Some Characteristics of Children with Central Auditory Processing (CAP) Problems
Definition: A child with a central auditory processing (CAP) problem has normal hearing but has difficulty in the reception and interpretation of auditory information.
Symptoms. The symptoms of a CAP problem are very similar to the symptoms of a peripheral hearing loss (a hearing loss caused by a problem in the ear itself.) The child with a CAP problem has trouble making sense out of what he or she is hearing. Although the sounds are loud enough, the child has difficulty understanding the message, therefore acting like someone with a hearing problem.
Following is a list of symptoms teachers and parents have often observed in children with a CAP problem.
Does the child…
• have difficulty with reading and spelling?
• pay attention only when he or she wants to, or have difficulty responding to part of the message?
• have difficulty staying on task and completing an assignment or project?
• look around for visual cues from other children before beginning an assignment?
• appear to tune out what is in the environment and become lost in his or her own little world?
• have upper respiratory problems such as allergies, sinus, colds, adenoid problems, or mouth breathing?
• have a history of fluctuating hearing loss, ear infections, earaches, feelings of pressure in the ears, discharge from the ears, or a complaint of noises in the ears?
• ever seem confused about where sounds are coming from and have trouble locating them quickly?
• have difficulty telling the difference between words that sound similar, such as cone/comb?
• demonstrate unusual expressions or body postures while listening (e.g., facial expressions, turning or tilting of the head, turning the body)?
• respond fairly well in quiet situations but have great difficulty listening in noisy environments such as with the TV or in a noisy crowd or classroom?
• have difficulty remembering what is heard (e.g., names, stories, numbers, multiple directions)?
• have trouble saying certain sounds correctly or have delayed language abilities or knowing the meaning of words as well as other children of his or her age group?
• pay attention to sounds within the environment? Is there curiosity about sound and attempts to imitate sounds?
• seem to be able to associate certain sounds correctly with the source (e.g., siren with picture of fire engine)?
• seem to be able to learn children’s songs and TV jingles easily?
• have difficulty remembering information in the order it was said?
• respond to very simple instructions but not to more complex instructions?
• tend to use the same words or phrases over and over instead of responding appropriately to changing verbal information?
• have difficulty associating letters of the alphabet with their sounds?
• seem to be visually alert (e.g., watching the speaker’s face very closely, watching what others are doing)?
• show behaviors that are inappropriate (e.g., aggression, withdrawal, impulsiveness)?
• perform more poorly on tests requiring verbal language understanding rather than a “hands on” test situation?
• seem to be slow to respond to auditory information, as if it takes longer to think through the information?
• have difficulty working independently?
• seem to be easily distracted and appear to have a short attention span?
• perform very inconsistently – sometimes very well and other times very poorly on the same task?
Source: Educational Audiology Association: Great Educational Handouts, Vol. 1, 1998. Developed by Gail G.Rosenberg, M.S., CCC-A, School Board of Sarasota County, FL. Reprinted with permission from the Educational Audiology Association.
Adults with CAPD: Symptoms and Considerations
The symptoms of CAPD in adults are very similar to the above listed for children. What is different for adults is that, since most have undiagnosed APD problems, they have, over time, developed coping mechanisms which may have compensated for some effects, or simply hidden–at least in part– the effects in others. A common hallmark associated with APD is difficulty listening in the presence of background noise or poor acoustical environments; however, the deficit may also be seen in one or more behaviors noted in the American Speech-Language-Hearing Association (ASHA) consensus statement on auditory processing disorders (ASHA, 1996): auditory discrimination, sound localization, difficulty understanding speech in competing noise and/or speech signals of degraded quality. Also recognizing auditory patterns and processing the temporal (time-based) elements of auditory signals can be impaired.
In addition to these deficits, commonly reported symptoms in adults with APD include:
- Lack of music appreciation/ aptitude
- Difficulty following conversation on the telephone
- Difficulty following directions (especially multi-stage)
- Difficulty following long conversations
- Difficulty taking notes
- Difficulty learning a foreign language or technical information where language is novel or unfamiliar
- Social issues—difficulty “reading” others/or being misunderstood by others as to intent or mood
- Difficulty with subtle meanings: sarcasm, subtle humor
- Having a “flat” affect to their speech which lacks appropriate stress and intonation patterns
- Spelling, reading, writing issues
- Organizational problems
Other Significant Factors:
- Peri- or Post-menopausal women often develop symptoms of APD.
- Persons with traumatic brain injury (TBI) have high incidences of APD.
- Persons with persistent communication problems, but normal audiogram results.
- Adults who have children, parents or siblings with auditory, speech/language, reading, or learning problems, especially if they themselves experienced similar academic /developmental problems.
- Adults who experienced recurrent middle ear infections or a history of P.E. (ventilation) tube insertion(s).
- Adults who were diagnosed with attention-deficit problems or dyslexia as students.