Central Auditory Processing Deficit (CAPD)
Auditory Processing (AP), Auditory
Processing Disorder (APD), Central
Auditory Processing (CAP), Central Auditory Processing Dysfunction
(CAPD), or Central Auditory Processing Deficit (CAPD).
Children with this disorder may demonstrate difficulties in speech,
language, and/or learning, especially in the areas of spelling and
reading. They may also appear hearing impaired, be inattentive,
easily distractible, and have difficulty following oral directions.
A list of some common issues:
- Poor language discrimination or comprehension, often
hears the wrong word
- Lack of interest in verbalization
and communication
- Hyper-acute and/or painful hearing
- complaints of sounds causing pain or discomfort
- noise or tinnitus in the ear
- startle responses to loud noises
- Inappropriate vocal intensity (volume)
- Inappropriate expression and interaction
- Poor eye contact
- Poor academic performance
- Impulsivity and restlessness
- Distractibility
- Lethargy
- Irritability
- Lack of independence and self-esteem
A student with CAPD student has normal
hearing, but difficulty
analyzing or making sense of what they hear.
Diagnosis of CAPD would be evaluated
by an audiologist and
speech/language therapist. While the
speech and language therapist can determine the areas of language the
child has difficulty with, the audiologist can determine hearing acuity
and middle ear function. Your child needs to be 7 or older to get
an evaluation for CAP.
Regular audiologists
do not have the training or equipment for this; an audiologist who
specializes in CAPD evaluations is necessary. You can find a list of CAPD audiologists.
A CAPD evaluation can determine CAPD
subtype
(s).
This website has
a checklist of the CAPD symptoms and five
subtypes.
Learning
About CAPD (for a chart of five
subtypes, scroll down 1/4 way
down the page) and has some helpful links.
Types of therapies / programs available for children with CAPD?
Two types:
1. Sound Therapy or Auditory Integration
Training (AIT)
Auditory integration training
addresses hearing distortions, hyperacute hearing, and sensory
processing anomalies which cause discomfort and confusion in persons
suffering from learning disabilities, including autism (Stehli, 1995).
The theory that human behavior is
largely conditioned by the manner in which one hears (Berard,
1993). The therapy is harmless and does not require an
evaluation so it can be used on anyone 3 or older.
Links on Auditory Intervention Techniques (AIT):
These three programs have been around
for 20 years, they use an older
technology. (The
majority of the research on AIT's
involve autistic children.):
Tomatis
Berard
- Earducator
Samonas -
Spectrally
Activated Music of Optimal Natural Structure
Related AIT method links:
Neuro
Therapeutics
(Overview of AIT methods, and
give some comparisons of the therapies, located
in Oregon.)
Project
Child (Occupational therapy
services and sound training. Center for Holistic
Integration, Listening and Development located Beverly, MA).
These programs
use the newer
technological sound production:
Earobics - Computer based program
with speech games to improve listening skills. Can be useful for
students with decoding (phonemic awareness) deficits. It is a bargain
out of the other auditory therapies. Recommended 15-20 min/day; 3
levels, ages 4-7, ages 7-10 and older.
The Listening Program (TLP)
- Enhanced classical music on 8 CD's with a specific listening order
and intensity. Good prep for FFW, for severe cases, TLP
prep can make
FFW much easier to get complete the program.
FastForWord
(FFW) -
Computer
based program with games that teaches processing of speech sounds and
works on
short term auditory memory and auditory sequencing. The program
essentially attempts to correct neural pathways with process the sounds
of language through an intensive set of drill and practice. FastForWord
trains the auditory system to process the sounds of speech more
efficiently. It can be a good choice for increasing auditory processing
speed and auditory memory. (It seems to works for those who have a
specific subtype of auditory processing problem, sometimes called
"auditory decoding deficit". (100
min/day, 5
days/week; 4-8 weeks; requires a provider).
Holistic
Therapies - Music Therapy:
The Mozart
Effect® - Is an inclusive term signifying the transformational
powers of music in health, education, and well-being. It represents the
general use of music to reduce stress, depression, or anxiety; induce
relaxation or sleep; activate the body; and improve memory or
awareness. Innovative and experimental uses of music and sound can
improve listening disorders, dyslexia, attention deficit disorder,
autism, and other mental and physical disorders and injuries.
Hemi-Sync®
- helps alter brainwaves with
multi-layered patterns of sound frequencies. When you hear these
through stereo headphones or speakers, your brain responds by producing
a third sound (called a binaural beat) that encourages the desired
brainwave activity.
Chanting
Throat Tones - Variety of chanting
links from various cultures. Gregorian Chants are used with music
therapies
(i.e. Tomatis Method) and support AIT and can be used as a follow up or
supplement
to other therapies.
2. Body Work
Bodywork is a fundamental therapeutic
approach to CAPD.
Usually bodywork is provided in the
form of Occupational Therapy (OT).
Severe CAPD often interferes with
vestibular system development
(timing, rhythm, balance) and often contributes to sensory integration
(SI) disorder.
An Occupational Therapy approach that
specifically addresses the issues
of CAPD children:
NeuroNet
is a
sensory and motor therapy program. Creating rhythmic integration
of vision, hearing, balance and movement. (It is new and not
widely available.) Can be helpful for children with certain types
of auditory processing disorder that interfere with vestibular
development (Vestibular problems could include: balance (difficulty
learning to ride a bike), rhythm (difficulty clapping hands in time to
music), timing (very slow processing, could be motor, auditory, visual,
thinking, etc.)
Balametrics is a system of
materials and activities that use
balance therapy and sensory integration to stimulate the neural
networks in the brain. Also aimed at development of the
vestibular system. Brain Gym and Balametrics stimulating both sides of
the brain to work together. Balametrics can be done as a home
program. (A form of bodywork that is incorporated into NeuroNet.)
Brain Gym® educational kinsesiology, movement
exercises to access the
whole brain, works to get the right and left hemispheres of the brain
working together and accessing some parts of the brain that are
not readily getting accessed. Is a program of
physical activities that enhance learning ability. Works on
increasing relaxation, blood circulation and oxygenation of the brain,
stimulating both sides of the brain to work together, etc.
(Can be provided by Occupational Therapist (OT), Brain Gym. It is
probably a good follow on to SI
therapy or done in conjunction with SI OT as it helps to
fuse together
some of the Sensory Brain connections. It combines
techniques
"borrowed" from many places including Tai Chi,
sensory/motor and vision
therapy.
Interactive
Metronome (IM) - works on motor
planning and coordination; done
through a provider (15 hours). This program can be helpful
for motor problems (child poor at sports, motor coordination in
general, or handwriting).
After sound and
bodywork therapies have done all they can to reduce the
sensory-motor deficit (s), cognitive training might be the next step:
Cognitive training programs:
PACE =
Processing and Cognitive
Enhancement
It is a cognitive
training program. A brain-training program for enhancing mental
skills. BrainSkills is
a "Do-It-Yourself" version of the PACE training program. It is intended
for people who will dedicate themselves to the discipline and intensity
required. It can
be used
at home, BrainSkills starts with exercises at the age 6. It has a
strong auditory processing component (Including segmenting, blending or
phoneme manipulation skills.)
Audiblox
is a system of
cognitive exercises, aimed at the development of foundation learning
skills. Audiblox can help with word memory (less sounding out the
same word repeatedly during the same page) and visual memory.
Does work on digit span and auditory memory. Audiblox despite its
name, does not have a strong auditory processing component (No
segmenting, blending or phoneme
manipulation skills).
was initially developed as a
preschool readiness program, so it includes exercises suitable for 4
years
and up. (cost much
less then PACE.)
Therapies that
usually help develop
attention skills are
Audiblox, PACE, and Interactive Metronome.
For reading remediation
(Decoding subtype), students with
Phonemic Awareness (PA) deficits and decoding issues:
A decoding deficit means difficulty
with the discrimination of speech
sounds which has a certain impact on learning to read.
The
Lindamood Phonemic Sequencing™ (LiPS™) Program stimulates phonemic
awareness. (The original name was the ADD Program, Auditory
Discrimination in Depth). The program which has been proven by
research to help this area.
Telian Learning Concepts
(TLC) and
Wisnia-Kapp Reading Programs, Inc. (WKRP) Both these programs teach phonemic
awareness and phonics. Both developers are located in Massachusetts.
Earobics - Computer based program
with speech games to improve listening skills. Can be useful for
students with decoding (phonemic awareness) deficits. It is a bargain
out of the other auditory therapies. Recommended 15-20 min/day; 3
levels, ages 4-7, ages 7-10, and older.
Reading
Reflex, by McGuiness is a
how-to guide for the
reading instruction method they've
developed called Phono-Graphix. Their approach, stresses the 43
sounds of the English language, treating
letters as symbols of these sounds. Phono-Graphix
teaches children to
separate each phoneme in a word so that the phonemes can later be
blended back in the right order to work on segmenting,
blending, and phoneme manipulation skills (often lagging in those with
auditory processing
problems). The book is written for parents who want to tutor a
child at home.
Phono-Graphix has an excellent
auditory processing component.
Book:
When the Brain Can't Hear : Unraveling the
Mystery of Auditory Processing Disorder (2003)
by Terri James Bellis, Ph.D
Like Sound Through Water: A Mother's
Journey Through Auditory Processing Disorder (2002)
by Karen J. Foli,
(forward by Edward M. Hallowell)
Here
some related links:
Berard auditory integration
training (AIT), (AIT FAQ, several Mass. providers)
Society for Auditory Intervention Techniques
(SAIT)
(Lots of good articles on therapies, located in Oregon.)
Innovated
Development for Education Achievement (IDEA),
(AIT FAQ,
located in Connecticut.)
The
Georgiana Institute
(FAQ,
compares Berard
and the Tomatis methods,
located in Connecticut.)
Parents who have children with CAPD have found this Auditory Processing Yahoo group
extremely helpful.
