What is Central Auditory Processing Disorders (CAPD)?
On-line AIT Checklist
Auditory Processing Disorder Can Severe Limit Your Child's School Performance
and His Ability to Control His Behavior at Home.
excerpts from the article
Some children have normal hearing
ability but have difficulty using information they hear in academic and social
situations. These children may have a Central Auditory Processing Disorder.
Children who have this difficulty are able to hear well, but have trouble paying
attention to, remembering, and utilizing auditory information for academic and
social purposes. Central Auditory Processing Disorders may have a very
negative impact on their language acquisition, social skill development, and
Some researchers feel that many
children are misdiagnosed with ADHD and actually have a Central
Auditory Processing Disorder. This condition is particularly common if the
child has other sensory integration disorders, such as touch sensitivity. In
addition, children with ADHD may also have a Central Auditory
What is a Central Auditory
A Central Auditory Processing
Disorder is an impaired ability to attend to, discriminate, remember,
recognize, or comprehend auditory information in individuals who typically
exhibit normal intelligence and normal hearing.
When a person is exposed to a
sound, the ears detect the sound and transmit the information to the auditory
part of the central nervous system. The sound stimulus is processed in several
parts of the central nervous system. In the end, the listener will know the
direction from which the sound comes, identify the type of sound, be able to
separate the sound from background noise, and interpret the sound. The listener
stores the memory of this sound stimulus and develops a mental sound library,
which he uses to help him evaluate, interpret, and utilize new sound information
that he experiences in the future.
When a child has a Central
Auditory Processing Disorder he has an impaired ability to attend to,
discriminate, remember, recognize, or comprehend auditory information. These
processing difficulties become more pronounced in challenging listening
situations, such as noisy backgrounds or poor acoustic environments, great
distances from the speaker, speakers with fast speaking rates, or speakers with
What the Child Experiences
Distorted Speech Sounds
Nobody talks the same way. There
are always slight variations in pronunciation and emphasis that makes one
personís speech patterns differ from those of another. In order to understand
the speech of other people, a child must make a series of mental adjustments.
First he hears words. Then based upon his memory of similar sounds, he places
the sounds of the words in context and decodes the meaning that is being
In a child with a Central
Auditory Processing Disorder there is a break somewhere in this decoding
process. The child isnít able to derive the correct meaning from words because
he cannot accommodate the different distortions of different speakers.
Excess Background Noise
When we are in a noisy room, we
need to block out the extraneous noise in order to distinguish and understand
words that are being spoken to us. One way we do this is by pinpointing the
location of the voice of the speaker and neurologically suppressing the sounds
coming in from other locations. A child with a Central Auditory Processing
Disorder may have difficulty pinpointing sounds. With this in mind it is
understandable why he canít block out extraneous noise. As a result a child
with a Central Auditory Processing Disorder appears to be easily
Misses Social Cues
Speech can be very complicated.
Beyond understanding simple instructions there are the nuances of language usage
that help convey the true meaning of the message being transmitted. It is these
nuances that allow for social interactions. A child with a Central Auditory
Processing Disorder may have a deficit in receiving and understanding the
meaning of sounds. Such a child will be very slow to follow the complexity of
the message that is conveyed by particular word usage and tones of speech.
Like other sensory motor defects,
Central Auditory Processing Disorders rarely occur alone. A child who
cannot effectively suppress extraneous noise may also not be able to use his
eyes to track words across a page or co-ordinate his fine muscles in his hand to
Since a child with a Central
Auditory Processing Disorder may not be able to block out meaningless noise,
he may appear to the observer to be easily distractible. This is one of the
reasons children with a Central Auditory Processing Disorder may be
misdiagnosed with ADHD. However, if a Central Auditory Processing
Disorder child also has ADHD and so that he already has a deficit of
inhibition, then the effects of his Central Auditory Processing Disorder
are much worse.
Children who have Central
Auditory Processing Disorders may behave as if they have a hearing loss.
Here are some of the common behaviors displayed by children who have Central
Auditory Processing Disorders:
Donít respond to speech in a
Frequently ask for words to be
Difficulty following speech in
Frequently misunderstand what
Difficulty following long
Poor memory for verbal
Difficulty pinpointing the
direction from which sound is coming
History of middle ear
In addition, children with
Central Auditory Processing Disorders show many of these characteristic
deficits in school performance:
Poor reading, writing, and
Poor speech sound
Difficulty taking notes
Difficulty learning foreign
Poor short-term memory
Social or behavioral problems
Poor language skills
Poor academic skills.
An audiologist uses a battery of
tests to evaluate the peripheral and central auditory systems. Peripheral
hearing tests are used to determine if the child has a hearing loss, and, if so,
the degree to which the loss is a factor in the childís learning problems.
Central auditory tests evaluate the childís ability to understand and respond to
mild distortions of speech. It is also helpful to have a speech pathologist
evaluate the childís perception of speech and receptive-expressive language use.
Treatment Standard treatment
focuses on remedial help and splinter skills to expand upon the childís
There are now a number of new
treatment techniques that directly address the hearing deficits. The pioneer of
these techniques was Dr. Alfred Tomatis, who began treating Central Auditory
Processing Disorders over forty years ago.
Training is another effective technique. This program was developed by the
French otolaryngologist, Dr. Guy Berard, one of Tomatisís students.