So THAT'S the reason! Common but little-known condition could explain why you need subtitles to watch TV - despite having good hearing

4 months ago 7

If you find yourself having a hard time following your favourite TV shows without subtitles, it might not be because there's anything wrong with your hearing. 

Instead, experts say that a common but little-known condition could be to blame.

Psychiatrist and ADHD specialist Dr Sasha Hamdani says that an inability to follow dialogue can be a sign of auditory processing disorder (APD).

APD affects about five per cent of the population and can make it extremely difficult to understand auditory information.

Speaking in a video posted to her TikTok, Dr Hamdani says: 'APD basically means that, even though you hear just fine, your brain has trouble interpreting speech into something you can understand.'

Psychiatrist and ADHD specialist Dr Sasha Hamdan explains that you might feel like you need subtitles because of a common condition 

With the rise of video-on-demand services like Netflix and Amazon, using subtitles has become increasingly common - especially with younger watchers.

A recent YouGov poll found that while only 28 per cent of people said they generally prefer to watch TV and movies with subtitles on, that figure rises to 61 per cent among 18-24-year-olds.

But while some people may prefer to watch with subtitles, others might find that they simply cannot understand what they are watching without them.

Dr Hamdani says: 'Maybe you get distracted by the background noise or the sound effects or the soundtrack, maybe there's a volume change and suddenly someone's whispering and you can't interpret it.' 

If this sounds like a familiar experience, it could be because you have APD.

If you always need subtitles turned on then it might be a sign you suffer from Auditory Processing Disorder (APD)

In her TikTok video, Dr Hamdani explains: 'Some signs of auditory processing disorder include...having difficulty understanding what people are saying, especially in places where there's a lot of background noise'. 

Dr Hamdani also points out that symptoms can include difficulty following verbal directions or not always being able to respond immediately when spoken to.

According to the NHS, APD is 'where you have difficulty understanding sounds, including spoken words.'

The condition most commonly develops in childhood where it can cause difficulties in the classroom but some people can also develop APD in later life.

Since people with APD may find it difficult to understand spoken conversations in noisy places, it can make it very difficult to follow the dialogue in TV shows or movies where there is often a musical score or sound effects in the background.

Those with APD struggle to interpret spoken information when there is noise in the background. This means that subtitles can help people with the condition follow the dialogue in TV shows and movies 

This means that captions can be extremely helpful to those who struggle with this condition.

In a blog post, Empire Caption Solutions, a provider of captioning services, writes: 'People with auditory processing challenges can have difficulty distinguishing between similar sounds and with comprehending speech over background noise, and may need more time for what they have heard to “click".'

'Being able to see the captions at the same time as hearing the spoken words or sounds can help someone with APD process what they’ve heard more quickly and keep up with the pace of the audio as it occurs.'

As Dr Hamdani points out, you can still suffer from this condition even if you have otherwise perfect hearing.

She says: 'That's why subtitles help; you rely on reading because you have difficulty interpreting what you are hearing.'

What is Auditory Processing Disorder?

Auditory Processing Disorder (APD) is a condition which makes it difficult to understand sounds including spoken words.

If you have APD you may find it difficult to understand:

  • people speaking in noisy places
  • people with strong accents or fast talkers
  • similar sounding words
  • spoken instructions

There is no cure for APD but treatment can include improving listening abilities through auditory training 

You should consult a GP about the issue if you or your child find it hard to hear or understand speech.

Source: NHS  

However, watching with subtitles on all the time is not necessarily a bad thing.

In fact, scientists say that children should be encouraged to watch TV with the subtitles on in order to improve their reading skills. 

Researchers found that children aged four to seven are twice as likely to become proficient readers if they watch TV with subtitles turned on. 

This is because when subtitles are playing on the screen, anyone watching can't help but look at and follow them. 

A 1997 study by researchers from the University of Leuven found that both children and adults exhibit 'automatic reading behaviour.' 

That effect also helps people focus on what is happening which can help people to concentrate on information like the dialogue and plot.  

APD is often mistaken for ADHD when it presents in children since the two have several overlapping symptoms, but there are a few key distinctions.

A 2018 study found that children with APD have difficulties which are exclusively related to sound while ADHD causes more general disruptions.

For instance, people with APD find it difficult to learn songs or localise the source of a sound.

Dr Hamdani says that people with ADHD also suffer from APD. The two conditions are distinct but in practice can be very hard to distinguish 

People with ADHD meanwhile may struggle with auditory tasks but also struggle to follow written instructions.

However, since issues with auditory processing can affect attention and executive function, the two conditions can be extremely hard to separate.

Likewise, ADHD makes it harder for people to focus on auditory information which can make it difficult for people to distinguish one sound from another in a distracting environment.

To make things more confusing, many people actually have both ADHD and APD.

Dr Hamdani says: 'I'm an ADHD specialist and I see this all the time.

'If you're thinking that sounds a lot like ADHD, you're not wrong. APD is more common in neurodivergent people so you may feel like you need subtitles because, without them, it's too hard to follow a show or movie.'

WHAT IS ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a behavioural condition defined by inattentiveness, hyperactivity and impulsiveness.

It affects around five per cent of children in the US. Some 3.6 per cent of boys and 0.85 per cent of girls suffer in the UK. 

Symptoms typically appear at an early age and become more noticeable as a child grows. These can also include:

  • Constant fidgeting 
  • Poor concentration
  • Excessive movement or talking
  • Acting without thinking
  • Inability to deal with stress 
  • Little or no sense of danger 
  • Careless mistakes
  • Mood swings
  • Forgetfulness 
  • Difficulty organising tasks
  •  Continually starting new tasks before finishing old ones
  • Inability to listen or carry out instructions 

Most cases are diagnosed between six and 12 years old. Adults can also suffer, but there is less research into this.

ADHD's exact cause is unclear but is thought to involve genetic mutations that affect a person's brain function and structure.

Premature babies and those with epilepsy or brain damage are more at risk. 

ADHD is also linked to anxiety, depression, insomnia, Tourette's and epilepsy.  

There is no cure. 

A combination of medication and therapy is usually recommended to relieve symptoms and make day-to-day life easier. 

Source: NHS Choices 

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