Central Auditory Processing Disorder
Children with CAPD hear sounds typically but have difficulty processing and interpreting what they hear. In other words, this isn’t a disorder of the auditory organs within the ear, but rather a brain disorder. Often, when parents observe auditory problems in their children, they take them for a hearing test, and the child passes with flying colors. In the absence of knowledge of CAPD, parents are left to categorize the child’s difficulty as behavioral. However, the ability to detect sounds is only one part of the processing that occurs in the auditory system. “Auditory processing is a term used to describe 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 transformed into electrical information that can be interpreted by the brain. The “disorder” part of auditory processing disorder means that something is adversely affecting the processing or interpretation of the information.”1
The cause of APD is unknown but it is known to frequently co-exist with sensory processing disorder, autism, Asperger’s syndrome, auditory or visual dyslexia, ADHD, hyperacusis, and tinnitus. CAPD has been linked to heredity and chronic ear infections.2 The symptoms of CAPD can look similar to other conditions, like learning disabilities or attention deficit hyperactivity disorder (ADHD).3 It’s important that children with CAPD are accurately diagnosed so they can receive the therapy that best meets their needs.
Below is a general checklist of APD symptoms. If your child exhibits any or several of the symptoms below then they are considered at risk and candidates for testing. In addition, children who show poor auditory performance on questionnaires like the CHAPPS are possible candidates for auditory processing screening. If the auditory deficits aren’t identified and managed early, the child may have speech and language delays and academic problems.
Is your child easily distracted or unusually bothered by loud or sudden noises or by noises that don’t bother other people (like a toilet flushing)?
Are noisy environments upsetting to your child?
Does your child’s behavior and performance improve in quieter settings?
Does your child have language difficulty (e.g., they confuse syllable sequences and have problems developing vocabulary and understanding language)?
Does your child have difficulty following directions whether single or multi-step?
Does your child have poor listening skills and conversations are hard for your child to understand?
Have trouble paying attention to and remembering information presented orally?
When you ask your child a question, does the child often say what or ask you to repeat what you said? This indicates they need more time to process information.
Does your child have reading, spelling, comprehension, vocabulary, writing, or any other speech-language difficulties?
Are verbal (word) math problems difficult for your child?
Does your child have low academic performance?
Does your child have behavior problems?
Is your child disorganized or forgetful?
Does your child appear not to hear you or ignore you?
Have difficulty recognizing rhymes?
Have trouble recognizing the difference between sounds, such as near or far, angry or pleasant, high or low voices?
Seem unaware of the source of sounds?
Be unable to speak clearly enough to be understood?
Auditory Processing Disorder will not present the same way in every child, though it is rare to find a child who only suffers in one of the listed areas. Auditory Processing Disorder usually exists as a blend of difficulties – however, one issue may be more dominant than the others. There are different subtypes of CAPD. However, audiologists are not all in agreement on one model. To read more about the different models, consult The Sensory Processing Anthology.
1. The National Institute on Deafness and Other Communication Disorders (www.nidcd.nih.gov/health/voice/auditory.asp),