What is Central Auditory Processing Disorder?
Central Auditory Processing Disorder (CAPD) (also called "Auditory Processing Disorder” or ‘APD’) is a condition characterized by listening challenges in the presence of normal hearing.
Listening Challenges Associated with CAPD
Hearing well, but struggling to hear and understand in group situations
Increased difficulty hearing in noise
Difficulty when communication is rapid.
Difficulty working with more than one modality at the same time, for example note-taking which requires verbal and listening skills as well as visual and writing skills
Difficulty interpreting the intent of a message, for example identifying a question vs a statement, sarcasm or jokes.
Does Your Child Exhibit the Signs of CAPD?
Frequently says “what?” or “huh?”
Mishears words or messages
Struggles hearing in noisy environments
Has difficulty following directions and frequently requires repetitions
Has a speech, language and/or reading problem
Assessing Central Auditory Processing Disorder
We use best practice recommendations in determining which children may be at risk for a CAPD and would benefit from evaluations. The testing is done only on children over the age of 7 because the tests used were developed only for children over this age (eg they were “normed” on children 7 and older). Younger children will almost always perform poorly on these tests even if they do not have CAPD as their neurological and auditory pathways have not matured sufficiently.
Our process is:
CAPD Consultation Appointment: Parent interview and a review of other multidisciplinary evaluations such as speech and language evaluations, neuropsychological evaluations or psycho-educational assessments. This can be done by phone or video-conference. If your child has not had a recent speech/language evaluation, this is strongly recommended. In a sense, what a child “does” with his or her hearing is dependent upon what they know about language. The audiologist must understand your child’s language competencies, language “age,” vocabulary and articulation scores, and general information about your child’s strengths and weaknesses. For children receiving therapy, we also need to know what the speech therapist is working on in their sessions. This information is important so that the audiologist can collaborate with the speech therapist in terms of intervention.
Comprehensive Audiological Evaluation- This in-person appointment is important to rule out a hearing loss. Intervention for a hearing loss is different than intervention for a CAPD. Testing is approximately one hour long. If results of the hearing testing show hearing to be within normal limits and the audiologist determines further testing is appropriate for your child, CAPD testing is then scheduled.
Comprehensive CAPD Testing Battery- This in-person appointment involves approximately one and a half hours of challenging listening activities, some of which involve speech material and some which involve tones or numbers. For this “behavioral” test battery, your child will listen through headphones and be asked to repeat what they hear. Your child’s performance is compared to that of age-matched peers.
Electrophysiologic Testing- While we use standardized behavioral test materials at CHC, our approach is to look for patterns in performance and substantiate findings with additional tests if deemed appropriate. Electrophysiologic testing, for example, auditory brainstem response testing and/or cortical auditory evoked potential testing may be recommended to further assess the auditory pathways of the brain. For these tests your child does not actively participate, but sits quietly listening to sounds while responses are recorded using surface electrodes (stickers on the scalp). This test is scheduled on a separate day.
Comprehensive Written Report- Parents will receive a comprehensive written report summarizing tests performed, explaining your child’s performance compared to age-matched peers, strengths and weaknesses and individualized recommendations.
CAPD Result Review and Parent Counseling- This virtual appointment is available for parents who wish further explanation of test results and recommendations. This appointment may take place by video call or telephone.
CAPD Intervention and Services for Children
Every child is different. At CHC, instead of a “one-size fits all” approach to intervention for CAPD, recommendations are customized to reflect your child’s specific needs. For example, recommendations for children who have difficulty hearing in noise will be different than those who have trouble interpreting the rhythm and prosody of speech, or those who have an imbalance in processing of auditory information between the right and left sides. The audiologist may recommend environmental modifications, “deficit-specific” auditory practice exercises and/or suggested compensatory strategies. The audiologist will consult with your child’s speech/language therapist to assist in implementing any activities that may supplement the speech therapy session activities upon your request. Children who are diagnosed with CAPD may also benefit from an educational consultation.
CHC’s Education Specialist will provide you with educational recommendations and referrals to meet your child’s needs.
Classroom site visit
CHC’s Educational Specialist can assess your child’s classroom environment and assist in suggesting environmental modifications which may be appropriate for your child. In addition, the Education Specialist can assist your child’s teachers and other school service providers to understand which compensatory strategies are appropriate for your child.
CHC’s Education Specialist can assist parents in opening an Individual Education Plan (IEP) with the Department of Education (DOE). Once the IEP is opened, CHC Education Specialist can help you prepare for the IEP meeting and participate in the meeting to help secure appropriate services for your child.
Hearing Education Service Provision
Individual sessions to address academic weaknesses and to teach self-advocacy skills.