Beyond Dyslexia: Understanding Central Auditory Processing Disorder

Introduction

Hi! Welcome to our series Beyond Dyslexia! We realize that, for many, all reading difficulties are immediately called dyslexia. There's been growing awareness surrounding dyslexia, which is great, but it's not always the answer. The reality is, there are a lot of reasons a student may be struggling with reading. It takes a solid, trained professional to tease out components of dyslexia and differentiate it from other diagnoses.

When we call everything dyslexia, we can fail our students who are struggling for other reasons. (That being said! For a lot of reading disorders, the treatment remains the same, which is good news. It still matters to know why your kiddo is struggling, though.)

The goal of this blog series is to help you either better understand what factors can contribute to dyslexia, or if you’re a parent, help you understand how a different diagnosis, like the ones we chat about, may impact your students' reading.

Each blog will dive into different diagnoses. We will explore the differences (or the environments) that impact a student’s reading. As we explore the topic (or diagnosis), we can chat about who can diagnosis or identify it and then share with you what interventions are most recommended.

So, welcome. We’re glad you’re here!

What is Central Auditory Processing Disorder (CAPD)?

Our first featured disorder - drum roll, please - is Central Auditory Processing Disorder (CAPD).

CAPD is not as well known as dyslexia (although it’s growing in ‘popularity,’ if you will, now that we have more professionals specializing in this). Understanding how CAPD affects students, how it influences reading, and how we can support students is crucial.

So what is Central Auditory Processing Disorder? Great question. CAPD is a condition that impacts how a person’s brain processes auditory information. It can make it challenging to make sense of the sounds we hear, but there’s not always (or often) an issue with a person’s actual ability to hear. In other words, these kiddos will often pass hearing tests, but still constantly be saying, “wait, what?”

So the hearing of a person with CAPD is essentially functioning as it should, but the brain is struggling to process the intricacies of sound. What this ends up looking like can vary, but a few examples are: difficulty understanding what they’ve heard (spoken language), challenges picking up on subtle nuances in speech (think about how we slightly shift tone to show sarcasm), and a hard time telling the difference between sounds.

My favorite example of this is a student who went through therapy for CAPD and then, on Valentine’s Day, was legitimately astounded to learn, “wait! It’s not ValenTIME’s day???” You can image how much his spelling improved once we realized what we were hearing…

CAPD can also make it incredibly hard when a person is in an environment with background noise, and this can range from an air conditioning running in a classroom to restaurants, to everything in between. Additionally, people can struggle to identify where a sound is coming from.

People with CAPD will sometimes describe this as a fuzzy radio station, especially in noisy environments. They’re often working overtime to decipher what someone says. Here’s an example: You’re at the zoo and someone says (allegedly), “Look at that nunkey!” You know there’s not an animal called a nunkey, so you deduce they must mean monkey.

Can you see how this makes school (and life) challenging? If a kiddo is constantly doing the mental gymnastics to leap to the next-best-thing, they’re missing out on what comes between the word that confused them and the rest of the teaching, instruction, or question.

You can also see how it can make learning vocabulary incredibly challenging because you don’t even know what the real word is supposed to be (again, ValenTIME’s day).

CAPD impacts not only kids at school, but people in the work place who are trying to keep up with a conference room’s conversation while a lot of people are talking. It also impacts you during a night out to dinner when you’re in a noisy restaurant and can’t hear your best friend.

CAPD Symptoms: How to Recognize It

We’ve talked about a few ways that CAPD can present, but let’s look now specifically at how CAPD may show up in our kids. With our students, challenges at school (or home) show up in tasks that ask them to process auditory information. (This is also known as… listening… so you can see how that’s problematic.)

Students with CAPD often have trouble following verbal instructions, especially when it’s noisy. As a quick note, noisy is going to be relative to each person. This can be music, air conditioning, a person humming behind them, etc. There’s no easy way to know or label what “noisy” is as a result. It’s very personal.

Additionally, students who have CAPD often have a very hard time telling the difference between words that sound same. (Again, Valentine versus Valentime.) They also can have a hard time understanding what’s being said in a group setting. This can look like a child having trouble understanding a teacher’s directions when working in a group setting where other students continue to talk.

These students can begin to develop difficulty across all subjects because teaching and learning require listening. They can begin to struggle to learn new vocabulary (especially if they’re not seeing it in print), follow along with new concepts, remember what the teacher asked them to do, and participate in group class conversations.

Unfortunately, it can also start to impact social interactions for a variety of reasons. Obviously if you can’t properly process what was said, conversations immediately become harder. This can be embarrassing if you’re perceived as being always behind or confused. Additionally, you may miss a conversational turn because your brain is still working to process what a “nunkey” is and by the time you realize, everyone else has moved on to the elephants.

Causes of CAPD: Is it Hereditary?

One of the things that is so challenging about CAPD is that we’re aren’t entirely sure what causes it. There may be specific lesions on the brain, but that feels complex.

Essentially, a lesion is any area of tissue on the brain that has been damaged or is abnormal. When it comes to CAPD, that can mean that part of the brain - usually the part that digests sound - is damaged or abnormal. It can be injury, infection, lack of blood to that area of the brain, or even a genetic disorder. This makes CAPD very complex because there are a lot of reasons (that we still don’t clearly understand) that may influence, impact, or cause CAPD.

As far as CAPD being heredity, there is some research that it runs in families. That being said, it’s usually genetic predispositions and environmental factors combined. What that means is someone may have the genetic component (think light switch), but it can be “flipped on” by the environment or an illness (or maybe not).

Other considerations are prenatal risk factors. Here are some examples: prenatal exposure to infections like rubella, maternal drug or alcohol use, poor maternal nutrition, or birth complications like oxygen deprivation.

Again, these things alone aren’t going to necessarily “cause” CAPD, but if there are genetic predispositions, it can increase the likelihood.

It’s important to remember that CAPD is not caused by a person’s lack of intelligence or effort. People with CAPD can still be incredibly capable and intelligent.

How CAPD Affects Social Skills and Classroom Performance

In earlier portions of the blog, we briefly touched on how CAPD can impact people’s lives, especially the lives of our kiddos. Let’s a take a minute though to talk more about social skills, classroom performance, and CAPD combined. We briefly chatted about how tone can be unclear when a student has CAPD, but it’s not always clear how that can present at home or in the classroom.

When we struggle to interpret tone, this can make it hard to understand the underlying emotion of a person’s message. In the classroom, a frustrated teacher’s tone may go unnoticed, leading to detentions or the assumption that the student is trying to be disrespectful. At home, or in social circles, missing out on sarcasm can mean you don’t understand the joke, or (perhaps more detrimentally) don’t realize someone isn’t joking. You can see how this can lead to confusion for all parties involved, especially when the kiddo wasn’t trying to be disrespectful or take something too far.

There are often less realized consequences of CAPD, but some more academically-meaningful ones are CAPD’s impact on a student’s ability to follow directions, focus during classroom teaching, and participate in group discussions.

When your brain is struggling to digest sounds, and you’re then compensating for this difficulty, you aren’t going to pick up on all the important components of the classroom. This occurs because of all the reasons discussed above. In short, your brain is working hard to both listen, digest, and respond.

The really hard part? Our kids are aware something is different. They’re trying to listen, participate, and be involved, but part of their brain is actively making things harder for them. We care about this because it impacts their self-esteem, can cause anxiety, and will lead to frustration which is often tied to frequent misunderstandings.

Diagnosis and Assessment of CAPD

The main question parents have when they start to suspect that CAPD may be the underlying cause of their child’s academic or reading struggles is… what do I now?

The good news is, specific and special tests exist that measure how your student’s processing sounds. Finding an audiologist that specializes in the diagnosis and treatment of CAPD helps tremendously.

The tests audiologists administer for CAPD are built to measure how well your child’s brain can filter out (block) background noise, how well their brain recognizes noise, and how the brain understands spoken language.

Here are three common tests:

1. Gap Detection Test: It’s a common way to assess CAPD. Your student will listen to sounds that are divided by gaps. The goal is to detect the gaps, and the administrator is looking to see how small of a gap can exist before your kiddo can no longer tell that it’s there. Essentially, it’s looking at auditory processing of signals related to the time the brain is taking to process at a fine level. The question is: how finely can a brain recognize timing of sounds at this minute level.

2. Dichotic Digits Test: In this test, the student hears different sets of numbers at the same time in one ear, and another set is played in the other ear. The student tested is asked to recall what they heard from either each ear, or all the information at once. This looks at how the brain can both process and separate information that comes in to both ears at one time. It focuses on how well the brain can both manage and tell the difference between auditory input.

3. Filtered Words Test: This test is a tool that helps us assess how a student can listen to words that have been “partially filtered” to essentially muffle the words. The student then has to repeat the words. This is how we can tell how a student may process words (or conversation… or teaching…) that is delivered in less-than-ideal scenarios. (This goes back to remembering that these less-than-ideal- scenarios will differ from student to student.)

Treatment Options Accommodation Strategies for CAPD

When it comes to CAPD, treatment does exist, but many students also benefit from accommodations.

Let’s start by chatting about treatment (which actually includes accommodations). Treatment is often a combination of programs like auditory training programs, speech therapy, and environmental accommodations.

In other words, a team of people who know what they’re doing is often the best approach. When it comes to auditory training programs, there are several variations.

There are computer-based programs that focus on discriminating between sounds.

Additionally, programs target increasing a student’s ability to better understand the timing between sounds. And finally, there are programs that help students improve their listening skills in noisy environments. These look at helping students increase their ability to hone in on important information even when environments are noisy.

When it comes to speech therapy, SLPs can help improve listening skills, support a student’s ability to distinguish between sounds/words, and work on improving phonological awareness. Finally, an SLP can help improve auditory memory and comprehension. In other words, they make it easier to follow directions and understand more complex information.

A final way to support a student is through accommodations in the classroom. As always, accommodations are meant to be student-specific and not a one-size-fits-all. That being said, here are a few classroom accommodations that may help your student:

• Preferential seating which minimizes background noise and distractions
• Assisted listening devices that amplify a teacher’s voice like an FM system
• Providing notes
• Allowing additional time to process
• Providing quiet workspaces

At home, a student with CAPD may benefit from:

• A quiet, distraction free study area
• Visual aids
• Tasks broken into smaller steps
• Frequent breaks to prevent overwhelm
• Consistent routines and clear communication

Will My Child Outgrow CAPD?

For the most part, no. A student will not simply “outgrow” CAPD. That being said, kids are incredibly capable, resilient, and good at responding to intervention and support.

When students have access to appropriate treatment, strategies, accommodations, and parent support, they’re incredibly capable of offsetting the impact CAPD has on their lives and academic careers.

If we can combine early identification, targeted intervention, and support (both emotional and academic), our kids can absolutely improve how they process and respond to sounds.

It’s also important to note that progress varies. For some, as they grow and their brain develops and mature, the symptoms of CAPD they experience lessens. For others, they become capable of independently accommodating and creating environments that best match what their brain needs.

Conclusion

While Central Auditory Processing disorder cannot simply be outgrown, hope and help exist! We know that students respond best when they have been identified early and provided with targeted and consistent support.

This means our kiddos with CAPD can still absolutely thrive academically. While progress varies because each student and brain are so different, we do know that some symptoms may decrease as our students mature.

Additionally, even symptoms don’t decrease, we know that students effectively learn how to compensate and support their needs as they become more familiar with their our needs. Overall, with the right supports, interventions, and resources, our students living with CAPD succeed and flourish. To schedule a consultation. visit LD expert today!