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People with Central Auditory Processing Disorders may appear to suffer from hearing loss or concentration problems, but their brains have difficulty processing auditory stimuli. What is CAPD, what are the symptoms, and how is it diagnosed?

Central Auditory Processing Disorders are hard to understand, to the point that some people, including some doctors, claim they don't exist at all. "Hard to understand" also describes a good bit of the difficulties encountered by individuals with CAPDs, because a lot of the things people tell them may simply not make any sense.

What does that mean in real terms? Imagine living in a world where you can't understand what people tell you, because you're hearing something really quite different to what they're actually saying. Imagine encountering even more difficulties in the presence of any type of background noise and having to spend all your energy correctly decoding what is being said. Not only will you still not understand everything correctly, you'll also be unable to recall information afterwards because your working memory was spent trying to comprehend the message.

While this is obviously incredibly frustrating, other people may not have any idea what's going on and could label you as inattentive, rude, or simply not very intelligent. 

What Is Central Auditory Processing Disorder?

What causes CAPDs, then? Are we talking about a hearing impairment? No. Deaf people can't hear sounds because they never get to the brain. Most individuals affected by Central Auditory Processing disorders do not suffer from any kind of hearing loss, so testing will reveal normal hearing. Auditory stimuli do reach the brain, but they get "scrambled" — are improperly processed — once they get there. 

Central Auditory Processing Disorder, or CAPD for short, refers to a physical impairment that impacts the way in which the brain processes auditory stimuli including verbal communication.  

Rather, CAPD is an umbrella term that refers to a group of disorders that affect auditory processing in different ways, which is why you'll see the term pluralized quite often. Since auditory processing is a complex process, quite a lot can go wrong between the physical input of a sound and the brain's interpretation of it. CAPD comes in several sub-types that describe exactly where the impairment lies. Individuals with CAPD may have one or more of these issues. 

Auditory Decoding Weakness

Auditory decoding weakness represents the classic profile of CAPD. Patients display auditory discrimination difficulties, meaning they have trouble telling different sounds apart, particularly in the presence of background noise. They'll often ask what you just said, and are unlikely to be able to repeat what you said back to you. In addition, they may substitute a similar-sounding word for the one they had intended to say, and may encounter problems with decoding letters (learning to read) as well. 

Prosodic Weakness

Individuals with a prosodic weakness find coping with the patterns and rhythm of speech a challenge; their speech may sound monotonic and cognitive tests reveal verbal skills are more advanced than non-verbal skills. Those with this CAPD profile may misunderstand the underlying meaning of words, and also often have poor social skills. 

Integration Weakness

Individuals with an integration weakness will have difficulty following (complex, multi-step) verbal directions. They will also typically struggle with note-taking, physical coordination, following lengthy conversations, and functioning in the presence of background noise. Components of speech may be missing and spelling and reading may be hard. 

Output-Organization Weakness

This CAPD profile pertains to articulation, expressive language, eloquence and recalling information — particularly in a certain order. These individuals may have poor organizational skills in general and they may demonstrate an inability to function in noisy environments.

Associative Weakness

Receptive language difficulties are characteristic to those with associative weaknesses. The meaning of speech is often unclear to these individuals, who also have a tendency to take expressions very literally. Expressive difficulties go along with comprehension challenges. Grammar and words with multiple meanings will be tricky. 

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