1 Central Auditory Processing Disorder Trish Doty + Sarah Ackerman

2 CAPD or APD (Central) Auditory Processing Disorder [(C)APD] refers to difficulties in the perceptual processing of auditory information in the CNS as demonstrated by poor performance in one or more of the following skills: sound localization and lateralization; auditory discrimination; auditory pattern recognition; temporal aspects of audition, including temporal integration, temporal discrimination (e.g., temporal gap detection), temporal ordering, and temporal masking; auditory performance in competing acoustic signals (including dichotic listening); and auditory performance with degraded acoustic signals. A CAPD is a physical hearing impairment, but does NOT show up as a hearing loss on routine screenings or an audiogram. 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).

3 CAPD A child with CAPD may test “normal” on a hearing assessment but have tremendous difficulty processing sounds in a meaningful way.

4 Identifying someone with CAPD Specialized testing: auditory memory (for sentences, nonsense syllables, or numbers backward) sequencing tonal pattern recognition or sound blending store of general information (which is most often acquired through listening). The most accurate way to sort out CAPDs 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.

5 Possible Causes: head trauma tumors degenerative disorders childhood viruses recurring ear infections oxygen deprivations lead poisoning brain development issue Although, in many children, it is related to maturational delays in the development of the important auditory centers within the brain. Often, these children's processing abilities develop as they mature. However, in other children, the deficits are related to benign differences in the way the brain develops. These usually represent more static types of problems (i.e., they are more likely to persist throughout the individual's life). For other children, the CAPD can be attributed to frank neurological problems or disease processes. Which are caused by the following: trauma ~ tumors ~ degenerative disorders ~ viral infections surgical compromise ~ lead poisoning ~ lack of oxygen ~ auditory depriva

6 Characteristics of students with CAPD Easily distracted Disorganized Excessively upset by noise Difficulty following verbal instructions or multi- step direction May wander during conversations or have problems developing a vocabulary In general: reading, spelling, language, and comprehension are a TREMENDOUS struggle

Instructional Strategies Modifications and Accommodations Enhancing the individual’s auditory perceptual skills Speak clearly Rephrase information Provide preferential seating Use visual aids

Instructional Strategies Modifications and Accommodations Enhancing the individual’s language and cognitive resources Auditory training procedures and phonological awareness training Repeating directions back Using expressive sentences

Instructional Strategies Modifications and Accommodations Improve the quality of the auditory signal Personal assistive listening devices Modify the environment to reduce noise Acoustic Modification to classroom Carpeting, Ceiling tiles, Window treatments

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Assistive Technology Programs Personal hearing aids Assistive listening devices Headphones Cochlear implants Amplifications systems Wireless

Parent and Teacher Organizations NIDCD Information Clearinghouse NIDCD Information Clearinghouse 1 Communication Avenue Bethesda, MD Toll Free: (800) TTY: (800) Internet: American Academy of Audiology American Academy of Audiology 8300 Greensboro Drive, Suite 750 McLean, VA Voice: (703) Toll-free: (800) AAA-2336 TTY: (703) Internet: American Speech-Language- Hearing Association Rockville Pike Rockville, MD Voice: (301) Toll-free: (800) Hours: 8:30 a.m.-5 p.m., eastern time TTY: (301) Fax: (301) American Speech-Language- Hearing Association

Resources org/CAPD/listening- therapies-for-capd.html ory.edu/divisions/neonat ology/dpc/georgia.html hear/spring00/centralaud itory.htm When the Brain Can't Hear : Unraveling the Mystery of Auditory Processing Disorder by Teri Bellis Central Auditory Processing Disorders: Mostly Management by M. Gay Masters Assessment and Management of Central Auditory Processing Disorders in the Educational Setting: From Science to Practice by Teri James Bellis

14 Resources Continued hear/spring00/centralau ditory.htm rticle/5919/ s/html/tr html#sec1.10