Central Auditory Processing Disorder (CAPD)

The teacher tells everybody to take out a pencil, a piece of paper, and turn to page 32 in the spelling workbook. Pretty straightforward and easily accomplished. For everyone except for the child with CAPD who, despite having normal hearing and intelligence, has trouble understanding and following the teacher’s verbal directions. Learn more:

What is CAPD?

People with central auditory processing disorder (CAPD) generally have normal hearing sensitivity, but find it difficult to process and make sense of what they hear. The disorder is most common among children, but it also affects adults.

CAPD is characterized by various problems which occur in different listening environments when the ears and the brain don’t fully coordinate. People with CAPD may have trouble receiving, analyzing, organizing, storing, and using auditory information. These symptoms may get worse in places with a lot of background noise or acoustic problems.

Children with CAPD may have difficulties with speech, language, and learning – especially in the areas of reading and spelling. They may also appear to be hearing impaired, inattentive, easily distracted, and have problems following oral directions. Some children who have CAPD may also be diagnosed with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD).

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Symptoms of CAPD

People with CAPD may have difficulty:

  • Hearing in noisy in places that are noisy or have poor acoustics
  • Following long conversations
  • Hearing conversations on the telephone
  • Performing academically with reading and/or spelling
  • Learning challenging vocabulary words or a foreign language
  • Remembering spoken information
  • Taking notes
  • Staying focused on an activity when other sounds are present
  • Developing organizational skills
  • Following multi-step directions
  • Directing, sustaining, or dividing their attention
  • Processing nonverbal auditory information, such as music

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Causes of CAPD

CAPD is a neurological problem that interferes with the brain’s ability to process speech and other sounds. It may be inherited, caused by a birth defect, or result from causes or combinations of causes such as head trauma, disease, tumor, and lead poisoning. The cause usually can’t be determined or attributed to one specific thing.

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Diagnosing CAPD

The process of evaluating a CAPD often is a collaborative effort between an audiologist and a speech-language pathologist. A learning disabilities specialist or mental health professional may also be involved. An evaluation usually includes a complete hearing exam, standardized testing, questionnaires, and behavioral inventories.

The audiologist first tests hearing sensitivity and middle ear function. (Some middle ear conditions can affect central auditory performance.) More sophisticated tests follow to determine the patient’s ability to understand speech in the presence of background noise, competing speech, and less-than-optimal listening conditions.

The role of the speech-language pathologist is to evaluate the linguistic characteristics of the disorder. Additional testing is done to assess the patient’s ability to understand and use language, follow difficult directions, discriminate between sounds, and understand language.

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Treating CAPD

A thorough CAPD evaluation can guide health professionals in developing individualized therapy and strategies to help patients deal with the disorder. Treatment options include:

  • Auditory trainers or FM systems: These electronic devices reduce background noise interference, allowing a person to focus attention on the speaker. They’re often used in classrooms, where the teacher wears a microphone and transmits sound to the student, who wears a headset
  • Environmental modifications: An audiologist can suggest ways to improve the listening environment, such as improving a room’s acoustics or changing seating arrangements
  • Remedial exercises: A range of exercises have been developed to help increase the patient’s language base and build on vocabulary
  • Auditory memory enhancement: Patients can learn techniques to condense complex information to a more basic form that’s easier to remember
  • Strategies: Practices like writing down verbal instructions and checking them off as they are completed can prove helpful with school- and work-related tasks.

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