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Central Auditory Processing Disorder

Central Auditory Processing Disorder (CAPD) refers to a neurological disorder characterized by the impairment of the understanding of spoken language. Individuals with central auditory processing disorder may have normal hearing, but something within the brain prevents them from correctly processing auditory information.

Central auditory processing disorder can be hard to diagnose. There may be no indications of the disorder until the child starts going to school and begins the formal education process. The first signs of the disorder are likely to be behavioral problems such as inattentiveness, being easily distracted, and having difficulty following multi-step instructions, especially those presented verbally instead of in written format. Most tests for CAPD are not considered valid until a child is six years old.

If a child has trouble with language comprehension, he or she will often be referred to a speech therapist working within the school. If the therapist suspects CAPD, an audiologist will be consulted to conduct specialized testing. CAPD can be evaluated through standardized behavioral inventories and questionnaires.



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The speech therapist will examine the linguistic aspects of the child’s hearing. The therapist looks at how well the child responds to directions by giving a series of increasingly complicated tasks. Being able to differentiate between different speech sounds is also investigated.

The audiologist examines the physical capabilities of the auditory system. The child is given standard hearing tests and tests that look at the function of the outer, middle, and inner ear. Once the hearing has been assessed, language comprehension will be tested under different noise conditions.

Hearing Impaired Children

It has been proposed that by default, most hearing impaired children suffer from CAPD to some degree. In this situation, it is likely that the hearing impairment will usually be noticed before CAPD is suspected. The child may already have a hearing aid, and perhaps academic accommodations and assistive technology to improve the child’s educational environment have already been provided.

However, if the child’s hearing loss is appropriately amplified and the child is still having difficulty understanding instructions and concentrating on tasks, CAPD should be considered. Because of the similarity in behaviour between children with CAPD and other learning disorders like Attention Deficit Hyperactivity Disorder (ADHD), the child may be tested for various conditions.

Once a diagnosis of CAPD has been verified, the same strategies can be used for hearing impaired children as for children with normal hearing. As long as the child’s brain is receiving auditory signals, whether through the aid of a hearing device or the regular function of the auditory system, the underlying problem of language comprehension can be dealt with.

Strategies for Coping

There are several things that can be done to help the child, especially in the classroom situation. One of the most important considerations is to reduce background noise. Ideally, the child can be placed in a classroom that is acoustically “damped”, thereby cutting down on echoes and acoustic “liveliness”.

The child should receive preferential seating near the front of the classroom, as close to the teacher as possible. The teacher can be trained in communication techniques to compensate for CAPD. The child’s attention has to be captured by saying his or her name, instructions need to be given one at a time, oral instructions should be supplemented with written instructions, and the teacher needs to check that the instructions have been understood by prompting the student to repeat back the instructions rather than just inquiring if the student understood.

The child should be taught listening skills, such as waiting for all of the instructions before beginning a task. A buddy system could be implemented so that other children can help in relaying information. Parents can assist their children by reviewing homework assignments with the teacher after class.

Visually distracting posters and pictures can hinder language comprehension for children with CAPD. If possible, such items should be removed from the classroom. A study carrel could be used to help the child concentrate. Structured classroom seating has been found to be less distracting than an open classroom.

Assistive hearing devices have also been found to be effective for children with CAPD. These are amplifying devices that transmit the teacher’s voice. The teacher speaks into a microphone, and her voice is transmitted either to earphones that the student wears, or to loud speakers placed strategically around the classroom. These devices can assist in cutting down background noise and allowing the student to concentrate on the teacher’s voice.

CAPD and Adults

CAPD is also a condition that can affect adults. A person may have grown up without ever being diagnosed with CAPD. They may have done poorly academically, and have had to endure many negative comments throughout their lives. They may have developed coping skills such as visual memorization and learned to rely less on auditory information.

The signs of CAPD are the same for both adults and children. They include sensitivity to sounds, turning the TV volume up, not responding when absorbed in a task, having difficulty following a series of instructions, asking for repetition or excessive clarification, and confusing words with similar sounds. Of course many of these signs can be indicative of other problems. The only way to know for certain if the problem is CAPD is specific testing.

Adults with CAPD need to communicate effectively to compensate for their comprehension difficulties. If they cannot understand a person because of excessive background noise, they need to make an appropriate request to move to a quieter place. When receiving instructions, it is suitable to repeat them back to verify understanding.


The causes of CAPD are poorly understood. It could be due to brain injury caused by a blow to the head, it could be a result of sickness, or it could be genetic. There is some evidence that CAPD runs in families. Diagnosis early in the academic years is especially important in CAPD so that the child can receive the proper assistance to cope with this disorder and develop appropriate compensatory skills. Children with CAPD can be very bright, but without appropriate support, they might become discouraged in an academic environment.

If someone is suspected of having CAPD, appropriate assessment for both this and hearing impairment are essential for providing a valid therapy plan. Click here to make an appointment to improve your hearing today!

For more information, see these web sites:

Central Auditory Processing: What Is It?
Living and Working With a Central Auditory Processing Disorder
Central Auditory Processing Disorders

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