Randi Fredricks, Ph.D.
Central Auditory Processing Disorder (CAPD) is a physical hearing impairment that doesn’t show up as a hearing loss on hearing tests (like an audiogram). Instead, it affects the hearing system beyond the ear in the brain. Although speech therapy is probably the most common form of therapy for CAPD, people suffering from it often seek psychotherapy to heal the stress and emotional problems associated with it.
The brains job with regards to sound is to take sound provided by the ear and separate a meaningful message from non-essential background sound and deliver that information with good clarity to the intellectual centers of the brain, the central nervous system. When we receive distorted or incomplete auditory messages due to problems with the ear and the brain, we lose one of our most vital links with the world and communication becomes difficult.
What does Central Auditory Processing Disorder look like?
The easiest, most efficient way to communicate is to say something and then listen to the other person’s reply. However, this simple process becomes more difficult when your listener has CPAD. Your sentence might come through with certain words drowned out by other noises, or with some words sounding like different words, or as meaningless strings of senseless verbiage. You might begin to suspect there is a problem when the person doesn’t respond the way you expected. Some of the ways a person with CPAD might respond to you are as follows:
- The other person’s expression doesn’t register understanding.
- He or she answers the wrong question – maybe one you posed earlier, or not at all.
- He or she asks you for additional information which most people would have been able to infer from what you just said.
Since most of us aren’t familiar with CPAD, we probably would just think that the listener is not very intelligent, doesn’t care about what we’re saying, or is simply inattentive or “spaced out”. Adults with CPAD, which often accompany a learning disability (LD), have been embarrassed by situations and reactions like these all their lives.
These short circuits in the wiring of the brain sometimes run in families or as a result from a difficult birth, like other learning disabilities and disorders. In some cases the disorder is acquired from a head injury or severe illness, such as frequent ear infections. Often the exact cause is not known. Children and adults whose auditory problems have not been recognized nor treated are forced to invent their own solutions. Frequently, this involves some form of self-medication.
The resulting behaviors can mask the real problem and complicate school, work, and close relationships, where good communication skills are vital. If the person chooses to self-medicate, the downward spiral begins.
The longer the person uses, the more difficult it becomes to tell where the disability or disorder begins and where the addiction leaves off. This is partially due to the fact that the addiction masks the symptoms, but also because of the often elaborate compensatory skills used to cope, as well as the development of other disorders associated with being an addict.
Testing for Central Auditory Processing Disorders
It takes specialized testing to identify a CPAD. Some of the tests used only give an indication that a CPAD might be present. These include tests of auditory memory for sentences, nonsense syllables, or numbers backward, sequencing, tonal pattern recognition or sound blending, and store of general information which is most often acquired through listening.
The most accurate way to sort out CPAD from other problems that mimic them is through clinical audiologic tests of central nervous system function. These tests are better for locating the site of the problem and reducing the effects of language sophistication on the test results.
If you have CPAD, there are many ways professionals can help you streamline your coping abilities. Also, there may be conditions accompanying the CPAD which are medically treatable such as allergies, Attention Deficit Disorder, Attention Deficit Hyperactivity Disorder, or nutritional deficiencies.
Common Features of Central Auditory Processing Disorder
The list below is common features of CPAD:
- Hears better when watching the speaker.
- Problems with rapid speech.
- Interprets words too literally.
- Talks or likes the television louder than normal.
- Often needs remarks repeated.
- Unusually sensitive to sounds.
- Asks many extra informational questions.
- Confuses similar-sounding words.
- Difficulty sounding out words.
- Ignores people, especially if engrossed.
- Difficulty following directions in a series.
- Speech developed unclearly.
- Late speech development.
- Poor communicator.
- Memorizes poorly.
You need to know how to identify the problem so that you can explain it to others and ask for what you need. If you grew up at a time or place where your CPAD wasn’t recognized you might need a knowledgeable professional to give you some insight into this. But if you listen to your feelings rather than trying to talk yourself out of them, you can generally get a good sense of the help you would like. Thus, if noisy people and places “bug” you, or if your most satisfying school memories were of projects you built or field trips you went on, you don’t need anyone to tell you you’d work best in a quiet place, or that you’re a hands-on or experiential learner.
References
Baran, J. A., & Musiek, F. E. (1999). Behavioral assessment of the central auditory nervous system. In W. F. Rintelmann (Ed.), Hearing assessment (pp. 549–602). Austin, TX: Pro-Ed.
Bellis, T. J. (2002). Developing deficit-specific intervention plans for individuals with auditory processing disorders. Seminars in Hearing, 23, 287–295.
Cacace, A. T., & McFarland, D. J. (2008). Controversies in central auditory processing disorder. San Diego, CA: Plural.
Chermak, G. D., & Musiek, F. E. (1997). Central auditory processing disorders: New perspectives. San Diego, CA: Singular.
Cooper, J., & Gages, G. (1991). Hearing in the elderly—The Framingham Cohort, 1983–1985: Part II. Prevalence of central auditory processing disorders. Ear and Hearing, 12, 304–311.
About the Author
Randi Fredricks, Ph.D. is a practicing therapist, researcher and author specializing in the treatment of anxiety, depression, addiction, eating disorders, and related disorders. Dr. Fredricks is a best-selling author of several books including Healing & Wholeness: Complementary and Alternative Therapies for Mental Health a 650-page compendium and landmark publication that provides a comprehensive overview of complementary and alternative treatments for mental health, with information and research on their effectiveness for treating specific disorders. For more information on Dr. Fredricks work, visit her practice website DrRandiFredricks.com.