Central Auditory Processing Disorder

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Written by Therapy Focus Speech Pathologist Ruyi Tong.

What is Central Auditory Processing Disorder?

Central Auditory Processing Disorder (CAPD) is the inability to understand verbal language in a meaningful way, in the absence of a hearing loss. In other words, there are issues with the way the ear talks to the brain, and the brain has trouble interpreting what the ear is trying to tell it.  The disorder may also be referred to as auditory comprehension deficit, word deafness and auditory perceptual processing dysfunction. This problem is commonly experienced when complex language is used, long instructions are given, speech is too rapid, and when there is a lot of noise.

“Everyone, please get your homework from your bags outside, put it on my desk, then come to the front with your blue maths book. Today we will talk about fractions, which are on page 5 of your book.”

Sam takes out her maths book and looks around, confused. She can’t understand why the rest of her classmates are leaving their desks and heading outside.

Is Sam being defiant? Why isn’t she following instructions? Her hearing has been tested and there is nothing wrong with it. Perhaps Sam has heard her teacher, but finds it difficult to process or understand what was said?

As a therapist, situations such as this set off alarm bells that signal there may be central auditory processing issues.

therapist and child playing a game outside

How is Central Auditory Processing Disorder treated?  

There are two treatment approaches for Central Auditory Processing Disorder.

The first focuses on training certain listening skills such as word discrimination (e.g. telling the difference between peas and bees), identifying where sounds are coming from (e.g. is it from the left or right side of your body), putting different letter sounds together to form words, or identifying a sound in the presence of noise (e.g. being able to focus on the ticking of a clock in a noisy room).

The downside of this approach is that some individuals may not be able to use these skills in everyday environments.

With this in mind, the second approach focuses on modifying the environments that the individual is regularly in. Examples include:

Seating arrangements

  • Sit the individual away from auditory and visual distractions. In the classroom, for example, choose a seat close to the teacher and white/blackboard and away from any windows and doors.

Setting

  • Reduce external visual distractions like busy bulletin boards
  • Place mats on the floor and walls to absorb noise
  • Ear plugs may be useful to distract from ambient noise such as the air-conditioner or a pencil sharpener
  • See an audiologist to discuss the use of an FM system. These systems work by transmitting the teacher’s voice directly to the individual’s ear, minus any background noise.

Speaking 

  • Gain the individual’s attention before speaking
  • Speak slowly and clearly
  • Break lengthy instructions into a few shorter instructions that follow a logical order
  • Emphasise key words
  • Use gestures
  • Use visual aids such as written instructions (depending on the individual’s literacy level)

Central Auditory Processing Disorder can affect reading and spelling, therefore early identification, typically by a speech pathologist or audiologist, is beneficial.

two therapists reading books with children
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