Central Auditory Processing Disorder (CAPD)
Individuals with CAPD may present with difficulties with read, spoken, and written words. However, they typically can derive the meaning of language from written words. Auditory processing is a term used to describe what happens when your brain recognizes and interprets the sounds around you. The “disorder” part of auditory processing disorder means that something is adversely affecting the processing or interpretation of the information.
CAPD goes by many other names. Other common names are auditory perception problem, auditory comprehension deficit, central auditory dysfunction, central deafness, and so-called “word deafness.”
The cause of CAPD is often unknown. In children, auditory processing difficulty may be associated with conditions such as dyslexia, attention deficit disorder, autism, autism spectrum disorder, specific language impairment, pervasive developmental disorder, or developmental delay. Sometimes this term has been misapplied to children who have no hearing or language disorder but have challenges in learning. A hearing test should be conducted to rule out a hearing impairment. An audiologist is responsible for diagnosing CAPD and typically cannot do so until the child is at least 6.5-7.0 years old.
What are the symptoms of possible CAPD?
Children with auditory processing disorder typically have normal hearing and intelligence. Over time, they may have learned to compensate for their auditory processing weakness; however, these skills will not always be efficient. They may be observed to have:
- Difficulty with reading, comprehension, spelling, and vocabulary
- Trouble recognizing subtle differences between sounds in words- small changes in sounds can be big changes in meaning and can lead to a multitude of problems in academic and daily life.
- Poor listening skills/ poor attention
- A dislike of reading because it is difficult and tedious
- Difficulty listening in the presence of background noise
- Say “what”, “I don’t know”, “huh” often
- Problems carrying out multi-step directions
- Noticeable fatigue at the end of the day
- Stronger academic performance in quiet, one-on-one learning setting or small groups
- A need for more time to process information and may need the information to be repeated
- Trouble paying attention to and remembering information presented orally
- Low academic performance
- Speech and language problems
- Sensitivity towards certain sounds
- Behavior problems
- Language difficulty (e.g., they confuse syllable sequences and have problems developing vocabulary and understanding language)
- Difficulties reading and writing because they are directly linked to language
- Difficulty spelling due to hearing sounds incorrectly
- Low frustration tolerance due to not being understood or not able to understand what is going on
- Difficulty localizing sounds
- Difficulty processing new vocabulary or information
- Weaknesses in phonics, reading and spelling
- Inconsistent performance
- May seem lazy, over dependent, or inattentive
What treatments are available for CAPD?
Much research is still needed to understand CAPD problems, related disorders, and the best intervention for each child. Several strategies are available to help children with auditory processing difficulties. Some of these are commercially available, but have not been fully studied. Any strategy selected should be used under the guidance of a team of professionals, and the effectiveness of the strategy needs to be evaluated. Researchers are currently studying a variety of approaches to treatment. Several strategies you may hear about include:
- Auditory trainers are electronic devices that allow a person to focus attention on a speaker and reduce the interference of background noise. They are often used in classrooms, where the teacher wears a microphone to transmit sound and the child wears a headset to receive the sound. Children who wear hearing aids can use them in addition to the auditory trainer. FM system- a wireless amplification system.
- Environmental modifications such as classroom acoustics, placement, and seating may help. An audiologist may suggest ways to improve the listening environment, and he or she will be able to monitor any changes in hearing status.
- Exercises to improve language-building skills can increase the ability to learn new words and increase a child’s language base.
- Auditory integration training may be promoted by practitioners as a way to retrain the auditory system and decrease hearing distortion. However, current research has not proven the benefits of this treatment.
Language Processing Disorder (LPD)-
Individuals with LPD demonstrate difficulty with both heard and read words.
Accommodations/ modifications for children with APD or LPD
- Send materials home in advance- books that will be read, vocabulary, themes that will be targeted
- Break up multi- step directives- “wash your hands first; come back to the table after” versus “wash hands; come back to the table”
- Have the child repeat back directives to ensure they understand
- Seat child away from window, doors, areas where there may be more noise or distraction
- Smaller group instruction
- Assign the child a “buddy”
- Classroom modifications- carpeting, felt bottom chairs, white erase boards
- Allow extra time for the child to think about and form their thoughts
- Omit non-essential details- keep language simple
- Get down to their level
- Use visuals and gestures
- Don’t choose this child first when going around to answer a question
- Allow for breaks from work
- When giving directions make sure the room is quiet, child is looking at you
- Decreasing noise levels
- Games to play- “telephone”, “simon says”, “grocery shopping list”
- Paraphrase and restate key information