has anyone checked your child's hearing lately?"
Key Takeaways
A child who seems not to listen is showing you a behavior. The behavior alone does not tell you why. A child who cannot hear the teacher clearly cannot attend to what was said. Ask your child's doctor whether hearing has been checked recently.
Some children do not hear well. Some lose your voice in a busy room. Some cannot keep their attention on the task. No sign we hold has been shown to tell these apart. Ask your child's doctor whether hearing has been checked recently.
A 2025 schedule from the American Academy of Pediatrics has hearing checked at routine visits. We hold no figure for how often a hearing problem is mistaken for inattention. Ask your child's doctor whether hearing has been checked recently.
A British audiology body describes auditory processing disorder as listening trouble with normal hearing (British Society of Audiology, 2018). One large UK study argued that auditory processing disorder is mainly an attention problem (Moore and colleagues, 2010). This is not settled. Ask your child's doctor whether hearing has been checked recently.
For a few days, note each time your child seems not to listen. Note the room and how noisy it was. Bring the notes when you ask your child's doctor about hearing.
”What to do tonightWhat to use next
An overview of processing skills. Our work on each runs alongside reading, spelling or math instruction, not in place of it.
Common questions from parents
Is it hearing, or is it attention?
A child who seems not to listen is showing you a behavior. The behavior alone does not tell you why. Some children do not hear well. Some lose your voice in a busy room. Some cannot keep their attention on the task. No sign we hold has been shown to tell these apart. Ask your child's doctor whether hearing has been checked recently.
Can glue ear affect what a child hears in class?
Glue ear can affect hearing at the time. A child who cannot hear the teacher clearly cannot attend to what was said. We hold no study of glue ear and attention. Ask your child's doctor whether hearing has been checked recently.
Should hearing be checked if auditory processing disorder comes up?
A US audiology body says audiologists should diagnose auditory processing disorder (American Academy of Audiology, 2010). ICD-11 is the World Health Organization's list of medical codes. In it, auditory processing disorder is listed among hearing conditions. That listing is not a definition. Have hearing and vision checked too. A child who cannot hear well needs that found. Ask your child's doctor whether hearing has been checked recently.