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Central Auditory Processing Disorder (CAPD): Living and Working with
CAPD
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The easiest, quickest way
to communicate is simply to say something and then deal with the other
person's reply, right? Right, unless your listener has a CAPD
(Central Auditory Processing Disorder), then your remark might come through
with certain words drowned out by other noises, or with some words sounding
like different words or as meaningless strings of verbiage. You
might begin to suspect this when the other person's expression doesn't
register understanding, or if he, "answers the wrong question,"
or he asks you for additional information which most people would have
been able to infer from what you just said.
Most of us aren't that sophisticated
about CAPD's, however, and are much more likely to wonder
if the listener is just not very intelligent or doesn't really care about
us and what we are saying. People with Central Auditory Processing
Disorder (which are usually part of a learning disability) have
been embarrassed by situations and reactions like these all their lives.
A
Central Auditory Processing Disorder is a physical hearing impairment,
but one which does not show up as a hearing loss on routine screenings
of an
Audiogram or
Listening Test. Instead,
it affects the hearing system beyond the ear, whose job it is to separate
a meaningful message from non-essential background sound and deliver that
information with good clarity to the intellectual centers of the brain
(the central nervous system). When we receive distorted or incomplete
auditory messages we lose one of our most vital links with the world and
other people.
These "short circuits
in the wiring" sometimes run in families or result from a difficult
birth, just like any Learning Disability (LD). In some
cases the disorder is acquired from a head injury or severe illness. Often
the exact cause is not known.
Children and adults whose
auditory problems have not been recognized and dealt
with are forced to invent their own solutions. The resulting behaviors
can mask the real problem and complicate not only school and work, but
even close relationships, where communication is so important. Advice
like "Pay attention," "Listen," or "Don't forget
--," hasn't helped either.
It takes specialized testing
to identify a Central Auditory Processing Disorder. Some
of the tests used by educational therapists, neuro-psychologists, and
educational psychologists give at least an indication that a Central
Auditory Processing Disorder might be present. These include
tests of auditory memory (for sentences, nonsense syllables,
or numbers backward), sequencing, tonal pattern recognition or sound blending,
and store of general information (which is most often acquired through
listening). The most accurate way to sort out CAPD's
from other problems that mimic them, however, is through clinical audiologic
tests of central nervous system function. These are better at locating
the site of the problem and reducing the effects of language sophistication
on the test results.
Do your best to choose a
professional who is familiar with CAPD's, is comfortable
working with adults, and who can write a useful and understandable report.
You might ask: "How many adults with auditory processing
disorders do you work with in a year?" or, "What kind
of a report would you write to help me or my employer understand my problem?"
Nowadays there are many ways professionals will help you streamline your
coping abilities. Also, there may be conditions
accompanying the Central Auditory Processing Disorder which are medically
treatable like allergies, Attention Deficit Disorder, Tourette syndrome,
or nutritional deficiencies.
This checklist
of common features of Central Auditory Processing Disorder might lead
you to consider such a possibility for yourself, a co-worker, or a friend
or relative, if several items apply:
- _____ Talks or likes T.
V. louder than normal.
- _____ Interprets words
too literally.
- _____ Often needs remarks
repeated.
- _____ Difficulty sounding
out words.
- _____ "Ignores"
people, especially if engrossed.
- _____ Unusually sensitive
to sounds.
- _____ Asks many extra
informational questions.
- _____ Confuses similar-sounding
words.
- _____ Difficulty following
directions in a series.
- _____ Speech developed
late or unclearly.
- _____ Poor "communicator"
(terse, telegraphic).
- _____ Memorizes poorly.
- _____ Hears better when
watching the speaker.
- _____ Problems
with rapid speech.
CAPD is a Physical Disorder
Under the Protection of the ADA (Americans with Disabilities Act).
But put yourself in the other
person's place: how can your supervisor or co-worker possibly know whether
you made a mistake because of impaired hearing, lack of interest, or stupidity?
You need to know how to identify the problem so that you can explain it
to others and ask for what you need. If you grew up at a time or place
where your Central Auditory Processing Disorder wasn't
recognized you might need a knowledgeable professional to give you some
insight into this. But if you listen to your feelings rather than trying
to talk yourself out of them, you can generally get a good sense of the
help you would like. Thus, if noisy people and places "bug"
you, or if your most satisfying school memories were of projects you built
or field trips you went on, you don't need anyone to tell you you'd work
best in a quiet place, or that you're a hands-on or experiential learner.
So
what do you tell them at work to keep this from becoming another one of
those jobs where you quit before they can fire you? Here are some ideas.
Do you:
-
Have
trouble hearing clearly when it's noisy?
This can be a failure of one or more of the automatic noise-suppression
systems of the brain. It is reasonable to ask for a desk away from
the computers or for a sound-absorbent partition. It is both polite
and efficient to say, "I'm interested in what you're saying.
Let's move away from this noise." A mild-gain amplifier can help
you hear accurately on the phone over the noise of a busy office.
- Sometimes make
"silly" mistakes or "careless" errors?
Intrusions of random sounds which normal-hearing people can ignore may
break your concentration so that you lose your place and skip a task
(like carrying a number or writing a small word in the sentence). Take
the work to a quieter place if necessary. Earplugs (sometimes in only
one ear which suppresses noise less well) are a possible emergency solution.
Make a deal with someone else to proofread your work.
-
Miss
important sounds or signals that others hear easily?
Poor noise suppression and sound localization skills can cause important
voices or signals to "disappear" in the general background.
It will save others time if they know to tap you on the shoulder before
they launch into their conversation. Telephone bells and alarms can
be adjusted for volume or pitch, or a visual or tactile signal can
be added.
-
Get
important messages wrong?
Sound distortion, sequencing, auditory-visual transfer, and/or short
term memory problems may be contributors. You can ask for the information
in writing, double-check later with someone else who was present,
or let the speaker know that she's going too fast. Even normal listeners
often say, "Let me read that back -- ," or "That's
'3489'?"
-
Forget
instructions?
Inefficient short term auditory and rote memory (or
habituation) may figure in this. Get in the habit of taking notes;
set up a logbook for longer-term assignments; ask that the information
be put in a memo. You might even carry a small tape recorder or dictaphone
in some situations. If you often forget to go back to it later, put
the memo or recorder where you must see it, as by your purse or underneath
something you use every day.
-
Only
get parts of more complex directions or lengthy explanations?
Here you may begin to suspect a problem with the subtleties of language
- difficulty forming rapid "word pictures" to help with
concept formation and memory, or failure to consider alternative word
definitions so that meaning is misperceived. You can "freeze"
it for later analysis by writing or taping. You can say "I learn
better if I do it myself while you watch." Have someone else
help you fill in details later.
- Have difficulty
knowing "what to say when" and are puzzled by others' reactions
to you?
One possibility is an inefficiency in the part of the brain which registers
tonality (expression in the voice) and gives us "quick fix"
on the situation (sometimes referred to with rough accuracy as a "right
hemisphere disorder"). A professional can help you learn other
cues by which to "read" how people are feeling about what
you said and how to change what you say accordingly, much as anyone
would have to learn about a foreign culture. In the meantime you might
explain the problem to people you trust so their feelings aren't hurt.
If you inherited parts of
your Central Auditory Processing Disorder or Learning Disability
from your parents, as is often the case, you need to remember
that they grew up when far less was known about these conditions than
the little which may have been know when you were young. They may have
raised you with some of the harmful "scripts" that were part
of the parenting they received in a generation where professionals and
parents knew nothing about CAPD's. Chances are your teachers
or other professionals you grew up with were not well-informed, either.
Thus you might have been told "You'd do fine if you just tried,"
or "You'll never amount to anything," or worse. If so, try to
remember that those things were not true or helpful, but just what comes
of lack of good information. Work to rid yourself of those inaccurate
parts of your self-image, and to forgive your parents and others for their
lack of knowledge. Above all, resolve not to pass on their "bad advice"
to your own children or to let it spoil relationships with other people
you care about.
Remember that for you to
have arrived at the point where you are educated and employable, you must
have many talents and strengths. You may have superb visual memory, or
be a gifted problem-solver or mechanic, or be loved for your way with
people, or be wonderfully creative. Some of your skills may have been
under-valued in an academic setting, but now they can be worth money!
These strengths will be there to help you through the rough spots so work
to identify them, either on your own or with the help of a good professional.
This article was reprinted by permission from
Judith Paton,
M.A., Audiologist, San Mateo, CA. | |
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