Central Auditory Processing Disorder

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 is a problem 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.

Example: “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 cannot understand why the rest of her classmates are leaving their desks and heading outside.

Is Sam acting 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.

 

How is Central Auditory Processing Disorder treated?  

There are two treatment approaches for Central Auditory Processing Disorder. Both approaches complement each other. A dual approach should be used to better therapy outcomes.

The first treatment option focuses on training specific listening skills. This includes word discrimination (e.g. telling the difference between peas and bees). Elements to this treatment method are:

• 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,
• 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 second approach focuses on changing the environments that the individual is in regularly. Examples include:

• Seating arrangements
  • Sit the individual away from auditory and visual distractions. E.g., in the classroom, choose seats close to the teacher and white/blackboard. Avoid windows/doors.
• Setting
  • Reduce external visual distractions like busy bulletin boards
  • Place some mats on the floor and walls to absorb noise.
  • Earplugs 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 keywords
  • 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.