Central Auditory Processing Disorder – Insights & Resources

Central Auditory Processing Disorder (CAPD) is a complex condition that can be present in children as well as adults. It is a fascinating and somewhat controversial area of study. It wasn’t too long ago that the disorder was not widely accepted to exist. Perhaps this contributes to the mystery surrounding the disorder.

It wasn’t until 2005 that The American Speech and Hearing Association (ASHA) published an official policy stating that “the scientific evidence is sufficient to support the existence of CAPD as a diagnostic entity.” An auditory processing disorder is considered to be the inability to understand speech in the absence of hearing loss.

Jeanane Ferre, PhD, CCC-A, a practicing audiologist in Chicago and leader in the study and treatment of CAPD explains that central auditory processing is “how we use the information that we hear.” For example, she states “Many people have Good Hearing but do not use information efficiently or quickly enough to meet the demands of classroom or everyday listening”. Frank Musiek, PhD, CCC-A, audiologist and researcher describes auditory processing as “How well the ear talks to the brain, and how well the brain understands what the ear tells it.”

The implications of undiagnosed or untreated CAPD are vast. The disorder can affect learning particularly in areas like reading and spelling. For children or adolescents this can put them behind in school and manifest in poor motivation and low self-esteem potentially adversely affecting their future success. CAPD can affect a child or adolescent socially and emotionally. Some CAPD problems result in misunderstanding the emotion or intent of a speaker. This can lead to hurt feelings and or interpersonal relationship difficulties.

Some of the signs or complaints of CAPD as listed by Ferre at www.Dr-Ferre.com may include the following:

  • difficulty hearing in noise or trouble hearing in groups
  • difficulty following directions and or needs frequent repetition seems to hear but does not understand
  • distractible, does not listen, short attention span, poor focus/concentration
  • speech language problem, weak memory skills
  • poor localization skills
  • problems in phonics, reading, spelling, written language

Some risk factors for children and adults may include:

  • history of ear infections or other otologic problems
  • history of learning disability
  • family history of learning problems
  • any disease, disorder or insult to the central nervous system that affects the auditory system, for example, seizure disorders, multiple sclerosis (MS), traumatic brain injury (TBI), space occupying lesions
  • vets exposed to combat-related trauma
  • aging population with presbycusis

Treatment is age specific and deficit specific. Treatment will be comprised of auditory therapy, environmental modifications, and compensatory strategies. Auditory therapy has several components some of which can be found in programs such as Angelsound, Fastforword, Earobics, Brain HQ and LACE. Environmental modifications may include reducing background noise or enhancing the speech signal through hearing aids or assistive listening devices. Compensatory strategies such as encouraging children to ask questions for clarification or using earplugs when studying to limit distracting noises are taught.

It is not recognized how much change can be expected from treatment. Early diagnosis and treatment is most effective. However problems can reoccur in adolescence or in adulthood or result from injury or disease.

If you think you or your child is a poor listener, frequently misunderstands speech and has difficulty following directions, the American Speech and Hearing Association suggests you consult an audiologist or speech language pathologist to determine if you have an auditory processing disorder.

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About the Author: JanaanMoore, Au.D., Doctor of Audiology at Michigan Avenue Hearing Health.

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