Central Auditory Processing Disorder or CAPD is a neurological disorder that affects the ear brain connection. 7% of school aged children are affected by it. Children with CAPD may have normal hearing but they have an impaired understanding of what they hear. Something within the brain is affecting the processing and interpretation of information so they have a hard time making sense of what they hear. There may be no indications of CAPD until the child start begins the formal education process. The first sign of the disorder manifest as behavioural problems like inattentiveness and hyperactivity which is commonly misdiagnosed as ADHD or other learning disorder.
Do you suspect your child might have CAPD? The most common characteristics of this disorder will help you decide whether your child needs to be tested. Below is a list of the most common characteristics noted in children with CAPD however these characteristics are also exhibited by children with other types of disorders such as ADHD, hearing loss, dyslexia and other learning disability. If any or combination of these characteristics are noted, the child can be considered at risk for CAPD and need to be referred to professionals for appropriate testing.
Characteristics of children with CAPD
• Difficulty listening when there is a background noise
• Speaks in monotone or shrill voice
• Easily distracted by sounds
• Have poor listening skill
• Says “huh” or “what” often
• Difficulty following oral instructions
• Have poor musical skill
• Poor organizational skill
• Have difficulty carrying on long conversation
• Have difficulty with reading, spelling and vocabulary
Speech and language skills are developed through auditory sensory mode; it is common to observe speech, language and academic problems in children with CAPD. The difficulty in recognizing the sound system of language can lead to comprehension problems and poor academic performance.
Different types of Auditory Processing Disorder
CAPD is not a specific problem but a set of problems that exist in different kinds of listening tasks. It will not show the same way in every child and usually occur as a blend of difficulties. The main types of CAPD identified in children are:
Auditory decoding deficit – this is the most common problem in children with CAPD. Children have problems recognising sounds and decoding words or messages. Words are commonly confused or misheard (“free” or “three”. These children are often described as having hearing deficiency. Many children with this form of CAPD have poor reading and spelling skills.
Auditory hypersensitivity – Children with auditory hypersensitivity have poor tolerance with background noise. They cannot hear well in a noisy environment. They are also unable to discriminate the sources of sound. This is especially problematic in school situation. They commonly misunderstood the teacher as she gives multiple instructions within one sentence. This is diagnosed through dichotic listening test by an audiologist.
Associative deficit – children with this type of CAPD have difficulty associating sounds with written language. They may have good sound discrimination but they have a poor ability to recognise whole words. They may be able to repeat instruction word for word but they do not understand the message. They also have difficulty understanding complex sentences.
Auditory integration deficit – children with this deficit have difficulty combining auditory cues with other sensory cues to understand a message. They can read written words but they do not know what it sound like when spoken. It is hard for these children to combine written and verbal information. They tend to wait for others to complete their task so they can do it themselves.
Organisational deficit – auditory signals are successfully received by children with this deficit but they are not organised in a meaningful way to elicit an appropriate response. They have difficulty with sequence information like step-by-step directions. They have trouble expressing themselves and task that requires planning are particularly difficult.
Prosodic deficit – children with this deficit speak in monotone, they will not modulate their voices to reflect tone, rhythm or stress. They are also unable to recognize rhythm, intonation or subtleties in other people’s voices. This fundamental skill for good communication is lost upon them. Children with this CAPD deficit commonly have social problems. Children with this problem also have little understanding or skill in music.
CAPD can be very confusing for parents, teachers and other people working with these children. Definitive diagnosis cannot be made until specialized auditory testing is completed and other causes have been ruled out. A combined effort of a multidisciplinary team of professionals is needed to diagnose the disorder. A paediatric doctor will assess the medical problems with the child’s hearing. An audiologist will conduct a battery of test to assess the child’s hearing. A speech-language pathologist will examine the child’s linguistic aspect. A child psychologist will test the child’s cognitive and behavioral information. A teacher will evaluate the child’s academic difficulties.
It is important for a child to be evaluated by qualified professionals. CAPD cannot be properly diagnosed before 7 years old. Children below seven are not candidates for diagnostic testing. If your child exhibits many of the behavioral characteristics of CAPD bring him for testing.Trained professionals like Tomatis Consultants can assess the possibility of CAPD through a Tomatis Listening Test and the child’s history and observation.
Central auditory processing disorder can be treated from childhood through teen years, the earlier the diagnosis and treatment the better. A combination of professional and home therapies is most effective. Treatment includes a wide variety of exercises that target the different auditory deficits. Therapy can range from one-on-one training from therapist to computer assisted programs. The different approaches target to overcome sound discrimination problem, sharpen auditory memory and manage language-processing problems.
Research in neuroplasticity indicates that brain function can be improved by the appropriate stimulation. The best way to improve the sensory function is through direct stimulation by listening to sounds or music. Considerable research has been conducted to learn the kind of sound that best stimulate the auditory system. Auditory Integration Listening training is the integration of the most recent research, theory and technology to deliver developmental training program. The most important work in this area was carried by Dr. Alfred Tomatis who developed the Tomatis Listening Program.
The Tomatis method of auditory stimulation is an intensive therapeutic intervention to help all types of auditory processing deficit in children.
The Tomatis Listening Program uses high frequency sounds to stimulate the brain’s ability to receive and process sound. An electronic device used strengthens the middle ear, the inner ear and the auditory system through sound processing. This non-invasive therapeutic intervention has been widely used in Europe and Canada since 1940’s. The Tomatis method has been effective in reducing symptoms of CAPD. This therapy is harmless and does not require an evaluation so it can be used for children three years and older.