(The sources for the following information are provided in links or brackets after the given information. More information can be found by clicking on the links given in this article.)
What is CAPD/CALPD/APD and what are the symptoms?
Central Auditory Processing Disorder (CAPD) is a learning disability that can cause a child to have significant issues with learning, particularly in a typical classroom where auditory input and background noise is difficult to control.
Auditory Processing Disorder (APD) is defined as follows by the National Institute of Health as: “A reduced or impaired ability to discriminate, recognize, or comprehend complex sounds, such as those used in words, even though the hearing is normal (such as coat/boat or sh/ch).”
- Difficulty understanding instructions
- They need to have directions repeated
- Problems understanding in the presence of background noise
- Spelling, reading, and other academic problems
- Behavioral problems
- Difficulty repeating sounds, letters, or numbers in sequence
- Speech or language delays
- A tendency to drop middle consonants or phonemes when learning to speak or write
- Slow reaction time
CAPD is more a brain processing sensory integration problem than a hearing problem. Children affected by CAPD process information more slowly than it is received, therefore, they fail to process much that they hear creating perceptual gaps. They have difficulty understanding directions and frequently need directions repeated. This slow processing of information is the result of slow reaction time and is indicative of slow brain processing and a sensory integration disorder.
“Children with APD often do not recognize subtle differences between sounds in words, even though the sounds themselves are loud and clear. For example, the request ‘Tell me how a chair and a couch are alike’ may sound to a child with APD like ‘Tell me how a couch and a chair are alike.’ It can even be understood by the child as ‘Tell me how a cow and a hair are alike.’ These kinds of problems are more likely to occur when a person with APD is in a noisy environment or when he or she is listening to complex information.”
Children with Central Auditory Processing Disorder often exhibit difficulties with language-based learning tasks. Such tasks include listening to instructions or lectures, reading, communicating with or understanding others. Needless to say, CAPD can make many aspects of daily learning seem confusing to the child. CAPD often causes difficulty with learning how to read, but there are programs to help your child at home or school.
The most common symptom is difficulty following directions. Your child may misunderstand spoken information. You may notice that your child often asks “what?” or “huh?” And you may need to repeat questions and directions frequently. Sounds and background noise may cause distraction easily. Your child may have difficulty paying attention and following conversations. Also, your child may be quite bothered by loud or sudden noises. Some sounds may be uncomfortable or even painful. Your child may have unusual behaviors in response to these sounds. Your child may not be able to discern the similarities and differences between sounds and words. Therefore, they may have poor phonics skills.
What are some of the possible causes of CAPD?
The cause of central auditory processing disorder may be any of the following problems:
- Recurrent ear infections (most common)
- Middle ear fluid
- Pregnancy complications
- Labor and delivery complications
- Birth defects
- Lead, mercury and other environmental poisons and toxins
- Exposure to loud sounds and toxic noise (unwanted and unstructured sounds)
- Auditory deprivation
- Brain trauma
Central auditory processing disorder is extremely difficult to diagnose correctly because many symptoms overlap with other disorders, such as ADHD. Also, many individuals with autism, ADHD, and various learning disabilities also have central auditory processing disorder. An audiologist specifically trained in central auditory processing disorders should diagnose this condition. Your child will be in a sound booth with headphones for several hours during testing. They will be asked various simple questions in which they will need to respond. Our audiologist provided several breaks periodically and allowed favorite stuffed animals in the booth also.
What are some tips for working with children who have CAPD?
- Use short simple verbal information
- Write down instructions
- Use lists
- Teach note-taking
- Use mnemonics
- Repeat or rephrase information to your child
- Ask for your child to repeat the information back to you
- Use visual and tactile cues whenever possible
- Eliminate competing sounds
- Reading aloud
- Use graphic organizers
- Play games that require auditory inputs, such as Guess Who? And Guess Where?
- Play charades, hangman, and scavenger hunts
- Listen to nature sounds and identify their location
- Learn to play the piano
- Teach active listening and whole body listening skills
If your child is in the classroom, you will find these tips useful.
- Sit close to the teacher in a quieter area of the room with minimal distractions
- Try an assistive listening device
- Allow your child to have notes from the teacher or another student
- Pre-teach important new information
By the way, learning a foreign language will be extremely difficult for these children with CAPD. It is hard enough for them to learn English! You may want to consider sign language or possibly Latin since there is no speaking or listening. If you do choose a living language, I would not suggest one with different characters like Greek, Hebrew or Chinese.
More tips for the classroom include:
- Classroom placement. Consider such critical factors as the acoustics of the classroom relative to noise level and reverberation, the amount of structure within the classroom and teacher’s communicative style. Structured situations are more effective.
- Classroom seating. Children with auditory deficits should receive preferential seating. Seat the child away from the hall or street noise and not more than 10 feet from the teacher.
- Gain Attention. Always gain the child’s attention before giving directions or initiating class instruction. Calling the child by name or a gentle touch will serve to alert the child and to focus attention upon the classroom activity. Secure eye contact before you begin to communicate.
- Keep verbal instructions brief. Pause between statements to allow time to process.
- Check Comprehension. Ask children with an auditory deficit questions related to the subject under discussion to make certain that they are following and understanding the discussion.
- Rephrase and Restate. Encourage children with auditory processing problems to indicate when they do not understand what has been said. Rephrase the question or statement since certain words contain sounds or blends that are not easily discriminated. Substituting words and simplifying the grammar may more readily convey the intended meaning.
- Write instructions. Children with auditory problems may not follow verbal instructions accurately. Help them by writing assignments on the board so they can copy them in a notebook. Also, use a “buddy system” by giving a classmate the responsibility for making certain the child is aware of the assignments made during the day.
- Visual Aids. Visual aids help children with limited auditory skills by capitalizing upon strengths in visual processing and thus providing the auditory/visual association often necessary for learning new concepts and language.
- Quiet Study Areas. Provide an individual study area relatively free from auditory and visual distractions.
- Pre-tutor Child. Have auditorily impaired children read ahead on a subject to be discussed in class so that they are familiar with new vocabulary and concepts.
- Inform Parents. Provide the parents with consistent input so that they understand the child’s successes and difficulties.
- Monitor Efforts. Provide short intensive periods of instruction with breaks during which the child can move around. Children with impaired auditory function become fatigued more readily than other children.
- S-P-E-E-C-H. This mnemonic device has been found helpful by parents and teachers. S=State the topic to be discussed. P=Pace your conversation at a moderate speed with occasional pauses. E=Enunciate clearly. E=Enthusiastically communicate using body language. CH= Check comprehension before changing topics.
[Inge W. Horowitz, M.Ed., Educational Consultant in Richmond, Virginia. 1995. “Managing ADD/CAP in the Classroom.”]
What Resources are available?
http://www.learningabledkids.com/learning_disability_LD/central_auditory_processing_disorder_resources.html recommends the following programs to help your child at school or home: FastForword and Earobics.
Earobics is an inexpensive program that can be used at home in a home school or tutorial environment pretty easily. It is best used with headphones to provide clarity. Our kids used this program and like it quite well. There are different levels for different ages, and for older children, you’ll want to be certain to get the version for adolescents and adults. It uses a game-based format that is entertaining, which makes it easy to get kids to use.
FastForword is an expensive program, which must be administered by a ‘clinical’ professional.
If your child has CAPD, you might want to consider teaching him or her American Sign Language as well. In many states, ASL can count for Foreign Language credit on a high school diploma and ASL will open doors of communication that might otherwise be limited for your child.
According to http://www.autism-in-the-christian-home.com/auditory-processing-disorder.html, an inexpensive and effective home-based program helpful dealing with Asperger’s Syndrome, PDD-NOS, ADHD, CAPD and sensory integration dysfunction, is The Listening Program.
There are many books and resources available on CAPD at Amazon.com.
Another good site is: National Institutes of Health – C.A.P.D. Information
See Also on this site: Recognizing Learning Disabilities
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