All About Central Auditory Processing Disorder
Have you ever noticed having to repeat instructions to your child? You’ve had his hearing checked, and everything came out “normal”, so… why is my child not registering verbal information? You also notice that he is having difficulties processing sounds in words, as he is having trouble reading and expressing himself clearly. If this is the case, your child may have Central Auditory Processing Disorder (CAPD) (*Disclaimer: always receive a professional evaluation by a speech-language pathologist, if there are concerns).
What is CAPD?
Children with CAPD have normal hearing; however, they do not decode language in the same way that most children do. Oftentimes, you’ll see these children have difficulties following directions, requiring frequent repetition. Children with CAPD may be weak in one or more of the four basic skills involved in auditory processing:
- Auditory Discrimination
- Auditory discrimination is the ability to notice and discriminate between a variety of distinct sounds. Children with CAPD may display difficulties with auditory discrimination, as they are not noticing the subtle difference between words. For example a child with CAPD may hear “bug” and “rug” at the same word, resulting in misinterpretation of information. Due to this, difficulties with reading and expressing one’s self appropriately is common, as they mix up similar sounds. Syllable attenuation is also common, which is when syllables of words are dropped, because the brain is only tuning into some of the structure of the word, but not the whole word.
- Figure-to-Ground Discrimination
- Figure-to-Ground discrimnation is the ability to filter out important sounds from background noise or adequately listen to one voice in a noisy atmosphere. There are various sounds in one environment; for example, imagine a classroom: there’s a teacher speaking, the air conditioner blowing, chairs moving on the floor, books closing, children chattering… For most children, they can tune into the teacher speaking and filter out the background noise. For children with CAPD, however, they might not be able to tune into the teacher because of all the competing noises. They have more difficulties realizing what noise to attend to.
- Auditory Memory
- Auditory memory includes the ability to remember things we hear, both short-term and long-term. Children with CAPD have difficulties remembering verbal information, often needing to write information down or utilize visual cues.
- Auditory Sequencing
- Auditory sequencing is the ability to understand and recall the order of sounds. He/she may mix up the order of numbers (e.g., remember “21” and “12), order of sounds (e.g., “toab” instead of “boat”), and follow directions out of order.
Signs & Symptoms of CAPD
So what are the signs and symptoms you should look out for? Below are some frequent signs and symptoms noted in children with CAPD.
- Difficulties following directions
- Frequently asks for repetition
- Does not pick up nursery rhymes or song lyrics
- Does not remember details
- Frequently mistakes two similar sounding words
- Difficulties understanding speech in noisy environments
- Difficulties learning to read and spell
- Difficulties expressing thoughts and feelings clearly
- Difficulties following along to conversation
It is important to note that these signs and symptoms often overlap with other diagnoses, such as Attention Deficit Hyperactive Disorder (ADHD). Thus, it is important to determine the true cause, so that each child can receive the appropriate treatment. Bringing your child in for a speech-language evaluation will help bring answers to light.
How to Help CAPD
Speech-language therapy will train children to improve their skills in distinguishing, remembering, and sequencing sounds. Speech therapy will not only help children improve these skills, but it will also increase their self-esteem. Children will learn how to compensate for the deficits, and build on their strengths. Below are also some useful strategies to utilize in the therapy room, in the classroom, and in the home setting:
- Use Visuals
- As children with CAPD have difficulties processing verbal information, incorporating visual information and cueing child to look at you while talking, can help tremendously
- Emphasize Key Words
- Using slower speech, increased vocal volume, and exaggeration on key words can help children with CAPD process information in an easier manner.
- Preferred Seating
- When possible, have the child sit in a quieter area and closer to the speaker (e.g., in a classroom, have child positioned in the front of the classroom to help tune into the teacher)
- Assistive Technology
- Luckily, there is also technology that can help children with CAPD. For example, children might use headphones to reduce background noise, and a teacher might wear a microphone that is wirelessly connected to the headphones.
If you live in Florida, we encourage you to call Exceptional Speech Therapy, as our skilled speech-language pathologists and their team can identify your child’s specific needs. Our approach always centers on not only improving skills, but also improving socioemotional wellbeing. We are here for you!
Andrea Scola, M.S., CF-SLP
Exceptional Speech Therapy Blog Writer