What is Central Auditory Processing?

Central auditory processing is the series of tasks done by parts of the auditory nerve pathways in the brain to sort out and refine the “raw data” delivered by the ear. This processing provides the recognizable sound message we use in thinking and communication.

When some of these tasks are done incompletely, a central auditory processing disorder (CAPD) results. It is a hearing disorder just like a peripheral (ear) hearing loss, in that it keeps a clear message from reaching the intellect.

CAPDs (also referred to as auditory processing disorders or APD) are physical inefficiencies with physical causes such as genetics, minor birth difficulties, illness, or injury. Often the cause is unknown. Most CAPDs are mild compared to other physical problems, but they can have a large impact on listening and analyzing what we hear (at school, at work, or socially).

When might I suspect a CAPD in my child or myself?

I believe that people want to do the right thing, to develop their skills, to love and feel appreciated. Before we assume that a child is “not very bright” or “a behavior problem,” that a teenager is “lazy, unmotivated, just not college material,” or an adult “lacks talent or self discipline,” I think we owe it to them to first assume they are doing the best they can and to check for problems that are getting in their way.

CAPDs present such a barrier to taking in ordinary classroom instruction, accurate messages in the workplace, and the nuances of social conversation. CAPDs can masquerade as the descriptions mentioned above, or as poor focus, or as an ADD (attention deficit disorder).

Most important, there is help available when the problem is recognized.

See CAPD Symptom Checklist for common signs and subtypes.

How can CAPD testing by an audiologist help?

  • By checking for auditory system problems before it is assumed that the person is simply “not trying.”
  • By describing to normal-hearing family and professionals what it is like for this person to hear, and what can be done to help.
  • To confirm the physical disability which brings the child or adult under the protection of educational and civil rights laws.
  • By getting beneath the surface of the auditory disorder suggested by psycho-educational or speech/language testing; to break the problem down into its basic parts (subtypes), so that therapy is more individualized and the job more manageable.
  • To help distinguish CAPD from ADD or other disorders producing similar-looking behaviors. The central auditory test tasks used by audiologists differ from IQ or academic tests, in that they were originally designed to check functions in the various regions of the auditory pathways. As such, they are backed by decades of research in peer-reviewed journals confirming their accuracy. Because they are sensitive only to auditory problems, they can help distinguish CAPD from problems of attention, language, or emotion. 
  • By uncovering possible ways of helping when the child is not progressing as expected in speech/language or educational therapy, or school Special Education programs. 
  • To gain a clearer picture of the exact problem, to help with decisions about a lengthy or expensive therapy of a particular type.

Is it too late to seek help for a CAPD if you are an adult?

Not at all. There is now a wealth of scientific research showing that we can still make changes in our brains even into old age. Moreover, adults bring to the process a rich life experience to help them strategize and overcome problems which are lifelong, or which are caused by a devastating life event like injury or illness.

The adults who come to my practice are usually at the point of making a “life change” in some way — large or small. They might be working in a job beneath their true ability, or afraid to work at all. Perhaps they may have to learn anew “who they are” after an injury or illness alters their hearing. Often they want a chance to solve problems that were never recognized and helped in school so that they can now complete their education. They are often the parents of children with CAPD and other learning problems.

My contribution as an audiologist is to give you a “map” of the CAPD, to let you know why you are not hearing well, to correct misinformation received from uninformed adults in the past, and to help you choose what to do to change the old patterns. Whether I am drawing from modern brain research or from the knowledge shared with me from other people with CAPD I’ve seen over the past twenty-five years, I can lead you to sources of help with other skilled professionals in many areas of therapy and health science.

To learn more about how adults can successfully cope with CAPD, read Ms. Paton’s article on Living and Working with CAPD.

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Who can benefit from AIT?

AIT can help people with hyperacusis (unusual sensitivity to specific sounds) and certain other problems associated with CAPD. Hyperacusis may accompany CAPD, learning disability, ADD, injury, or disorders of the autism spectrum. Symptoms include:

  • Marked discomfort, aversion, or startle to ordinary sounds the rest of us tolerate (hair dryers, vacuums, other children crying or shrieking, loud movies or shows, reverberant crowd situations)
  • Distraction and inability to concentrate on work due to very soft, distant sounds most people don’t notice
  • Striking behavior changes (coming “unglued” or “unavailable”) when noise levels become high (parties, school assemblies, indoor sports events, etc.) 

Here are examples of other features of CAPD where AIT has helped in my caseload:

  • Problems functioning in noisy classrooms or offices which are not solved by accommodations like preferential seating or FM amplification.
  • Slow processing speed, limiting ability to clearly discern normal-paced speech for long periods, affecting social relations on the playground, or slowing progress in speech/language therapy.
  • Some difficulties with language perception or accessing which do not respond to skilled teaching and therapy.
  • Poor working memory which has limited ability to stay on task, attend to details, or recall basic facts and routines.

How can AIT (Auditory Integration Training) help?

It has now been scientifically confirmed that highly repetitive stimulation done intensively over a short period of time can train the brain to do certain jobs that it couldn’t do as well under ordinary conditions. AIT uses a ten-day, twenty half-hour program of modulated music, individually filtered for each person’s sound sensitivities, to accomplish this stimulation of the auditory system.

AIT is almost unique among therapies in its ability to reduce the highly distracting, sometimes even painful, inability to temper or moderate the sound brought in by the ear. (In parallel, imagine how it would feel if your pupil couldn't constrict to protect you from bright light.)

Unlike most other music therapies, the painful frequencies are filtered out. This makes it a very kind therapy, unlike crude attempts to “desensitize” the person through noxious noise.

AIT is training the auditory system, and thus addresses the CAPD component in a variety of disorders. These may include LD (learning disabilities) and ADD (attention deficit disorder).

To read about a mother’s experience with AIT for her autistic child, go to the Connor’s Corner website including Ms. Paton’s explanation.

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