Central Auditory Processing
Central Auditory Processing Disorder (CAPD) Testing
Central Auditory Processing (CAP) refers to the way the brain processes and interprets auditory information. This includes the ability to differentiate between sounds, recognize speech in a noisy environment, and comprehend complex auditory signals. CAP plays a crucial role in communication, language development, and learning. Individuals with Central Auditory Processing Disorder (CAPD) have difficulty processing auditory information despite normal hearing. This can result in difficulty understanding speech, following directions, and participating in conversations.
What is tricky about this type of issue is that the anatomy and physiology of the ear are intact and so the audiogram will indicate that the person’s hearing is normal, even though that’s not entirely the case.
Why doesn’t it show up on an audiogram?
The simplest answer to this is that an audiogram is testing for conductive and/or sensorineural hearing loss. It is not meant to tell us what is happening in terms of the brain processing information.
Signs of CAP
There are usually behavioural indicators that help identify when something in the central auditory processing system isn’t working correctly. However, they can range from mild to severe and present differently depending on the person. The following list provides some indicators that may be present in individuals with CAPD.
- Difficulty following or remembering verbal instructions
- Repeating back words and phrases without comprehension (Echolalia)
- Difficulty with memorizing names and places.
- Difficulty repeating words or numbers in sequence
- Frequently replying with "huh" or "what"
- Needs instructions to be repeated multiple times
- Difficulty discriminating between sounds
- Difficulty understanding when there is background noise or more than one person speaking
- Highly distractible/active
- Difficulty learning in large noisy environments (classrooms and homes)
- Speech or language delays
- Poor receptive and expressive language skills
- Insecure, anxious, angry, or aggressive in situations with a lot of auditory stimuli
- Higher stress levels and difficulty in social situations
- Difficulty identifying where a sound is coming from
- Mishearing words or speech with background noise or loud environments
Diagnosing CAP
A hearing healthcare professional will administer a series of assessments designed to put stress on the auditory system in order to see the response. These assessments may include a hearing test (audiogram), listening activities such as repeating words in background noise, repeating two words presented at the same time, number or pitch recognition tests, as well as other tests. These tests will help to determine the areas of issue and what supports may be helpful to the individual.
Who is the CAPD test appropriate for?
CAPD is estimated to affect between 2-7% of children and can persist into adulthood.The CAP tests and methods are suitable for children age 7 and up. Children under the age of 7 are still undergoing brain development and so testing results may not be accurate for this age group.
As CAPD testing requires a reliable response to auditory stimuli it may not be suitable for individuals that are non-verbal, have learning or behavioural disabilities that will prevent them from accurately following directions. It may also not be suitable for individuals with a conductive or sensorineural hearing loss or individuals using their second language for assessment.
At Whisper Audiology, we offer CAP screeners as well as full comprehensive assessments with treatment options.
What should I expect when getting a CAPD test?
Central Auditory Processing (CAP) tests are designed to assess the brain's ability to process and interpret auditory information. These tests can help to identify individuals with CAPD (Central Auditory Processing Disorder), which is characterized by difficulty processing auditory information despite normal hearing. CAP tests can also help to identify specific areas of auditory processing that may be problematic, which can guide treatment recommendations.
There are several types of CAP tests that may be used, depending on the individual's age and specific auditory processing concerns. Some common CAP tests include:
This test involves presenting different auditory stimuli to each ear simultaneously, requiring the brain to process information from both ears. The individual is then asked to repeat back what they heard.
This test measures the ability to understand speech in the presence of background noise. The individual is typically asked to repeat back words or sentences while background noise is played at varying levels.
These tests measure the ability to process the timing of auditory stimuli. For example, the individual may be asked to identify the order of two tones presented in rapid succession. Auditory Figure-Ground Test: This test measures the ability to distinguish target sounds from background noise. The individual is typically asked to listen to a target sound, such as a specific word, while other sounds are played in the background.
These tests measure the ability to integrate auditory information from both ears. For example, the individual may be asked to identify a sound presented to both ears simultaneously, or a sound presented to one ear followed by a sound presented to the other ear.
CAP tests are typically administered by audiologists or other trained professionals. Results are typically reported in terms of a standard score or percentile ranking, which can be used to identify areas of auditory processing difficulty.
Treatment For CAPD
Treatment for CAPD often involves auditory training, which is designed to improve the brain's ability to process and interpret auditory information. This may include exercises to improve sound localization, speech recognition in noise, and temporal processing. Environmental modifications, such as reducing background noise, can also be helpful. Early identification and intervention are critical for individuals with CAPD. Children with CAPD may experience difficulties in academic settings, including reading, spelling, and comprehension. Identifying and addressing CAPD can help to improve academic performance and social communication skills. In conclusion, Central Auditory Processing plays a critical role in communication and learning. Individuals with CAPD have difficulty processing auditory information despite normal hearing, which can lead to difficulties in academic and social settings. Early identification and intervention can help to improve auditory processing abilities and support academic success.
Some recommendations may include:
- Hearing Aids
- Environmental Modifications
- FM System
- Working with a Speech Therapy
- Adapting the acoustic environment
- Individual Education Plan
- Auditory Therapy/CAP Therapy
Call us to book an appointment for Central Auditory Processing assessment today!
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