Central Auditory Processing Disorder is an umbrella term for a variety of disorders that effect the way the brains auditory cortex processes auditory information. A child presenting with C.A.P.D usually have peripheral auditory functioning (hearing) intact. That is the outer, middle and inner ear is functioning normally.
These children have difficulties receiving, perceiving, discriminating, processing, storing, remembering and retrieving auditory information (sounds and words).
C.A.P.D is generally developmental rather than acquired. It is a result of impaired neural functioning and is characterised by poor recognition, discrimination, separation, localisation, sequencing and ordering of speech sounds. It should not be confused as having links to deficits in general attention, language or other cognitive processes.
C.A.P.D can be difficult to detect and diagnose.
Characteristically, children that present with C.A.P.D often;
- Have poor listening skills
- Need more time to process information
- Have significant difficulties paying attention to and remembering information presented orally to them
- Experience language difficulties and delay in development. They may confuse syllable sequences that impact on verbal comprehension
- Have low academic performance
- Have behaviour problems
- Have difficulties with reading, comprehension, spelling and vocabulary
- Present with reduced auditory memory for both Digit Span (forwards & backwards), Number of Words List and the Competing Language Processing Task
Functionally, these children have difficulties determining the direction of incoming sounds, difficulties perceiving differences between speech sounds and the sequencing of these sounds into meaningful words. They may confuse similar sounds such as “hat” with “bat” and “there” with “where”, etc. Fewer words may be perceived than were actually said, as there can be problems detecting the gaps between words, creating the sense that someone is speaking unfamiliar or nonsense words. This causes confusion and reduced comprehension of message. The child may then dismiss parts of or the entire message. The children also experience difficulties with auditory figure ground skills. That is the ability to screen out irrelevant background noise such as the sound of a radio, T.V, noisy classroom or other competing voices. All attempts should be made to reduce internal and external noise sources.
Treatment for this disorder can be challenging. Optimising changes to the child`s learning environment is essential. The child should be seated front and centre of the classroom to minimise distraction. They should sit away from distracting children.
The teacher should use as many visual cues to augment auditory information processing.
Auditory verbal information should be presented slowly and in meaningful chunks and in simplified form. Instructions should be repeated and then reinforced in a positive way. If the information is given in sequential form, as stories usually are, ask for it back cueing the correct sequence. With older children, you can at times have them repeat back to you what you have said to them. In this way you can monitor and judge where the message may have broken down and then repeat the parts the child has missed. Do not ask “Did you hear me”? Instead ask specific questions about the instructions.
Efforts should always be rewarded.
Clinically, auditory training may assist in improving performance on auditory processing and phonic awareness measures.
If you are concerned about your child’s language development or their auditory processing ability, please contact an experienced Speech Pathologist for assistance.
Mr Craig Gorman
Speech Pathologist.