Central Auditory Processing Disorder (C)APD

Auditory processing of spoken language requires rapid recognition, discrimination, and integration of what we hear in order to understand the intended message. Accurate auditory processing is dependent on appropriate functioning of other systems such as arousal, social/emotional, attention, memory, linguistic, and executive function.

Those with normal auditory processing ability know who and what to listen to, what and who to ignore (background noise), understand the tone of the speaker, hold on to long and multiple step auditory information in an organized and sequential manner, and integrate what we hear with other sensory input.

Those with impaired auditory processing may manifest the inability to accurately process and interpret auditory information. Auditory processing has been described as “what the brain does with what the ear hears,” by renowned researcher and scholar Jack Katz, Ph.D. The disorder commonly impacts listening, spoken language, and learning.

Individuals with (C)APD may experience difficulty sorting auditory information, which may present in various ways. Some of them being difficulties listening to, comprehending, and/or remembering the information heard. Individuals with (C)APD may also experience difficulties interpreting the subtle meaning of what has been said, such as sarcasm, irony, and humour.

Signs Of CAPD

When the ear does not coordinate with the brain, sounds are incorrectly heard and often misinterpreted. Persons with CAPD especially experience difficulty understanding sounds and speech in background noise (i.e., the hum of a fan, chatter in a classroom). CAPD can negatively impact listening, language skills, and learning. Some signs of CAPD can include:

• Being easily distracted by background sounds/noise
• Difficulty focusing on or remembering spoken information or directions
• Difficulty with words: misspelling, mispronouncing, omitting syllables, confusing similar sounding words
• Difficulty processing and remembering language related tasks
• Often is thought to be ignoring people
• Says "what?" a lot even if they heard what was said
• Slow processing of thoughts and ideas
• Difficulty explaining him/herself
• Interpreting words too literally, often missing out on puns, jokes, and figurative language
• Difficulty with complex sentence structure or rapid speech

Evaluation

CAPD cannot be diagnosed by symptoms alone. Only careful assessment of the auditory pathway by a professional trained in auditory disorders, an audiologist, leads to an accurate diagnosis of CAPD. While other providers (i.e. educators, speech language pathologists, psychologists) are important members of the care team for a patient who exhibits the difficulties associated with CAPD, only an audiologist can diagnose CAPD.

Testing is completed under headphones and in a sound booth. Five core tests are administered, in which the patient is asked to repeat back information (words, numbers, and pitches) presented to either ear. The tests are designed to assess the specialized auditory skills of decoding, integration, and prosody.

TREATMENT

Treatment of CAPD is highly individualized and based upon the patient’s needs and diagnostic test results. Audiologists and speech language pathologists will work with you and/or your child to determine the best treatment plan, and help provide important information to educate teachers and school personnel to ensure classroom modifications are in place to assist learning.

Treatment plans are often intense in nature and involve home practice activities. Therapy can range from computer-assisted software programs to one-on-one training with our speech and language therapists. Approaches include, but are not limited to, auditory training and dichotic listening training with words, phrases and sentences presented in background noise, training the brain to differentiate sounds in increasing background noise (sound discrimination problem), repetition of sequencing routines (auditory memory), and self-advocacy skills to ask for repetition or rephrasing of instructions or comments (language processing problems).