What is CAPD?
An auditory processing disorder (APD), also known as a central auditory processing disorder (CAPD) occurs when children, adolescents and adults have trouble processing what they hear despite having normal hearing sensitivity. In simple terms, this means that the ear works fine, but the brain cannot process what it hears. Individuals with APD may do well in ideal listening situations (such as in a quiet room), but they have difficulties when there is any distortion of the speech signal (background noise, competing messages, ect). People with APD may have difficulty localizing sounds, discriminating speech and/or remembering information that is presented in an auditory manner.
What are the symptoms of APD?
APD is NOT diagnosed based on behavioral symptoms alone, but some behavioral symptoms may help us decide if an APD evaluation is warranted. Although symptoms vary, some symptoms that may be seen in the general population are:
- Trouble hearing in background noise.
- Frequently asking for repetition. Says “huh?” or “what?” often.
- Responds inconsistently to auditory stimuli.
- Difficulty following auditory directions.
- Difficulty understanding rapid speech.
- Trouble determining where sounds are coming from.
- Generally poor listening skills /decreased attention for auditory information.
- Easily distractible and restless in listening situation.
- Significant difficulties with reading, writing and/or spelling.
- Trouble relating sounds to their letters.
- Difficulty understanding jokes.
- Poor musical skills/appreciation.
What is APD Testing?
APD testing is a way of evaluating the auditory pathways which are central to the ear. Hearing is a very complex skill; with analysis of sound beginning at the ear and continuing to the cochlea, 8th nerve, brainstem and finally the auditory cortex. A standard hearing test assesses how well a patient detects the presence of a sound. Auditory processing is much more complicated and therefore requires more complicated testing.
Testing consists of two appointments, most often:
- In the first appointment we will confirm your child does not have a physical hearing loss by testing the entire auditory pathway using both behavioral and electrophysiological tests.
- In the second appointment we will evaluate your child’s ability to decode auditory information in more complex listening situation (e.g. competing sentences, numbers, and speech in noise).
Who can be tested?
- Individuals 7 years of age to 50
- Normal or near-normal peripheral hearing.
- Sufficient receptive and expressive language skills to understand and respond to the tasks.
- Sufficient cognitive function.
What Causes APD?
The exact cause of APD is still unknown. We do know that APD does sometimes run in families. We suspect delays are associated with subtle neurologic maturational delays. Under consideration as well is the possibility of subtle structural and/or biochemical differences in the brain which may cause a more disorganized neural relay system. Specific causes related to injury or disease in children are rare. Adults with auditory complaints (yet have normal hearing) can more frequently have known etiologies to their abnormalities. These include certain disease processes such a multiple sclerosis, vascular disease, strokes, hearing injuries and tumors can cause a significant reduction in the ability to process sound. Test results for both types of tests are compared to normative data and a profile evolves telling us which communication skills and auditory neural function(s) are normal or abnormal for a given age. The next step, and most important, is translating this into helpful information with regard to patient management.
Is There a Cure for APD?
To date there are no medications or specific procedure which “cure” the symptoms of APD. Most individuals feel a sense of relief knowing why they or their child are struggling with hearing. If you or your child are diagnosed with APD, you will return for a consultation to discuss appropriate recommendations which include therapy and/or strategies. For some, simple modifications in the environment may be sufficient. For others, therapeutic activities, or directed therapy, specific to the disorder may be recommended.