Could Your Child Have CAPD?
What is central auditory processing disorder (CAPD)?
CAPD occurs when an individual has excellent hearing but has difficulty understanding speech and concentrating in the presence of background noise. Just the presence of sound (pencils tapping, birds chirping, etc.) can challenge an inefficient central auditory nervous system and make it more difficult for students and adults to focus on, and listen to, the task at hand. The
Foundation has observed that gifted individuals with CAPD often appear anxious, easily distracted, exhausted, and/or emotionally sensitive as a result of not being able to connect to their auditory environments in a meaningful way.
Can a gifted individual have CAPD?
Yes, CAPD occurs independently of other strengths, including strong intellectual abilities. The Foundation has evaluated many gifted individuals including doctors, engineers, teachers, attorneys, professional athletes, musicians, engineers, etc. The common characteristic these people share is that they expend extra effort to listen and focus in the presence of background noise throughout their day. They can be irritable and frustrated at the end of the day as well as lack the energy to do other activities, including spending time with their family or socializing with friends. Regardless of where intellectual abilities fall, if CAPD is present, one can benefit from solutions that help manage their CAPD.
Why should we care about CAPD?
“I’m stupid.” “I’m lonely.” “I’m not smart.” “I don’t understand.” “I’m confused.” “I’m not good enough.” “You’re a bad kid.” “You’re lazy.” These are all phrases the Foundation’s gifted clients have said to us or have heard from others. Although these phrases are not true, our clients often believe them. If we do not understand how their auditory system is perceiving their environment, and make realistic expectations for what their auditory system can physically do, we may set these children up to fail every day. We would never tell a blind student to go home every day and try harder to read a book, just as we should not tell an individual with CAPD to try harder to listen and focus during their day.
What areas of life can be impacted by CAPD?
CAPD can impact academic performance, work performance, self-esteem, social relationships, overall well-being, and quality of life. Many gifted individuals evaluated at the Foundation have been accused of being lazy, unmotivated, rude, etc., which is unfair to that individual and incorrect. If CAPD goes undiagnosed and proper management is not implemented, expectations for a person with CAPD can be unreasonable and unrealistic.
Can you outgrow central auditory processing challenges?
The central auditory nervous system is a maturing system. Some individuals have grown out of their central auditory processing challenges, while others have not. CAPD can also be genetic. The majority of families seen at the Foundation suspect a genetic component. In these cases, individuals benefit from accessing tools throughout their life to better control their auditory environment.
What is the best referral process?
Many of the Foundation’s gifted clients have easily passed CAPD screening measures as these measures are easy to beat and do not access the entire central auditory nervous system. A conversation with an audiologist who specializes in CAPD regarding concerns and the behaviors presented will provide useful information to determine if a central auditory processing evaluation may be beneficial. The top behaviors reported by a random sampling of Able Kids Foundation gifted clients diagnosed with CAPD were sensitivity to sounds, easily distracted, difficulty following directions, easily frustrated, experiencing anxiety, history of ear infections, mishearing what is said, forgetful, appearing confused in noisy places, weak grasp of phonics, mispronouncing words, and confusing similar sounding words. Many gifted children with CAPD have “superhearing”: because their hearing is more sensitive than others (hyperacuity), they hear more and have a difficult time filtering out unimportant information they should ignore.
If someone has been to an audiologist and told their hearing or their child’s hearing is fine, can they still have CAPD?
Yes, this is a common scenario encountered at the Foundation. Most audiologists do not provide central auditory processing testing. If you or your child have normal hearing, but struggle to understand and focus in the presence of background noise, it is important to find an audiologist who has received sufficient training and is experienced in the diagnoses and management of CAPD.
Are all test batteries equivalent?
No, not all test batteries are created equal. Some tests are very easy to pass despite an individual having central auditory processing challenges. Similarly, if an eye chart is made big enough, there is a point when even those with visual challenges can pass it. Students who pass insufficient test batteries fall through the cracks and are continually misunderstood. Adequate test batteries will have cross-checks of performance, use age-normed data, and utilize measures that evaluate both the cortical and brainstem levels of the auditory system.
What are the management approaches for CAPD?
There are several different approaches utilized by audiologists for the management of CAPD. These approaches include the use of FM systems, compensatory strategies (preferential seating, using sound-attenuating headphones/earplugs, providing written directions, etc.), hearing aids, and the use of a passive filter. The Foundation employs an individualized data-based approach, which can include the use of a passive filter, compensatory management, and an FM system.
Final Thoughts
If we listen to and observe our children, they will tell us everything we need to know about how they are affected by their auditory environment. There are classic behaviors associated with CAPD that are easy to identify, if you understand what to look for. Central auditory processing disorder can impact one’s quality of life and should be considered and investigated.
Dr. Megan Locke is Executive Director of Able Kids Foundation in Fort Collins, Colorado. Able Kids Foundation specializes in the diagnosis and management of central auditory processing disorder. Founded in 2006, the Foundation’s testing and management program has attracted individuals from 50 states and 29 countries, ranging from 3 to 73 years of age.
