Central Auditory Processing Disorder

Central Auditory Processing Disorder (CAPD) is a broad term describing disorders that affect the way the brain processes auditory information. Individuals with CAPD have typical outer, mid, and inner ears; they generally do fine on traditional tone hearing tests. However, they struggle with processing or interpreting auditory information in a less than optimal listening environment. (‘Less than optimal’ varies among individuals. For some, it might mean the noise of a busy street; for others, it might mean anything louder than a quiet room.)  The trouble is not that a person cannot physically hear (though individuals with CAPD can also have physical hearing limitations), but that the brain has difficulties processing that information.

Some symptoms of CAPD are:

  • difficulty understanding speech in noisy environments
  • difficulty following directions
  • difficulty discriminating between similar-sounding speech sounds (mishearing p and b, or there and where)
  • frequently asking for repetition or clarification
  • need more time to process information
  • difficulty paying attention to and remembering information presented orally

Parallels exist between how CAPD appears and other disabilities, like dyslexia, ADHD, or autism, making diagnosis difficult. Noticing and diagnosing CAPD can be further complicated by the fact that many people with CAPD learn various coping skills starting from a young age, such as lip reading, reading body language, or guessing what’s expected of them based on what information was processed.

CAPD coupled with those coping skills can also lead some people with CAPD to dislike talking on the phone—if a person is accustomed to compensating for their difficulties by using a combination of lip reading and reading body language, then the loss of both these options during phone calls can create misunderstandings and confusion.

In children, CAPD can lead to low academic performance and behaviour issues in school, as the child fails to follow verbal instructions or falls behind in lessons. They might be distracted during group discussions or lectures, simply inattentive as a result of not being able to understand. For gifted children, this can be particularly devastating, as the child in question is often keenly aware of the performance gap between themselves and their peers.

The academic difficulties can also affect the correct identification of giftedness, leading educators to suspect ADHD or autism spectrum disorders. These possible misdiagnoses can be further reinforced by observations that a child with CAPD might struggle with social interactions. Inability to follow the flow of conversation in a group, missing jokes or social cues carried primarily through shifts in tone or cadence, or increased processing times can also lead to a child’s peers think they’re rude, slow, stupid, or weird. (Eide and Eide, p6-7)

For a gifted child already struggling to fit in, these extra challenges can further damage self-esteem and help contribute to depression and other mood disorders, especially if the cause of the struggles is unknown.

Just as CAPD manifests differently in individuals, no single treatment is universal. Reaching out to teachers to change the learning environment—by increasing visually-received information, or written instructions—is one way to address concerns at school. Coping skills like practicing active listening and encouraging the child to take an positive role in their listening (for example, letting people know when the background noise level is too louder for them to clearly hear) can also help the child adjust and compensate for CAPD.

For more information about CAPD, check out the American Speech-Language-Hearing Association’s section on CAPD, or Hoagie’s Gifted Education page for more information about the intersection of CAPD and giftedness.