The Sunflower is often used by organisations to develop their awareness of invisible disabilities for both their colleagues and customers and is a great catalyst to drive disability inclusion in the workplace. In this guest blog, Alyson Mountjoy, Chair APD Support UK discusses APD at work.
Our whole lives depend on our ability to communicate effectively, to understand what we hear. We tend to take it for granted that what we hear is what was said to us.
This is not always possible for someone with Auditory Processing Disorder (known as APD), and this can lead to miscommunication. Not being able to understand or remember what is said, or not being able to follow instructions appropriately in any situation can lead to distress, ridicule, embarrassment, lack of confidence and self-esteem as well as anxiety and a host of other issues throughout life.
What is Auditory Processing Disorder (known as APD)?
To understand the needs of adults with APD at work, we first need to understand the nature of APD itself. You may not have heard of APD: after all it is an invisible disability, one that cannot be easily identified.
APD is a processing disorder that affects what is heard. The World Health Organisation (WHO) also considers it to be a hearing disorder, one with a neurological cause. What we hear has to be processed by the brain in order to make sense. Even when speech is heard correctly, if the brain can’t make sense of what we hear, it will sound like a blur of noise. This is what happens with APD. APD doesn’t cause hearing loss, what is said is heard: it just might not make sense. But unlike hearing loss, the effects are also variable and intermittent, day to day, hour to hour, making APD harder to identify and manage.
APD affects understanding and remembering what is heard, and more, but it does not affect intelligence. Although it is not a learning disability, it can greatly affect learning at any age, and can disrupt other aspects of everyday life.
APD affects each individual uniquely
APD can be acquired at any time in life, by anyone, and they may not know they have it or why they struggle. Genetic factors, glue ear from frequent ear infections, head or brain injury and certain illnesses are some of causes known to lead to APD. It can be masked by automatic coping strategies like lipreading, or other conditions.
Noisy environments and large groups of people make it harder to understand what is said. People with APD who choose to avoid these situations as a coping strategy can be perceived as antisocial and this use of self-avoidance can lead to isolation and loneliness. But for those children and adults with APD who have a reliable diagnosis, are understood, accepted and support appropriately, success is possible in all areas of life.
20% of adults in the UK are estimated to have APD
APD is thought to affect up to 10% of children and 20% of adults. The estimated numbers rise to 40% if children with APD also have learning disabilities. By comparison, autism affects 1.1% of children. There is no cure, so every child with APD will grow up to be an adult with APD.
APD also often exists alongside any number and variety of unrelated conditions which can also worsen its effects, and vice versa. They can include hearing loss, also compounding the effect. APD is known to be a cause of dyslexia, but not everyone with APD is dyslexic. APD is now believed to be present in some measure in every autistic child and adult - but not everyone with APD will be autistic. APD is complex.
If APD is suspected, it is essential to get an accurate diagnosis to identify its unique effects in each person, to work out ways to cope and get around it, and so they can learn to ask for the help that they need (*see the link at the end). Self-knowledge, coping strategies, and self-advocacy skills are imperative for anyone with APD. There may be things that they may not be able to do alone, so they may need support and equipment that will make life easier, particularly in education and at work.
The commute to work
Let’s start with the journey there. Travelling to work extends the working day and can significantly add to the stress and tiredness experienced by adults with APD (which in turn make it harder to process what is heard).
A journey inevitably involves planning and organisational skills: you need to know where to go, how to get there and what time to arrive. This is even more important if the location is a new one. If the directions are conveyed by phone, it can be very difficult for someone with APD to process due to degraded sound signals, unfamiliar voices and accents, whether by smartphone or landline. Location details and directions should always be provided in writing - by letter, text, or by email.
Driving with APD
There are a number of barriers that need to be overcome for someone with APD choosing to drive to work. The first is acquiring a driving license: fortunately choosing an understanding instructor, and requesting appropriate support for the lessons and the driving test itself can all help. Trying to understand a satnav can be a challenge, if you use one. Even sharing a lift to work can present barriers: if your travelling companion insists on having the radio on or chatting, this can mean the commute to work leaves you exhausted, in sensory overload, or with a headache, all before you even get there.
What about public transport?
Self-inflicted social isolation as a coping strategy can prevent people wanting to leave the safety of their home, yet travel is essential for those who need to work outside the home. Confidence issues and not wanting to appear foolish both contribute to social anxiety for those with APD. Using public transport can make this worse with concerns over strangers striking up a conversation, missing a bus/train, being late for work, risking disapproval from your employer or even worries about losing your job.
Buses, trains, or the underground all present significant challenges for people with APD. Speech is harder to understand in noisy environments and stations are busy, noisy and full of people. Announcements can be hard to process, and people difficult to understand (especially those with new voice patterns, accents, fast-talkers).
Even with hybrid working, there will be times when travelling to work is unavoidable. This journey can leave someone with APD exhausted, in sensory overload or with a headache before they even get there. Then after a stressful day, they have to endure it all again before they can get home and rest.
APD in the workplace
The workplace is generally where working adults spend most of their waking hours, and APD can lead to a myriad of issues in seeking and maintaining work. The support needed may vary from one individual to another, depending on the specific type and severity of APD experienced. Such support is also needed in workplace training (and in other types of adult education).
There are situations that someone with APD may need to find ways around or avoid, as well as those for which that they may need help. There is no shame in being supported to work efficiently: everyone needs help sometimes. Someone with APD is just asking for reasonable adjustments and/or equipment to allow them to do what people without APD do automatically: simply understand what they hear.
To disclose or not to disclose?
Declaring a disability/health condition at work can be daunting; it is sometimes hard to admit that you need help. Although no-one is obliged to declare a disability, health or mental health condition, not declaring a diagnosis can mean that lack of access to support and reasonable adjustments within the workplace and at the interview can make the workplace and the role more challenging.
Also, an individual can request reasonable adjustments at work if:
- they were diagnosed with a disability/chronic health condition after starting the job
- they have received additional diagnoses since starting a job
- a condition which caused no problems earlier has become problematic
- their role and duties have changed
- they only just felt able to discuss their disability/health condition/s with their employer and they need support.
To receive reasonable adjustments at work, at any stage during their employment, an individual with APD or auditory processing difficulties is advised to declare the diagnosis for support to be provided.
Types of reasonable adjustments for someone with APD
Here are just some of the reasonable adjustments that someone with APD may find useful, and should be tailored to their needs and the recommendations in their diagnosis report. They can also be beneficial to those with hearing loss and/or other communication difficulties. They might choose from:
- assistive listening devices/ALDs (e.g. an FM system, speech recorder, speech to text software, noise-cancelling headphones)
- items to minimise background noise (carpet/rugs, notice boards, noise cancelling headphones etc.)
- frequent breaks in a quiet place to avoid sensory overload
- text or email contact instead of phones
- answerphone to record calls to play later (check with regard to data protection)
- a note-taker, or pre-printed materials before meetings plus email reminders before and notes emailed afterwards
- extra time to prepare reports
- working from home, if/when appropriate to the job and provide equipment to support this for instance a laptop
- reasonable adjustments for training (e.g. a reader/scribe/quiet room for tests in which to take them (preferably alone with an invigilator).
- for video conferencing/work meetings, all necessary equipment and support should be provided e.g. subtitles, and a transcript provided afterward
- Support should be what the employee feels they need, not just what the employer suggests. Someone with APD, or any disability/chronic illness, can also apply to the DWP “Access to work” scheme for a grant to help pay for practical support at work. https://www.gov.uk/access-to-work
Honesty about any limitations that APD brings is an essential part of coping. This includes realising that there are situations that need ways around them (or avoidance), also those for which a little help will make them possible. There is no shame in being supported to work efficiently: everyone needs help sometimes. People with APD just need some minor adjustments and/or equipment to allow them to do what people without APD do automatically: simply understand what they hear.
Support should be what the employee feels they need, not just what the employer suggests. Someone with APD, or any disability/chronic illness, can also apply to the DWP “Access to work” scheme for a grant to help pay for practical support at work. https://www.gov.uk/access-to-work
APD Support UK is the only organisation in the UK dedicated to supporting individuals and families affected with APD. Information about APD for parents, adults and professionals is available on the APD Support UK website as well as access to online support groups.
If you suspect that you or your child may have APD, please seek diagnosis as soon as possible. Visit APD Support UK’s Diagnosis page for a list of specialist testing centres. On our page specifically for adults there is a longer article “APD and employment” and one on “APD, phones, video conferencing and virtual learning.” There is also a new handout on the page for professionals, “An APD Guide for employers” describing in more detail how APD affects adults at work and the needs for reasonable adjustments, and the handout “APD-friendly Interviews - for Employers” which can also aid those with hearing loss. https://apdsupportuk.yolasite.com/