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Information and Support for Central Auditory Processing Disorder (CAPD)

Updated on March 5, 2013

All about Central Auditory Processing Disorder (CAPD)

I am a mom of a boy with central auditory processing disorder. I went through an arduous process getting him diagnosed, and through that ordeal realized there was a need for more organized information on the subject to help parents figure it out.

This lens gives information and resources about Central Auditory Processing Disorder (CAPD). CAPD is not as rare as once thought, and current trends suggest that many children are being diagnosed with ADHD, PDD or Autism when in fact they have CAPD.

Hearing through a CAPD disability can make it challenging for a child to learn to speak and socialize, and school becomes a frustrating and confusing experience. The information provided here includes resources and information on how to help and cope with central auditory processing disorder.

What is Central Auditory Processing Disorder (CAPD)?

Some call it "dyslexia of the ears".

When our ear hears a sound, the sound is taken into the inner ear and delivered to the brain and the brain translates what is being heard. When a person is deaf, the part of the ear that delivers the sound to the brain does not function.

When a person has central auditory processing disorder (CAPD) the part of the brain that translates what the ear delivers does not function properly. The person with CAPD can hear sounds, but how the brain translates those sound is disrupted, and the end result is a garbled message. Some call it "dyslexia of the ears."

People who have CAPD have normal hearing, so they are not considered hearing impaired. The neurological processing of the sounds they hear is impaired, which is why it's called a processing disorder.

What does CAPD sound like?

This example shows how a person with auditory processing disorder perceives what is being said.

Simulation of CAPD:
Reading of Ladle Rat Rotten Hut (Little Red Riding Hood)

The way the ear takes in sound is usually not an issue for people with CAPD. The outer ear, middle ear and cochlea (snail-shaped part) are all functioning properly. The brain also doesn't have an issue receiving the sound signal. The problem arises within the brain when the electrical signal from the cochlea is not processed accurately.

Imagine being in a country where you did not speak the language. You try to talk to people, and you can hear them perfectly fine, but you can't understand what they are saying. That is what CAPD is like.

What are the symptoms of CAPD?

The symptoms of CAPD can often mimic other learning challenges.

The symptoms of CAPD vary greatly and often are different for each sub-type (see below). This list is not meant to diagnose, although a list similar this one was the light bulb that lit up for me that allowed me to figure out my son has CAPD.

  • Difficulty hearing in the presence of ambient noise
  • Difficulty following along or keeping up in conversations
  • Poor auditory memory
  • Difficulty following auditory instructions, especially multi-step instructions
  • Speech delay from a young age
  • Often misinterprets what is said, but doesn't realize it's been misinterpreted
  • Missed subtle social cues
  • May have difficulty with phonics and learning to read
  • Exhibits attention issues
  • May exhibit auditory distractibility
  • Often says "huh?" or "what?"
  • With younger kids, will appear to not listen or look at you blankly when asked to do something.

Sub-types of CAPD

There are 5 sub-types of CAPD, each with its own symptoms and challenges.

Central Auditory Processing Disorder is a general term used to describe a spectrum of various areas of auditory processing dysfunction. The subtypes describe more specific auditory dysfunction so that specific remedies can be implemented. A person could have one or more of these subtypes.

AUDITORY DECODING: Presents with auditory discrimination difficulties, especially in the presence of ambient sound. They have challenges analyzing differences between sounds. Challenged to hear rapid speech and often asks "huh?". Behaves as if there is a hearing loss when there is none. This is the classic type of CAPD.

INTEGRATION: This sub-type demonstrates difficulties in tasks that require both sides of the brain to work together. Presents with reading challenges, reading comprehension, note-taking difficulties as well as physical coordination issues. May also have poor visual-motor abilities.

ASSOCIATIVE: Presents with receptive language difficulties, especially with regards to the meaning of speech (semantics). Sometimes called a receptive language disorder. May have difficulty understanding common expressions that aren't literal (i.e. Aren't you just beat?).

OUTPUT-ORGANIZATION: Difficulty with organizing language and difficulty with expressive language. Presents difficulty with recalling information in a specific order and may have articulation issues.

PROSODIC: Presents as challenge with the prosodic elements of speech: tone, pitch, intonation. Listener cannot understand the underlying meaning behind the words that are said. May include poor pragmatic language skills and social challenges.

Visit website for Jeanne M. Ferre, PhD for a detailed explanation of CAPD Subtypes.

Autistic-Like, but Not Autistic

We heard this phrase so much during the diagnosis process...

Our son has had nearly 2 dozen assessments from the age of 2-1/2 to 8-1/2 years old. He has been seen by:

  • speech therapists
  • school psychologists
  • regular psychologists
  • psychologist specializing in ADHD
  • pediatrician
  • neuropsychologist
  • neurologist
  • reading/language specialist
  • behavioral specialist
  • occupational therapists
as well as being in special education classes where he was overseen by teachers and aides who are experts in the field. Through all these assessments, NOT ONE SINGLE person brought up the subject of auditory processing disorder. Every single one of them missed it!

Throughout the process we repeatedly heard "your son is autistic-like, but he doesn't seem autistic". It is a fact that autism is on the rise in this country, and so it's the diagnosis that experts seem to gravitate towards.

The symptoms of CAPD look very similar to autism include:

  • Not responding when spoken to
  • Answering with an unrelated topic.
  • Inappropriate social responses
  • Inability to comprehend what is happening with those around them (i.e. mixing up game rules).
  • Speech delay (big one!)
  • Unintelligable speech
  • Difficulty staying focused
  • Difficulty following instructions

Best book to figure out the puzzle!

The Mislabeled Child: Looking Beyond Behavior to Find the True Sources and Solutions for Children's Learning Challenges
The Mislabeled Child: Looking Beyond Behavior to Find the True Sources and Solutions for Children's Learning Challenges

If you only want to read one book, I HIGHLY recommend this book. It really assisted me in sorting out the puzzle of my son's diagnosis. This book goes through every learning disability, explaining what it is and what the symptoms are. The most valuable thing is offers is a cross-reference to OTHER learning disabilities it can also resemble. This one book could help you figure out your own child's puzzle.

 

Is it ADHD or CAPD?

Another diagnosis often foisted on our son, ADHD...

It is true that ADHD and CAPD can co-exist in the same individual, but often CAPD is the only condition, and it is misdiagnosed as ADHD. Both challenges present with very similar symptoms. The symptoms are often so similar a child with CAPD will test positive for ADHD on assessment tools.

As you can see from my list of specialists above, most learning disability assessors miss CAPD. But they want to give you a firm diagnosis, so they will give you what it looks like. It's really not their fault. Many are unfamiliar with CAPD, and when a child's hearing tests are fine, they assume there is no problem with the entire hearing system.

What signs show the difference between CAPD and ADHD?

From my experience the best way to determine the difference is environment. Our son is less distracted and understands more when he is in a quiet environment. In a noisy classroom, he looks like a kid with ADHD. Indeed, the way I figured out it was CAPD was when he was first mainstreamed into a typical classroom. While he was praised for attention in special ed classes, he was labeled a "problem" child in his 22+ child kindergarten class which was adjacent to the school's main playground. Lots of background noise = huge distractibility.

What causes Auditory Processing Disorder?

Experts do not have a specific answer to this question.

Unfortunately nobody really knows what causes auditory processing disorder. There are theories, but it is a little-known disorder and not enough research has been done to confirm the theories.

Hereditary CAPD is a mis-wiring of the brain. The brain is actually hardwired so that the auditory system cannot correctly process auditory information. Hereditary CAPD does not seem to gain help from therapies. A person's best strategy is to learn how to accommodate their challenges.

I have met adults with CAPD that have tried many different therapies and nothing has made any difference. In their case they have had multiple members of their family with CAPD. Obviously there is some sort of genetic link.

Acquired CAPD is the result of some insult or trauma to the brain. This could include a minor head injury from a fall, excessive ear infections or high fever. In all these cases, the brain was effected and auditory development was hampered and/or delayed. With under-stimulation, the auditory system did not mature properly, and therefore presents CAPD. Acquired CAPD can respond very well to therapies that improve brain function, but there are no guarantees. It's a trial and error process to figure out which therapies will help.

In our son's case the audiologist theorized that excessive ear infections as a toddler, and subsequent conductive hearing loss, caused an under stimulation of the auditory system. She believed he would grow out of his auditory processing disorder if he is auditory system received the right stimulation. I happen to agree with her because our son has seen tremendous progress with the therapies we have tried. AIT (auditory integration training) was the first therapy we tried, and it actually remedied his conductive hearing loss and suddenly he was able to understand us a bit better (when it was quiet). We have since discovered that he also has mild traumatic brain injury from a couple bad falls as a toddler. 55% of individuals with brain injury have CAPD, so we believe this is the major cause of his CAPD.

How do you know if it's hereditary or acquired?

There really is not way to know for sure. Clearly if nobody else has CAPD, and your child has a history of ear infections, the probability is that it is acquired. On the other hand, if several people in your family have CAPD, there is a strong probability it is hereditary. Then again, the family may also have a history of ear infections and everybody got a mild acquired CAPD.

You don't know which type it is until you try some therapies. If the therapies help, then it is acquired. If they do little or nothing, then chances are it is hereditary. That does not mean you give up on therapies. Keep trying! New therapies are coming to light all the time, and you never know when something will help.

A mother's story of getting a diagnosis...

Like Sound Through Water: A Mother's Journey Through Auditory Processing Disorder
Like Sound Through Water: A Mother's Journey Through Auditory Processing Disorder

This wonderful book is written in novel style. This mom's story is so similar to our own, beginning with a speech delay that mushroomed into social problems and a big question mark as to the cause. If you are trying to figure out why your child is having problems, this book is an inspiration that shows the determination and love that go into helping our special children.

 

Why does CAPD cause memory problems?

CAPD can effect a child's ability to remember what is said. Because the listening process requires intense focus by the child, the child's brain does not have the resources to store in short-term memory what has been said. If a child with CAPD has to listen to long-winded instructions, the child may exhibit signs of fatigue, inattention or frustration because of the extra effort required to attune to the auditory information.

People with CAPD have a lot of difficult following multi-step instructions because of the resource memory issue. It is best to use visual cues or only provide instructions 1 or 2 steps at a time.

People with CAPD also have issues with rapid speech. They cannot process the information that is coming at them quickly because they do not have the brain resources to store the information. Slowing down a bit really helps this processing challenge.

A Reading Solution for Kids With CAPD

Learning to read is a fundamental skill for school success, but kids with APD are at a disadvantage.

APD affects a person's ability to distinguish between the individual sounds that make up words, or phonemes. As a result, speech is heard as "blending all together" or somewhat muddied. Because of this difficulty, when a child with APD begins reading, they have significant difficulty learning phonics. As a result, they are unable to learn how to sound out, or decode, words properly.

Children with APD will often compensate for this by learning to sight read the words. This means they memorize the words as whole pictures, but are unable to sound out the individual phonemes that make up words. This strategy words in Kindergarten and 1st grade, but by the time they reach 3rd grade the volume of words they must memorize begins to become overwhelming. In addition, because they have memorized the words as pictures rather than letter patterns, their spelling is atrocious. As a result, any reading skill they have gained halts and may even backslide.

Many other children with APD are unable to manage a sight-reading approach, and these children never make progress in reading, despite a lot of effort by the school and parents. This was the case with my son. He started 3rd grade reading at a Kindergarten level. The school was out of ideas, and I sought out a solution.

How my son learned to read

My son with CAPD is a very visual learner, so I searched for a visual reading program for him. I thought it might be possible that we could use his strength to help his weakness. What I found was the Easyread System. They have several programs that use the child's visual strength to teach phonetic reading.

They use an approach called Guided Phonetic Reading which uses cartoon characters to represent the phonemes, and the child then uses these characters to learn how to decode words. Through repetition, the reading because fluent and effortless for the child. In addition, they have identified 8 causes of reading difficulties, and we found our son had 2 of them, so we were able to work on resolving them.

My son took to the Easyread System like a fish to water. Six weeks into the program he was reading at a 2nd grade level, and 7 months into it he had caught up to reading at grade level! It was the best decision we ever made for him.

When we found our younger son had an auditory weakeness and difficulty with reading, we put him on Easyread Accelerator, and he also learned how to read in a matter of months.

Is it called CAPD or APD?

Auditory Processing Disorder is a term used to describe any issues related to the auditory system. This could include outer, middle and inner problems, as well as neurologic issues related to getting the message into the brain or translation of the message once it reaches the brain.

Central Auditory Processing Disorder was initially the term used to describe the auditory processing disorders that occur in the central nervous system, i.e. the brain. Over time the term has been shortened to Auditory Processing Disorders, and these days CAPD and APD are essentially interchangeable.

Video that Explains CAPD

These videos discuss auditory processing disorder in children. They talk about the signs, diagnosis and accommodations that may help for CAPD.

Blogs and Lenses by people who live with CAPD

I have found some very interesting accounts of people who live with CAPD. They share the challenges they face in work and relationships, and things they have done to assist in working with their CAPD.

Young People Raising Awareness of CAPD

These kids and their parents are working to raise awareness of CAPD. Follow them and leave them comments and show them that you support their efforts to make a difference!

Resources to help with CAPD

The following websites have information, resources or online communities for CAPD.

Why are you looking for information on CAPD?

Why are you seeking help for CAPD?

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Have you tried any therapies for CAPD? - Have the therapies helped or done nothing?

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    • profile image

      Mike Allers 2 years ago

      Thank you for compiling all that you have. I read your information, and listened to the multiple videos with my wife and my son. As educators, my wife and I have always felt that our son should have been diagnosed with CAPD. It is something that school systems are reluctant to explore. This is primarily due to the fact that school psychologists espouse the belief that children under the age of 7 cannot be tested. This automatically removes the early intervention so vital for kids with disabilities of this sort.

      Like other parents, we have worked through the variety of diagnoses presented to us over the years to arrive where we currently are. It was frustrating for us, but gigantically problematic for our son. He is 20 now, and in college part-time. High School was rough, making friends difficult, and trying to explain his communications issues nearly impossible. Our son has taken ASL courses to try to learned a second means of communication in college. He has also taken a slow approach to working through a degree. Recently, we took a class together. I had a front row seat to witness him in action. The process of gathering information presented in the manner he has to do so, is simply exhausting for him. This is also the case with making friends, speaking with girls, and keeping up with conversations. Fortunately he is a hard worker, so keeping a job has not been hard to do. He is highly sought after to work extra hours, but does run into issues when communicating on a more than surface level with colleagues and customers.

      In the coming weeks, we are taking our son to an audiologist to discuss therapies going forward. We are hopeful. We have not been totally unsuccessful in our approaches and efforts to make our son successful, but his frustration of late is growing beyond our abilities.

      Thank you once again for your hard work!

      Mike

    • profile image

      anonymous 4 years ago

      Hi my son was diagnosed with capd after being misdiagnosed with autism...its been a long long long road but thank God we were blessed to find an awesome Audiologist. However the public school system refuses to accept this diagnosis and my husband and I have been fighting to get more than modifications but teachers who actually know how to teach him. This sparked me to start my blog on face book called Its not always autism. We are currently looking into starting a parent advocate program and support group so assist other parents and family members in order for them to know and understand capd in order to help their children. We are currently trying to get equipment to assist him in his classes....thank you soooooo much for this wonderful information. Its been a long long road with great stages of progress. Hang in there everyone! God bless.

    • profile image

      anonymous 4 years ago

      Thank you again for all this wonderful informations, please let us know if the neurofeedback was helpful and worth to try for my 10yrs old daughter who is recently diagnosed with APD after many different evaluations!

    • profile image

      anonymous 4 years ago

      Thank you so much for sharing, it was very helpful for a hopeless mom who was still searching for a treatment my daughter was diagnosed with PDD but now they found out its APD, I would like to know if you heard about Tomatis and therapeutic listening program i would love to hear your opinion...thanks again!

    • Bonzlee LM profile image
      Author

      Bonzlee LM 4 years ago

      @anonymous: APD and Dyslexia are commonly found together. There are many reading programs out there that can help. You need to find the one that works best for you. The Barton and Orton-Gilligham programs are very time intensive and require you to learn about word structure. Both my boys learned to read with Easyread (http://www.easyreadsystem.com) which plays on their visual strength to learn to read phonetically.

    • Bonzlee LM profile image
      Author

      Bonzlee LM 4 years ago

      @Spiderlily321: Yes, I am a mom to 2 kids who are both twice exceptional -- gift but with learning challenges.

    • Bonzlee LM profile image
      Author

      Bonzlee LM 4 years ago

      @anonymous: I'd be happy to add your blog. Could you give me the URL so I can create a link? Thanks!

    • profile image

      anonymous 4 years ago

      Nicely presented information! It is nice to hear therapies are helping. Would you like to add the following blog to your list of resources, "What is Auditory Processing Disorder (APD)?" on WordPress - written mainly for adults to enhance mutual understanding between them and the people in their lives with respect to the impacts of CAPD, based on descriptions by adults in support forums and current understanding of the condition.

    • Spiderlily321 profile image

      Spiderlily321 5 years ago

      This is a very good lens. I featured it on my âAre you the parent of a child with special needs? Lens. Thank you for sharing

    • profile image

      anonymous 5 years ago

      I was recently showed and told that there may be a link to dyslexia and APD. I resonate strongly with the dyslexia information that Susan Barton talks about on her website brightsolutions.us. However, I come and read about APD and it's clearly me too in many of the areas (not all). I was diagnosed at 19 because I was doing terrible in college and needed to understand why. I am 44 years old now and my son is potentially dyslexic at 6 years old we are seeing possible characteristics. I talked to a woman about this with me and she said she feels there wasn't enough research back when I was diagnosed to not catch the dyslexia too. However, she feels that if I did the Ortin-Gillingham (sp?) reading training for dyslexics, it may help my brain make the changes that it never got. I do know how to read, but from the sounds of the training (as in teaching my son this now) it may help my brain function improve in areas that were lacking. Food for thought anyway.

    • Bonzlee LM profile image
      Author

      Bonzlee LM 6 years ago

      @ebaybee: Thanks for your compliments. I am sorry to hear you are going through this process. It's such a journey. Check into mild traumatic brain injury (MTBI). When there is a smattering of symptoms that cross diagnosis, it's possible it's a MTBI from a fall and hit on the head. It can also be caused by high fevers during illness. We have recently found out this is our son's diagnosis, and now we know exactly what to do to fix it (and it can be fixed).

    • Bonzlee LM profile image
      Author

      Bonzlee LM 6 years ago

      @anonymous: I wish I had a good answer for you. We actually moved to a small town near Ventura, California which has excellent special ed. We moved from a horrible city near Los Angeles where we had to hire a lawyer. It wasn't pretty. Unfortunately I think the later scenario is the norm. I think you just have to ask around. One of the challenges is that APD is not listed as a disability, so there is a lot of gray area around it. If you find a good district, please let me know. I am asked this question often.

    • Bonzlee LM profile image
      Author

      Bonzlee LM 6 years ago

      @javr: Thank you for your kind words. It has been frustrating, but I hope my learning makes it easier for others. He is improving with therapies. I haven't written a lens on that yet, but it's coming!

    • javr profile image

      javr 6 years ago from British Columbia, Canada

      Good luck to your son. It must be a very frustrating condition.

    • profile image

      anonymous 6 years ago

      has anyone had a good school experience in the US with a child with APD? Where? we have had terrible experiences and want to relocate.

    • ebaybee profile image

      ebaybee 6 years ago

      Thanks for this informative Lens. My grandson was recently diagnosed with Sensory Processing Disorder, but he could have CAPD as well. This info has been very helpful to us.

    • profile image

      pawpaw911 6 years ago

      Very informative.

    • indigoj profile image

      Indigo Janson 6 years ago from UK

      Excellent informative page on CAPD. Good job on raising awareness, it's clear you've had a hard time getting a diagnosis for your own child and I'm sure this will help others.

    • norma-holt profile image

      norma-holt 6 years ago

      This is a very informative and well presented lens. *-*Blessed*-* and featured on Sprinkled with Stardust

    • profile image

      anonymous 6 years ago

      Much information provided on CAPD. Had no earlier awareness of it. Thank you.

    • kismetsc profile image

      kismetsc 6 years ago

      Nice lens! I didn't know much about this topic, but you do a good job of covering it.