Difficulty with auditory discrimination—the ability to differentiate between words with small differences when you hear them—can affect the communication skills of children and adults. Because of this, people might misinterpret words during conversations and in educational settings. For example, “cat” may sound like “cot” or “fourteen” like “forty.” Children who experience this sometimes struggle to develop strong reading, writing and listening skills.  

Often, weak auditory discrimination is a part of a larger auditory processing disorder, which means the brain and ears don’t effectively work together to recognize and interpret sounds like speech. It can also be from undetected hearing loss. 

Auditory processing disorders are relatively uncommon, affecting only 3% to 5% of American school-age children. For adults age 55 or older, auditory processing disorders are more common due to age-related hearing loss and cognitive decline. What causes this disorder is frequently unknown, but it can be tied to:

• Head trauma
• Lead poisoning
• Repeated ear infections
• Old age
• Hearing loss
• Central nervous system disorders

To find the root of the problem and receive a diagnosis, a physician needs to evaluate you. If you’re struggling to understand things you’re hearing, talk to an audiologist, speech and language pathologist, or hearing care professional.

Young children should also try an auditory discrimination test, in which a person reads off words and asks the child if they’re the same or different. Other potential auditory processing tests include:

• Speech in noise test: Tests your ability to distinguish speech in a noisy environment
• Dichotic listening test: Tests if you can comprehend two words when said at the same time
• Gap detection test: Tests if you notice a short pause between two of the same sounds

For adults and seniors having trouble, a hearing test with a professional can help determine if hearing loss is a factor.

Treatment of preexisting causes, such as ear infections and central nervous system disorders, can also support your auditory discrimination abilities.

Early intervention is key in preventing long-term side effects, including learning disabilities, delayed speech and difficulty spelling. Working with a speech-language pathologist can minimize these issues for children and provide them with the skills they need to succeed in life and learning. Counseling, art or music therapy and occupational therapy can also benefit auditory discrimination, depending on the cause of the difficulty.

Aside from the skill-building exercises, you can try other auditory discrimination activities. Some of these may include:

• Sitting outside. Closing your eyes,  picking out the noises around you and naming them.
• Playing a game of Telephone. Get a group of people together, whisper a message in one person’s ear and pass it along to see what the message comes out to in the end. If you want to increase the challenge with speech-in-noise perception, try putting music on in the background.
• Using rhyme flashcards. Purchase or make flashcards with rhyming words and see if your child can pair the ones that sound alike.

These activities can help build the skills necessary to improve auditory discrimination, but talk to your audiologist or speech-language pathologist to ensure you’re taking the right approach to these hearing and listening difficulties.