Auditory Processing Disorder

From time to time, I am asked by parents about Central Auditory Processing Disorder (CAPD) as a possible cause for their children’s attention problems or difficulties at school.

Since this condition doesn’t get a lot of coverage, I thought it would be a good topic to cover in this column.

CAPD is described as a problem in the communication between the ear and the brain. Individuals have no hearing deficits, but seem to experience difficulty processing the information they hear in the same way as other people.

Some experts believe as many as five percent of school aged children experience CAPD and that it can be easily confused with ADHD, autism or learning disorders.

Kids with this disorder often do not recognize subtle differences between sounds in words – even if they are loud enough to be heard. Something adversely affects the way the brain recognizes and interprets sounds and especially the sounds involved in speech.

This deficit in coordination between the brain and the ears seems to be worst in situations with a lot of background noise – which encompasses many of the regular activities of an average child.

Although children with CAPD do not have a problem with hearing sensitivity, if their disorder is not managed early, they may experience speech and language delays as well as academic problems.

Some of the main symptoms to watch for in CAPD include: being easily distracted; getting upset or bothered in noisy environments or sudden loud noises; improved behaviour and performance in quieter settings; difficulty following directions; reading, spelling, writing or other speech-language difficulties; difficulty comprehending abstract information; difficulty with verbal math problems; forgetful and disorganized; and difficulty following conversations.

Obviously, many of these symptoms are hallmarks in other common childhood disorders including ADHD and this has contributed to the diagnosis and even the existence of CAPD being somewhat controversial even among the professionals who deal with it.

Diagnosis may be difficult and should be done by an audiologist – although this usually can’t happen until the child is at least eight or nine years old.

Once a diagnosis has been made, children usually work with a speech pathologist and visit the audiologist once a year for follow up.

It would likely also be a good idea to have a child with these symptoms screened for other disorders including ADHD and it is possible for both conditions to exist simultaneously.

This could be ruled out by monitoring the child’s progress with the treatment and aid of the audiologist. If measures such as giving the child a quieter school environment, moving him or her to the front of the room for less distraction, and other specific CAPD treatments are not effective, it might be wise to consider other issues as contributing to the problem.

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About the Author

Paul Latimer has over 25 years experience in clinical practice, research, and administration.

After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar.

Since 1983 he has been practicing psychiatry in Kelowna, BC, where he has held many administrative positions and conducted numerous clinical trials.

He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders.

He is an avid photographer, skier and outdoorsman.

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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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