What is Central Auditory Processing Disorders (CAPD)?
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A Central
Auditory Processing Disorder Can Severe Limit Your Child's School Performance
and His Ability to Control His Behavior at Home.
excerpts from the article
by Anthony
Kane MD
"Auditory Integration
Training is another effective technique. This program was developed by the
French otolaryngologist, Dr. Guy Berard, one of Tomatis’s students."
Some children have normal hearing
ability but have difficulty using information they hear in academic and social
situations. These children may have a Central Auditory Processing Disorder.
Children who have this difficulty are able to hear well, but have trouble paying
attention to, remembering, and utilizing auditory information for academic and
social purposes. Central Auditory Processing Disorders may have a very
negative impact on their language acquisition, social skill development, and
school performance.
Some researchers feel that many
children are misdiagnosed with ADHD and actually have a Central
Auditory Processing Disorder. This condition is particularly common if the
child has other sensory integration disorders, such as touch sensitivity. In
addition, children with ADHD may also have a Central Auditory
Processing Disorder.
What is a Central Auditory
Processing Disorder
A Central Auditory Processing
Disorder is an impaired ability to attend to, discriminate, remember,
recognize, or comprehend auditory information in individuals who typically
exhibit normal intelligence and normal hearing.
When a person is exposed to a
sound, the ears detect the sound and transmit the information to the auditory
part of the central nervous system. The sound stimulus is processed in several
parts of the central nervous system. In the end, the listener will know the
direction from which the sound comes, identify the type of sound, be able to
separate the sound from background noise, and interpret the sound. The listener
stores the memory of this sound stimulus and develops a mental sound library,
which he uses to help him evaluate, interpret, and utilize new sound information
that he experiences in the future.
When a child has a Central
Auditory Processing Disorder he has an impaired ability to attend to,
discriminate, remember, recognize, or comprehend auditory information. These
processing difficulties become more pronounced in challenging listening
situations, such as noisy backgrounds or poor acoustic environments, great
distances from the speaker, speakers with fast speaking rates, or speakers with
foreign accents.
What the Child Experiences
Distorted Speech Sounds
Nobody talks the same way. There
are always slight variations in pronunciation and emphasis that makes one
person’s speech patterns differ from those of another. In order to understand
the speech of other people, a child must make a series of mental adjustments.
First he hears words. Then based upon his memory of similar sounds, he places
the sounds of the words in context and decodes the meaning that is being
conveyed.
In a child with a Central
Auditory Processing Disorder there is a break somewhere in this decoding
process. The child isn’t able to derive the correct meaning from words because
he cannot accommodate the different distortions of different speakers.
Excess Background Noise
When we are in a noisy room, we
need to block out the extraneous noise in order to distinguish and understand
words that are being spoken to us. One way we do this is by pinpointing the
location of the voice of the speaker and neurologically suppressing the sounds
coming in from other locations. A child with a Central Auditory Processing
Disorder may have difficulty pinpointing sounds. With this in mind it is
understandable why he can’t block out extraneous noise. As a result a child
with a Central Auditory Processing Disorder appears to be easily
distracted.
Misses Social Cues
Speech can be very complicated.
Beyond understanding simple instructions there are the nuances of language usage
that help convey the true meaning of the message being transmitted. It is these
nuances that allow for social interactions. A child with a Central Auditory
Processing Disorder may have a deficit in receiving and understanding the
meaning of sounds. Such a child will be very slow to follow the complexity of
the message that is conveyed by particular word usage and tones of speech.
Co-morbidity
Like other sensory motor defects,
Central Auditory Processing Disorders rarely occur alone. A child who
cannot effectively suppress extraneous noise may also not be able to use his
eyes to track words across a page or co-ordinate his fine muscles in his hand to
write easily.
Since a child with a Central
Auditory Processing Disorder may not be able to block out meaningless noise,
he may appear to the observer to be easily distractible. This is one of the
reasons children with a Central Auditory Processing Disorder may be
misdiagnosed with ADHD. However, if a Central Auditory Processing
Disorder child also has ADHD and so that he already has a deficit of
inhibition, then the effects of his Central Auditory Processing Disorder
are much worse.
Symptoms
Children who have Central
Auditory Processing Disorders may behave as if they have a hearing loss.
Here are some of the common behaviors displayed by children who have Central
Auditory Processing Disorders:
-
Don’t respond to speech in a
consistent fashion
-
Frequently ask for words to be
repeated
-
Difficulty following speech in
noisy surroundings
-
Frequently misunderstand what
is said
-
Difficulty following long
directions
-
Poor memory for verbal
information
-
Difficulty pinpointing the
direction from which sound is coming
-
History of middle ear
infection
School Performance
In addition, children with
Central Auditory Processing Disorders show many of these characteristic
deficits in school performance:
-
Difficulty expressing
themselves
-
Difficulty understanding
language
-
Poor reading, writing, and
spelling
-
Poor phonics
-
Poor speech sound
discrimination
-
Difficulty taking notes
-
Difficulty learning foreign
languages
-
Poor short-term memory
-
Social or behavioral problems
-
Poor language skills
-
Poor academic skills.
Diagnosis
An audiologist uses a battery of
tests to evaluate the peripheral and central auditory systems. Peripheral
hearing tests are used to determine if the child has a hearing loss, and, if so,
the degree to which the loss is a factor in the child’s learning problems.
Central auditory tests evaluate the child’s ability to understand and respond to
mild distortions of speech. It is also helpful to have a speech pathologist
evaluate the child’s perception of speech and receptive-expressive language use.
Treatment Standard treatment
focuses on remedial help and splinter skills to expand upon the child’s
strengths.
There are now a number of new
treatment techniques that directly address the hearing deficits. The pioneer of
these techniques was Dr. Alfred Tomatis, who began treating Central Auditory
Processing Disorders over forty years ago.
Auditory Integration
Training is another effective technique. This program was developed by the
French otolaryngologist, Dr. Guy Berard, one of Tomatis’s students.
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