Central Auditory Processing Disorder
Auditory processing is what happens when your brain recognizes and interprets the sounds around you.
Humans hear when energy that we recognize as sound travels through the ear and is changed into electrical information that can be interpreted by the brain.
The "disorder" part of auditory processing disorder means that something is affecting the processing or interpretation of the information at the nervous system and brain processing level.
Central Auditory Processing Disorder affects up to 5% of people. They cannot process the information that they take in at the brain level, and are usually labelled as "poor listeners".
When tested for hearing issues, they will usually have normal hearing ability, and they are often even told that they have perfect hearing-Leaving a parent or the CAPD person themselves frustrated and unsure of what to do next, because they know there is something wrong.
Rest assured, you are not making it up, and it is not in your mind. It is real, and CAPD is a genuine “hearing” disability and should be treated as such. It is just at the brain level, not the ear level. Be aware that typical hearing tests only test the mechanics of the ear parts from the outer ear TO the cochlea, so it is not seen in a typical hearing test.
CAPD hearing issues happen past the cochlea of the ear. The processing of the sounds as electrical feedback to the brain is scrambled somewhere past the cochlea to the brain. A person with CAPD has issue with how the brain interprets the sounds it is fed from the cochlea.
For example, someone may say to a person with CAPD "would you like the couch or the chair?”, and the CAPD person might hear “would you bike the cow of the hair?”
You can see how anyone with CAPD, but especially a child just learning language and communication with CAPD may have a confused look on their face when you speak to them!
People with CAPD have a hard time processing audio in environmental settings where there is a lot of background noise. Like a classroom, a store with loud carts banging into the corral, or overhead system announcements,anywhere where there is running water, outside in the wind, and in a moving car, etc.
These struggles can cause speech, language, and learning problems, especially in spelling, reading, writing, and speaking skills.
CAPD often is found comorbid with other neurological based disabilities such as language disorders or delays, learning disabilities, dyslexia, autism or ASD, ADHD.
What Does CAPD “look” Like?
There are many indicators that a child may have CAPD. a parent or caregiver would be the first people to notice them, as they spend the most time with the child.
Many of these behaviours are also indications of other issues mentioned above. Sometimes CAPD can be missed and diagnosed as ADHD, especially in school by a teacher, because CAPD can look a lot like ADHD from the outside in behaviour.
But, also know that CAPD and ADHD can come together as a package deal. When this is the case, it can cause a child even further struggles and frustrations with school and social interactions with family, friends and peers.
A diagnosis of CAPD can be made 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, so they usually will wait until a child is at least 7 before they do these tests. Children can be lightly sedated for the CAPD test that reads how the brain receives sounds through monitors of brain waves and may require a day clinic in patient stay to be performed, so often parents will be put off to wait by a doctor saying that they do not want to cause anxiety in the child to perform the test, and suggest a wait and see approach.
Many parents rightly so worry and feel that by 7 their child has missed a lot of learning time with undiagnosed CAPD and will be far behind their classmates. If you are being told to wait, you can seek a second opinion. In the meantime, the best thing to do is learn as much about CAPD as you can yourself through books and websites and online support groups, and find out how you can guide your child through the early years with CAPD until they can be assessed.
Treating a child as if they have CAPD because they have all the signs of it, will not hurt them. Since they are all environmental surrounding changes and learning and teaching your child coping skills and how to advocate for themselves, they will benefit them over all.
Once diagnosed, CAPD kids often work with a speech therapist to improve their processing abilities and instill coping mechanics. If you have already taught them good habits to compensate for their CAPD, you will be way ahead of the game and they can begin going farther to get progress faster.
CAPD is a recognized learning disability and should therefore be recognized and qualify a student to apply for and get help though IEPs and special education programs. It differs from school board to school board, and an official diagnosis is needed to apply. So, once you have an official diagnosis you can begin that process.
The following are all daily signs and symptoms of a person with CAPD
- Difficulty hearing in noisy environments,and may shy away from loud places, complain that movie theaters are hurting their ears ( wax ear plugs help CAPD children a lot)
- Frequently misunderstands oral instructions/questions
- Says “huh?”, “ waa?” or “what” a lot, leaving you frustrated.
- Often needs directions or information repeated over and over…and over.
- Difficulty remembering spoken information in class, chores given out verbally at home.
- Difficulty with reading, comprehension, spelling, vocabulary, writing, or understanding accents in people’s speech ( use closed captioning on tv shows and movies at home, ear phones on the computer)
- Difficulty with phonics or distinguishing speech sounds
- Difficulty with organizational skills
- Difficulty following multi-step directions verbally. They will hear “Go to the kitchen”, but not know you said “ ...and get me a spoon” because the brain only heard the first part.
- Difficulty maintaining focus on an activity if other sounds are present or is easily distracted by other sounds in the environment because the brain can’t prioritize the sound as unimportant to what they are doing. ( noise cancelling headphones with instrumental music can help them concentrate to read or do homework and even chores)
- Difficulty following long conversations and will appear to be daydreaming or staring off into space or confused or disinterested.
- Can’t understand LOUD TALKERS, or fast talkers. Will look scared or confused when spoken to too loud or to fast. have meltdowns and cry because they can’t express that they don’t understand, or are afraid to admit you sound like Charlie Brown’s teacher.
- Complain of noise hurting their ears. Often say they SEE noise, or noise has color or even tastes.
- They may lack “Volume Control” in their talking and seem like they are yelling in situations where it is not needed.They can’t tell they are doing it.
- Loud sudden noises startle them easily, they jump out of their skin,may complain about an upset stomach from the adrenalin rush from the startle. They hate fireworks, and race tracks, or public swimming pools that echo loud noises from other.
- Young children may cry hard when you “startle” them with something as little as “boo”, they may seem like they are overreacting to the situation.
- Difficulty taking notes from verbal lessons in class
- Difficulty with verbal (word) math problems
How Can I Help my Child?
- Reduce background noise at home. Provide your child with a quiet study place or take an auditory input break after school and noisy social situations. It tires them out. They may need quiet time after school to rest their brains from all the input all day.
- Have your child look at you when you speak. Get face to face with them, down on your knees. Touch their shoulder before you start speaking,to have them look at you first, then talk. Lip reading helps CAPD people compensate a lot for what their brain misses.
- Use simple, expressive sentences. The longer you speak the less they hear.
- Speak at a slightly lower rate of speed with intention and emphasis. “go upstairs, get me all your laundry” not “I want you to go to your room and gather me all your laundry and bring it down to the laundry room so I can wash it” Teach them what “all your laundry” means before, so they know.
- Use routine checklists on bedroom walls and bathroom walls. Visual cues help A LOT
- Don’t yell directions when you are frustrated. Take a break,breathe, tell them over again, clearly in a normal pitch voice.
- Ask your child to repeat back to you what you said or asked them, to make sure they got it. Tell them again. Write directions on notes. Use Checklists.
- Teach your child to write notes of directions given to them by teachers and by you.
For older kids, text message them their chores list, or directions. Example. “after school, straight home, eat, then be ready for soccer for 4pm, confirm you got this-Mom ”
- Keep in regular contact with school officials about your child's progress.
- Ask the teacher to alter seating plans to accommodate their CAPD. Closer seats to the front of the class helps, do it discreetly to avoid peer teasing.
- Ask the teacher to provide visual aids to supplement auditory instructions when possible. If a teacher gives a verbal lesson in class, ask for the corresponding written material in text books so they can go over it again.
- Ask the teacher to provide written instructions or a homework list.Not just verbal “read pages 2 through 40 tonight!” as the students are leaving the class.
- Ask the teacher to be available for 5 minutes after class, and teach your child to see the teacher and confirm homework and projects in writing.
- Ask the teacher to email you important dates like tests and projects due.
- Ask if there is a student to partner with your CAPD child. Organized booksmart neurotypical kids often are happy to help a student if the teachers asks them and gets permission from their parents. Often photocopies of another student's notes from a verbal lesson in class can help a lot. Let the student text the CAPD student the homework assignment so they have it in writing.
- Hire a tutor to help them learn to organize projects and go over homework with them. College students love tutor jobs to make money. It saves you the frustration and tears too, often kids will work better with a tutor than a parent.
- For younger CAPD kids still learning to read and write, research audiologist and speech therapist recommendations online for language building skills and phonological awareness training at home to help speech and reading skills.
- Kids with CAPD can learn easier if you put lessons in a rhythmic musical flow. Sing the history chapter they need to read.
- Watching shows like The Electric Company that show the mouth on the screen as they say a sound will help a lot
Remember that the symptoms and behaviours by a child with CAPD are NOT within the child's control. It is not bad behaviour, or attention seeking or laziness or defiance.
Educate the friends and family closest to a person with CAPD so they feel supported and not bad or broken as they learn to develop new coping skills.
Teach self advocacy to your CAPD child. “I’m sorry, I have a bad ear, can you face me, I need to read your lips before you repeat that” often is enough to allow them to get the information again in a way that is not embarrassing and gives the other person the extra patience and compassion needed when communicating with a person with CAPD. It may be a technical lie, but since everyone understands that hearing and ears go together, this little white lie is easier than going into explaining “ it’s a brain thing called CAPD”.
If a child has CAPD there may be other nervous system processing issues going on as well. Educate yourself about Sensory Processing Disorder as well and work to develop coping skills and create “sensory diets” to help your child feel better over all. Scratchy tags will distract them if they have SPD too, and will make them paying attention harder, and they already have CAPD working against them.
Self esteem issues with CAPD and SPD are common when a child can easily see they are not like their siblings, friends or school peers. So hugs and positive feedback go a LONG way in helping your child with CAPD ( and just childhood in general)
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This information on CAPD was written by SuperADDmom and provided for informational purposes as a resource for www.superaddmom.com and not as a diagnostic tool-Copyright 2015.