Central Auditory Processing Disorder

CENTRAL AUDITORY PROCESSING DISORDER

Written by Allison Evans, 4th Year Audiology Fellow

Central Auditory Processing Disorder (CAPD) is a hearing disorder that impacts the brain’s ability to process sounds (Chermak, 2013). CAPD manifests itself in different ways that may be similar to other conditions such as language impairment, attention deficit disorders, or hearing loss. Therefore, comprehensive assessment for CAPD is most beneficial and accurate when analyzed in combination with patient and family report, observation, and diagnostic assessment (Bellis, 2004).

Symptoms of CAPD

Individuals with CAPD may experience on or more of the following symptoms:

• Problems discriminating words especially in a noisy environment
• Difficulties following directions
• Issues differentiating between speech and other sounds
• Problems spelling or reading
• Difficulty understanding information in the classroom

It is important to note that individuals who experience these symptoms do not always have CAPD, which is why diagnosing CAPD is most accurate with a multidisciplinary team approach (Bellis, 2004).

Diagnosing CAPD

The diagnostic multidisciplinary team for CAPD includes the following: Audiologist, speech-language pathologist, educator, psychologist, physician, and parents. An audiologist is responsible for performing a standard hearing test to rule out peripheral hearing loss and administering an evaluation that screens for CAPD. The speech language pathologist analyzes the child’s receptive and expressive language skills. The psychologist determines the individual’s cognitive skills. An educator provides information regarding the child’s academic abilities and ability to listen in the classroom. The physician is responsible for ruling out other pathologies that may impact the individual’s listening or learning abilities, and parents are able to provide information regarding the child’s ability to listen at home, additional concerns regarding the child’s ability to process sounds, and relevant medical history (Chermak, 2013).

Treatment/ Management

Currently, there is no cure for CAPD and more research is needed with regard to CAPD treatment efficacy. However, research has shown that auditory stimulation is beneficial to the brain’s ability to adapt and process sounds. Once CAPD has been diagnosed, it is important to take into consideration the reported difficulties of the individual so that treatment can be as deficit-specific as possible. Management of CAPD, much like assessment of CAPD, should involve a multidisciplinary team. Generally, management of CAPD includes the following (Chermak, 2013):

• Environmental modifications: There are various techniques that can be used to optimize the listening environment, particularly in the classroom. Signal to noise ratio (SNR) is a term used to describe the relationship between the speaker (i.e. the teacher) and unwanted background noise. In order to provide an optimal listening environment, it is critical to minimize the signal to noise ratio by increasing the level of the speaker while decreasing the level of competing noise. First and foremost, preferential seating in the classroom should be utilized to minimize SNR and provide visual cues for the listener. Assistive listening devices (ALDs) may also be used in the classroom. ALDs involve a microphone that is worn by the teacher and a receiver that is worn by the child to enhance the signal of the speaker. These devices are available at SENT Hearing Aid Center.

• Remediation Activities: Unlike environment modifications, remediation techniques for CAPD involve a challenging listening environment and focuses on specific deficit areas. Remediation activities are used to maximize the brain’s ability to process sounds through auditory training exercises. This is the most individualized management of the three treatment options because the direct therapy is specific to the listener.

• Compensatory strategies: Active listening techniques can be used to better enhance the listener’s ability to focus on the speaker. Problem solving techniques can also be used to better the child’s ability to listen when in a difficult listening or learning situation (i.e. advocating for oneself by asking for repetition).

Conclusion

Behaviors and symptoms of CAPD are similar to other disorders, which is why a multidisciplinary approach is critical to fully assess those who exhibit signs of CAPD. Effective treatment for CAPD does is not always clear and should be focused on the individual’s listening deficits. More research is needed regarding the assessment and treatment to better the outcomes for individuals diagnosed with CAPD.

If you think your child struggles with CAPD, contact our office to discuss the use of a device that consists of a teacher-worn microphone (transmitter) and child- worn, cosmetically appealing, open-fit hearing device (receiver).

References

Bellis, T. J. (2004). Understanding auditory processing disorders in children. ASHA-American Speech-Language-Hearing Association [artigo online]. Disponível em: http//www. asha. org/public/hearing/disorders/understand-apd-hild. htm (25 Abr 2006).[Links]

Chermak, G. D., & Musiek, F. E. (Eds.). (2013). Handbook of central auditory processing disorder. Retrieved from https://ebookcentral.proquest.com/lib/iub-ebooks/detail.action?docID=1887363