Central Auditory Processing Disorder (CAPD)
What is Central Auditory Processing Disorder?

Central Auditory Processing Disorder affects up to 5% of school-aged children. These students cannot process the information they hear and are usually characterized as “poor listeners.” They have normal hearing ability, but there is a disconnect between what is heard and what is understood. These children's brains interpret sounds differently than those of others. For example, a teacher may say, “Tell me how a couch and a chair are alike.” A child with CAPD may hear, “Tell me how a chair and a couch are alike.” It can even be heard by the child with CAPD as, “Tell me how a cow and a hair are alike.” These problems are more pronounced in a noisy room or when the student is listening to complex information. This can result in speech, language, and academic problems, especially in spelling, reading, writing, and speaking skills.

There is no one cause of CAP Disorder. We do know that it often coexists with other disabilities such as language disorders or delays, learning disabilities or dyslexia, autism or autism spectrum disorder, attention deficit disorders with (ADHD) or without (ADD) hyperactivity, pervasive developmental disorder or developmental delay, and social/emotional problems. CAPD is twice as prevalent in males as in females.


Detecting CAPD


There are a variety of possible behavioural indicators that a child may have CAP Disorder. Many of these behaviours are also indications of other disabilities as listed above. A diagnosis can be made following testing by a specialized audiologist using specific tests. Some of the skills evaluated by the audiologist do not develop in the child until age eight or nine. Once diagnosed, CAPD students often work with a speech therapist.


CAPD is recognized as a learning disability and should therefore be recognized as qualifying a student for exceptional status. This means that once a diagnosis is made and recommendations are clearly stated, including a trial with an FM system (a headset the student wears to listen directly to the instructor via microphone), in the audiologists report, parents should request an IPRC meeting in writing from the principal. The student will be eligible for an FM system to be placed in the classroom (see accommodations below). The cost of these systems are most often covered by the Ministry of Education rather than your school board or school, so funding is not an issue when obtaining this device. The Ministry of Education often provides someone to train the child and teacher on how to use the device. A few month's trial with the system is usually initiated to assess the benefits. If several children in the classroom suffer from this disorder, a surround sound system can be installed in the classroom.

Possible Signs and Symptoms
  • Difficulty hearing in noisy environments
  • Frequently misunderstands oral instructions/questions
  • Says “huh” or “what” frequently
  • Often needs directions or information repeated
  • Difficulty remembering spoken information
  • Difficulty with reading, comprehension, spelling, vocabulary, writing, or learning a foreign language
  • Difficulty with phonics or distinguishing speech sounds
  • Difficulty with organizational skills
  • Difficulty following multi-step directions
  • Difficulty maintaining focus on an activity if other sounds are present or child is easily distracted by other sounds in the environment
  • Difficulty following long conversations
  • Difficulty taking notes
  • Difficulty with verbal (word) math problems
For a detailed list of the five types of major problem areas for kids with Auditory Processing Disorders, please visit the following link: http://kidshealth.org/parent/medical/ears/central_auditory.html

Management Strategies

Parents
  • Reduce background noise at home. Provide your child with a quiet study place (not the kitchen table).
  • Have your child look at you when you speak.
  • Use simple, expressive sentences.
  • Speak at a slightly lower rate with a mildly increased volume.
  • Ask your child to repeat the directions back to you and to keep repeating them aloud (to you or to himself) until the directions are completed.
  • For directions to be completed later, teach your child to write himself notes, wear a watch, and maintain a household routine. General organization and scheduling are also beneficial.
  • Build your child's self esteem.
  • Keep in regular contact with school officials about your child's progress.
Teachers
  • Alter your seating plans to accommodate student(s) with CAPD.
  • Provide visual aids to supplement auditory instruction.
  • Speak clearly and rephrase information.
  • Provide written instructions or a homework list.
  • Provide additional aids for study like a tape recorder, photocopies of another student's notes, or assign the student a “homework buddy.”
  • Consider acoustic modifications to the classroom (For example: carpeting, acoustic ceiling tiles, window treatments, lighting that doesn't “hum”)
Accommodations
  • FM system: Auditory trainers are electronic devices that enhance the teacher's voice and reduce background noise in the classroom. The teacher wears a microphone and the child wears a headset to receive the sound.
  • Language building skills and phonological awareness training.
  • Auditory memory enhancement which reduces detailed information to a more basic representation.

More Information About CAPD


Remember that the symptoms and behaviours exhibited by children with CAP Disorder are NOT within the child's control. CAP Disorder is a real disability. By using the recommended coping strategies and techniques taught to them in speech therapy, these students can be very successful adults.


References


Auditory Processing Disorder. (2007). Retrieved July 22, 2008, from KidsHealth.
Web Site: http://kidshealth.org/parent/medical/ears/central_auditory.html

Auditory Processing Disorder in Children. (2008). Retrieved July 22, 2008, from National Institute on Deafness and Other Communication Disorders.


Web Site: http://www.nidcd.nih.gov/health/voice/auditory.asp


CAPD. (2002). Retrieved July 22, 2008, from Learning Disabilities Resource Community.


Web Site: http://www.ldrc.ca/contents/conditions/capd.php


(Central) Auditory Processing Disorders. (2005). Retrieved July 22, 2008, from BC Children's Hospital and Health Centre.

Web Site: http://www.bcchildrens.ca/Services/ClinicalDiagnosticFamilyServices/Audiology/Forfamilies/ (C)APD.htm


Kelly, Doctor Dorothy A. (1995). Retrieved July 22, 2008, from Central Auditory Processing Disorders: An Overview for Parents, Teachers, and Clinicians.

Web Site:
http://www.masp.mb.ca/SouthEast/auditory.pdf

Schminky, Mignon M. and Jane A. Baran. (1999). Retrieved July 22, 2008, from Central Auditory Processing Disorders: An Overview of Assessment and Management Practices.

Web Site:
http://www.tsbvi.edu/Outreach/seehear/spring00/centralauditory.htm
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