Central Auditory Processing Disorder
Most of us have heard of or know someone who has hearing loss. A condition that is less well-known, despite being quite common, is Central Auditory Processing Disorder (CAPD), which is related to hearing and can have a significant impact on a person’s ability to learn and understand language. However, with the help of holistic treatment, people with CAPD can learn to thrive and achieve all of their career and other life goals.
What is CAPD?
Central Auditory Processing Disorder (or CAPD) describes a range of conditions in which a person has difficulty understanding (or processing) information that they hear. Unlike hearing loss, where there is some part of the hearing mechanism (the ear!) that isn’t working as it should, people with CAPD usually have good hearing. The difficulty they experience is the brain not quite knowing what do to with the sounds it hears. CAPD is usually a life-long condition, however evidence has demonstrated that improvements in auditory processing can be made with the right treatments, and there are strategies that can be used by people with CAPD to improve their ability to learn.
Should I be concerned?
It can be difficult at times to work out whether a child is having difficulty hearing, having difficulty understanding, or is just being ‘selective’ (read: choosing to not listen to what you say!). The best advice here is - if in doubt, check it out! A delay in diagnosis due to the assumption that a child has ‘selective’ hearing can lead to a missed opportunity for earlier intervention and beneficial treatment. Some signs of CAPD include:
- Difficulty hearing where sound is coming from
- Difficulty understanding what is being said if there is background noise (e.g., the TV is on or you’re in the car), the space has an echo or someone is speaking quickly
- Taking longer than expected to respond when spoken to
- Frequently saying “what” or “huh”
- Inconsistently or inappropriately responding when spoken to
- Difficulty following complex instructions
- Difficulty learning songs or nursery rhymes
- Misunderstanding messages, such as interpreting sarcasm or jokes
- Poor musical and singing skills
- Difficulty paying attention
- Being easily distracted
- Reading, spelling, and learning problems
- Difficulty learning a new language
How is CAPD assessed?
Assessments for CAPD are conducted by an audiologist. The first step of the process is to have a hearing test! As many of the signs of hearing loss and CAPD are similar, it is important to first establish that hearing is functioning normally. If the results of a hearing test are found to be normal, but there are still concerns, an auditory processing assessment can be considered. This assessment, which is longer and more in depth than a hearing test, is also conducted by an audiologist. At the end of the assessment, you may receive a diagnosis, as well as recommendations for treatment and management
So where does a Speech Pathologist come in?
While assessment of CAPD is the field of an audiologist, Speech Pathologists are an important part of the team for delivering treatments that can manage and improve this condition. Some ways a Speech Pathologist can help are:
- Direct skill remediation: This involves working with a Speech Pathologist to improve the skills that are causing difficulty including auditory discrimination, phoneme discrimination and phonological awareness. The teaching of reading decoding and comprehension are also valuable for a person with CAPD.
- Providing compensatory strategies: Speech Pathologists can work with people with CAPD to teach them other ways to learn and remember things that can go some way to make up for the difficulty they are experiencing with auditory information. This is called meta-lingustic (thinking about language) or meta-cognitive (thinking about thinking) therapy.
- Environmental modifications: A Speech Pathologist can also observe and assess an environment where learning is difficult and make recommendations on how to maximise the person with CAPD’s ability to learn in it. Recommendations may include things such as the best place for the person with CAPD to stand or sit, or the placement of furniture or soft fittings the make the environment as easy to work in as possible.
ASHA (n.d.). Central Auditory Processing Disorder. https://www.asha.org/Practice-Portal/Clinical-Topics/Central-Auditory-Processing-Disorder/#collapse_6
Bellis, T. J., & Anzalone, A. M. (2008). Intervention approaches for individuals with (central) auditory processing disorder. Contemporary Issues in Communication Sciences and Disorders, 35, 143–153.