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Speech Therapy: Central Auditory Processing Disorder (CAPD)

In simple terms, CAPD is defined as when a person hears words spoken, but their brain cannot process the words normally. Central auditory processing disorder occurs when the ear and the brain do not work together, which interferes with the way a child perceives what is heard. Assuming your child's hearing is good (and this should be verified by an audiologist), auditory information breaks down somewhere beyond the ear.

What types of behaviors do children with CAPD exhibit?

  • Says "huh" or "what" frequently
  • Inconsistent responses to auditory stimuli
  • Often misunderstands what is said
  • Requests that information be repeated
  • Poor auditory attention
  • Exhibits extreme distractibility
  • Difficulty following oral instructions
  • Difficulty listening in the presence of background noise
  • Difficulty with phonics and speech sound discrimination
  • Poor auditory memory span
  • Poor sequencing skills
  • Poor receptive and expressive language skills
  • Slow or delayed response to verbal requests and instructions
  • Reading, spelling and other academic problems
  • Learns poorly through the auditory channel
  • Exhibits behavior problems

What are the academic symptoms of CAPD?

Children with CAPD may have any or all of the following deficits.

  • Auditory Discrimination Deficit:
    Child may have trouble understanding verbal directions; may make errors in repeating words and directions; may substitute words, numbers, etc. May have difficulty learning sounds for letters, letter names, etc. May have trouble learning names of people, places and things.
  • Auditory Memory Deficit:
    May have trouble recalling names of things, letters, words, numbers, etc. May not consistently remember addresses, phone numbers, etc. from day to day. May not remember how to pronounce letters and words.
  • Auditory Association Deficit:
    May have trouble learning sounds of letters and letter names, individual words with categories, etc. May not be able to follow verbal directions, conceptualize the concepts of words, numbers, etc. May have difficulty classifying objects and ideas presented verbally.
  • Auditory - Visual Association Deficit:
    This skill is the essence of word recognition. Children with this deficit will have trouble recognizing and naming letters, words, numbers, etc. May be able to write what is read, speak what is heard, but will have trouble speaking what is read, or writing what is heard. This manifests as note taking problems in school.

What can we do to help children with CAPD in school?

1) Seat the child near the source of instruction to allow the speaker to talk directly to the child. This helps reduce the interference of background noise.

2) Get the child's full attention prior to giving instructions using a tactile prompt such as a pat on the hand, calling the child's name, or establishing eye contact.

3) Reduce both auditory and visual distractions which compete for the child's attention. Other conversation and movement are the worst of these distractions.

4) Speak distinctly, using as few words as possible, as too much talking can act as a distraction to the child.

5) Simplify instruction using one-step directions. Write down key words or assignments for students who can read.

6) Have the student re-verbalize instruction, directions or conversations. This helps the student recall what was heard, and allows the teacher to monitor comprehension.

7) Structure the environment as much as possible, using a consistent routine.

8) A buddy system can be helpful, especially with older students, to check notes and assignments.

9) Visual aids provide good reinforcement for students with weak auditory skills.

10) Breaks during the day may be necessary for the child to relax. Tension and fatigue can occur when children are constantly straining to attend and comprehend what is going on around them.

11) Amplification systems, both personal and free field, allow students to hear the teacher more clearly with less interference from background sounds.

12) It is most important to allow the student to experience as much success as possible to promote a good self concept. When children are frustrated with themselves as well as having academic difficulties, it is hard to stimulate interest to build skills that will help restore confidence.

What can we do to help children with CAPD away from school?

  • Slow down. Rapid presentation of many facts doesn't help. Modify your speech patterns; use simple constructions; slow down the rate of presentation
  • Obtain visual attention. This will help the child maintain attention.
  • Get rid of background noise and other distractions when possible.
  • Seat the child close to the speaker.

Homes are increasingly noisy places with TVs, radios, siblings, etc. Try to have a set study time when no TVs or radios are being played in the house. Don't try to carry on conversations across large rooms, while the TV is playing or if the child is in another room. This will only frustrate the both of you.

Away from home, be aware of the environment. Your child may have problems at church and other places of gathering. Many public buildings have hard, reflective walls resulting in reverberations. Be aware that these types of listening environments are frustrating and difficult for children with CAPD. Remember to:

  • Provide encouragement.
  • Be understanding.

Your child needs your consistent support and advocacy.





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