Central Auditory Processing Disorders

Page 1 of 2 [ 20 posts ]  Go to page 1, 2  Next

Sophist
Veteran
Veteran

User avatar

Joined: 23 Apr 2005
Age: 42
Gender: Female
Posts: 6,332
Location: Louisville, KY

07 Jan 2006, 3:20 pm

For some reason it seems a fair amount of people have been mentioning/talking/asking about this lately and I found a site which gives a fairly good overview. Central Auditory Processing Disorders (CAPDs) are common throughout the Attention Behavioral Continuum (ABC)-- ASDs are in this grouping. There's more info on the webpage but I'm putting mainly the description on here.

http://www.tsbvi.edu/Outreach/seehear/s ... ditory.htm

Quote:
Central Auditory Processing Disorders - An Overview of Assessment and Management Practices

By Mignon M. Schminky and Jane A. Baran
Department of Communication Disorders
University of Massachusetts, Amherst, Massachusetts
Reprinted from Fall 1999 Deaf-Blind Perspectives,
Published by Teaching Research Division of Western Oregon University for DB-LINK


Hearing is a complex process that is often taken for granted. As sounds strike the eardrum, the sounds (acoustic signals) begin to undergo a series of transformations through which the acoustic signals are changed into neural signals. These neural signals are then passed from the ear through complicated neural networks to various parts of the brain for additional analysis, and ultimately, recognition or comprehension. For most of us, when someone talks about hearing abilities, we think primarily of the processing that occurs in the ear; that is, the ability to detect the presence of sound. Likewise, when someone is described as having a hearing loss, we assume that this individual has lost all or part of the ability to detect the presence of sound. However, the ability to detect the presence of sounds is only one part of the processing that occurs within the auditory system.

There are many individuals who have no trouble detecting the presence of sound, but who have other types of auditory difficulties (e.g., difficulties understanding conversations in noisy environments, problems following complex directions, difficulty learning new vocabulary words or foreign languages) that can affect their ability to develop normal language skills, succeed academically, or communicate effectively. Often these individuals are not recognized as having hearing difficulties because they do not have trouble detecting the presence of sounds or recognizing speech in ideal listening situations. Since they appear to "hear normally," the difficulties these individuals experience are often presumed to be the result of an attention deficit, a behavior problem, a lack of motivation, or some other cause. If this occurs, the individual may receive medical and/or remedial services that do not address the underlying "auditory" problem.

Central auditory processes are the auditory system mechanisms and processes responsible for the following behavioral phenomena.

1. Sound localization and lateralization
2. Auditory discrimination
3. Temporal aspects of audition including: temporal resolution,
temporal masking, temporal integration and temporal ordering.
4. Auditory performance with competing acoustic signals
5. Auditory performance with degraded signals

These mechanisms and processes apply to nonverbal as well as verbal signals and may affect many areas of function, including speech and language (ASHA, 1996, p. 41).

WHAT IS MEANT BY THE TERM "CENTRAL AUDITORY PROCESSING?"
Katz, Stecker & Henderson (1992) described central auditory processing as "what we do with what we hear." In other words, it is the ability of the brain (i.e., the central nervous system) to process incoming auditory signals. The brain identifies sounds by analyzing their distinguishing physical characteristics frequency, intensity, and temporal features. These are features that we perceive as pitch, loudness, and duration. Once the brain has completed its analysis of the physical characteristics of the incoming sound or message, it then constructs an "image" of the signal from these component parts for comparison with stored "images." If a match occurs, we can then understand what is being said or we can recognize sounds that have important meanings in our lives (sirens, doorbells, crying, etc.).

This explanation is an oversimplification of the complicated and multifaceted processes that occur within the brain. The complexity of this processing, however, can be appreciated if one considers the definition of central auditory processing offered by the American Speech-Language-Hearing Association (ASHA).

This definition acknowledges that many neurocognitive functions are involved in the processing of auditory information. Some are specific to the processing of acoustic signals, while others are more global in nature and not necessarily unique to processing of auditory information (e.g., attention, memory, language representation). However, these latter functions are considered components of auditory processing when they are involved in the processing of auditory information.

WHAT IS CENTRAL AUDITORY PROCESSING DISORDER (CAPD)?
CAPD can be defined as a deficiency in any one or more of the behavioral phenomena listed above. There is no one cause of CAPD. In many children, it is related to maturational delays in the development of the important auditory centers within the brain. Often, these children's processing abilities develop as they mature. In other children, the deficits are related to benign differences in the way the brain develops. These usually represent more static types of problems (i.e., they are more likely to persist throughout the individual's life). In other children, the CAPD can be attributed to frank neurological problems or disease processes. These can be caused by trauma, tumors, degenerative disorders, viral infections, surgical compromise, lead poisoning, lack of oxygen, auditory deprivation, and so forth.

The prevalence of CAPD in children is estimated to be between 2 and 3% (Chermak & Musiek, 1997), with it being twice as prevalent in males. It often co-exists with other disabilities. These include speech and language disorders or delays, learning disabilities or dyslexia, attention deficit disorders with or without hyperactivity, and social and/or emotional problems.

WHAT ARE SOME OF THE BEHAVIORAL MANIFESTATIONS OF CAPD?
Below is a listing of some of the common behavioral characteristics often noted in children with CAPD. It should be noted that many of these behavioral characteristics are not unique to CAPD. Some may also be noted in individuals with other types of deficits or disorders, such as attention deficits, hearing loss, behavioral problems, and learning difficulties or dyslexia. Therefore, one should not necessarily assume that the presence of any one or more of these behaviors indicates that the child has a CAPD. However, if any of these behaviors are noted, the child should be considered at risk for CAPD and referred for appropriate testing. Definitive diagnosis of a central auditory disorder cannot be made until specialized auditory testing is completed and other etiologies have been ruled out.

1. Difficulty hearing in noisy situations
2. Difficulty following long conversations
3. Difficulty hearing conversations on the telephone
4. Difficulty learning a foreign language or challenging vocabulary words
5. Difficulty remembering spoken information (i.e., auditory memory deficits)
6. Difficulty taking notes
7. Difficulty maintaining focus on an activity if other sounds are present child is easily distracted by other sounds in the environment
8. Difficulty with organizational skills
9. Difficulty following multi-step directions
10. Difficulty in directing, sustaining, or dividing attention
11. Difficulty with reading and/or spelling
12. Difficulty processing nonverbal information (e.g., lack of music appreciation)

There are a number of behavioral checklists that have been developed in an effort to systematically probe for behaviors that may suggest a CAPD (Fisher, 1976; Kelly, 1995; Smoski, Brunt, & Tannahill, 1992; Willeford & Burleigh, 1985). Some of these checklists were developed for teachers, while others were designed for parents. These checklists can be helpful in determining whether a child should be referred to an audiologist for a central auditory processing assessment.


_________________
My Science blog, Science Over a Cuppa - http://insolemexumbra.wordpress.com/

My partner's autism science blog, Cortical Chauvinism - http://corticalchauvinism.wordpress.com/


Musical_Lottie
Veteran
Veteran

User avatar

Joined: 14 Sep 2005
Age: 34
Gender: Female
Posts: 656
Location: Bedfordshire, East of England

07 Jan 2006, 4:05 pm

Yes, very good idea to start a thread for this, Sophist :) I also found this quite a good webpage

http://www.ldonline.org/ld_indepth/process_deficit/living_working.html

Quote:
The easiest, quickest way to communicate is simply to say something and then deal with the other person's reply, right? Right, unless your listener has a CAPD (Central Auditory Processing Disorder), then your remark might come through with certain words drowned out by other noises, or with some words sounding like different words or as meaningless strings of verbiage. You might begin to suspect this when the other person's expression doesn't register understanding, or if he,"answers the wrong question," or he asks you for additional information which most people would have been able to infer from what you just said.

Most of us aren't that sophisticated about CAPDs, however, and are much more likely to wonder if the listener is just not very intelligent or doesn't really care about us and what we are saying. People with CAPDs (which are usually part of a learning disability) have been embarrassed by situations and reactions like these all their lives.

A CAPD is a physical hearing impairment, but one which does not show up as a hearing loss on routine screenings or an audiogram. Instead, it affects the hearing system beyond the ear, whose job it is to separate a meaningful message from non-essential background sound and deliver that information with good clarity to the intellectual centers of the brain (the central nervous system). When we receive distorted or incomplete auditory messages we lose one of our most vital links with the world and other people.

These "short circuits in the wiring" sometimes run in families or result from a difficult birth, just like any learning disability (LD). In some cases the disorder is acquired from a head injury or severe illness. Often the exact cause is not known.

Children and adults whose auditory problems have not been recognized and dealt with are forced to invent their own solutions. The resulting behaviors can mask the real problem and complicate not only school and work, but even close relationships, where communication is so important. Advice like "Pay attention," "Listen," or "Don't forget --," hasn't helped either.

It takes specialized testing to identify a CAPD. Some of the tests used by educational therapists, neuropsychologists, and educational psychologists give at least an indication that a CAPD might be present. These include tests of auditory memory (for sentences, nonsense syllables, or numbers backward), sequencing, tonal pattern recognition or sound blending, and store of general information (which is most often acquired through listening). The most accurate way to sort out CAPDs from other problems that mimic them, however, is through clinical audiologic tests of central nervous system function. These are better at locating the site of the problem and reducing the effects of language sophistication on the test results.

Do your best to choose a professional who is familiar with CAPDs, is comfortable working with adults, and who can write a useful and understandable report. You might ask: "How many adults with auditory processing disorders do you work with in a year?" or, "What kind of a report would you write to help me or my employer understand my problem?" Nowadays there are many ways professionals can help you streamline your coping abilities. Also, there may be conditions accompanying the CAPD which are medically treatable like allergies, Attention Deficit Disorder, Tourette syndrome, or nutritional deficiencies.

This checklist of common features of CAPD might lead you to consider such a possibility for yourself, a co-worker, or a friend or relative, if several items apply:

Talks or likes T. V. louder than normal.
Interprets words too literally.
Often needs remarks repeated.
Difficulty sounding out words.
"Ignores" people, especially if engrossed.
Unusually sensitive to sounds.
Asks many extra informational questions.
Confuses similar-sounding words.
Difficulty following directions in a series.
Speech developed late or unclearly.
Poor "communicator" (terse, telegraphic).
Memorizes poorly.
Hears better when watching the speaker.
Problems with rapid speech.
CAPD is a physical disorder under the protection of the ADA (Americans with Disabilities Act). But put yourself in the other person's place: how can your supervisor or co-worker possibly know whether you made a mistake because of impaired hearing, lack of interest, or stupidity? You need to know how to identify the problem so that you can explain it to others and ask for what you need. If you grew up at a time or place where your CAPD wasn't recognized you might need a knowledgeable professional to give you some insight into this. But if you listen to your feelings rather than trying to talk yourself out of them, you can generally get a good sense of the help you would like. Thus, if noisy people and places "bug" you, or if your most satisfying school memories were of projects you built or field trips you went on, you don't need anyone to tell you you'd work best in a quiet place, or that you're a hands-on or experiential learner.

So what do you tell them at work to keep this from becoming another one of those jobs where you quit before they can fire you? Here are some ideas. Do you:

1. Have trouble hearing clearly when it's noisy? This can be a failure of one or more of the automatic noise-suppression systems of the brain. It is reasonable to ask for a desk away from the computers or for a sound-absorbant partition. It is both polite and efficient to say, "I'm interested in what you're saying. Let's move away from this noise." A mild-gain amplifier can help you hear accurately on the phone over the noise of a busy office.

2. Sometimes make "silly" mistakes or "careless" errors? Intrusions of random sounds which normal-hearing people can ignore may break your concentration so that you lose your place and skip a task (like carrying a number or writing a small word in the sentence). Take the work to a quieter place if necessary. Earplugs (sometimes in only one ear which suppresses noise less well) are a possible emergency solution. Make a deal with someone else to proofread your work.

3. Miss important sounds or signals that others hear easily? Poor noise suppression and sound localization skills can cause important voices or signals to "disappear" in the general background. It will save others time if they know to tap you on the shoulder before they launch into their conversation. Telephone bells and alarms can be adjusted for volume or pitch, or a visual or tactile signal can be added.

4.Get important messages wrong? Sound distortion, sequencing, auditory-visual transfer, and/or short term memory problems may be contributors. You can ask for the information in writing, double-check later with someone else who was present, or let the speaker know that she's going too fast. Even normal listeners often say, "Let me read that back -- ," or "That's '3489'?"

5.Forget instructions? Inefficient short term auditory and rote memory (or habituation) may figure in this. Get in the habit of taking notes; set up a logbook for longer-term assignments; ask that the information be put in a memo. You might even carry a small tape recorder or dictaphone in some situations. If you often forget to go back to it later, put the memo or recorder where you must see it, as by your purse or underneath something you use every day.

6.Only get parts of more complex directions or lengthy explanations? Here you may begin to suspect a problem with the subtleties of language - difficulty forming rapid "word pictures" to help with concept formation and memory, or failure to consider alternative word definitions so that meaning is mis-perceived. You can "freeze" it for later analysis by writing or taping. You can say "I learn better if I do it myself while you watch." Have someone else help you fill in details later.

7.Have difficulty knowing "what to say when" and are puzzled by others' reactions to you? One possibility is an inefficiency in the part of the brain which registers tonality (expression in the voice) and gives us "quick fix" on the situation (sometimes referred to with rough accuracy as a "right hemisphere disorder"). A professional can help you learn other cues by which to "read" how people are feeling about what you said and how to change what you say accordingly, much as anyone would have to learn about a foreign culture. In the meantime you might explain the problem to people you trust so their feelings aren't hurt.

If you inherited parts of your CAPD/LD from your parents, as is often the case, you need to remember that they grew up when far less was known about these conditions than the little which may have been know when you were young. They may have raised you with some of the harmful "scripts" that were part of the parenting they received in a generation where professionals and parents knew nothing about CAPDs. Chances are your teachers or other professionals you grew up with were not well-informed, either. Thus you might have been told "You'd do fine if you just tried," or "You'll never amount to anything," or worse. If so, try to remember that those things were not true or helpful, but just what comes of lack of good information. Work to rid yourself of those inaccurate parts of your self-image, and to forgive your parents and others for their lack of knowledge. Above all, resolve not to pass on their "bad advice" to your own children or to let it spoil relationships with other people you care about.

Remember that for you to have arrived at the point where you are educated and employable, you must have many talents and strengths. You may have superb visual memory, or be a gifted problem-solver or mechanic, or be loved for your way with people, or be wonderfully creative. Some of your skills may have been under-valued in an academic setting, but now they can be worth money! These strengths will be there to help you through the rough spots so work to identify them, either on your own or with the help of a good professional.

Reprinted with Permission from:

Judith W. Paton, M. A.
136 North San Mateo Drive
San Mateo, CA 94401
(415)343-7225/340-1280
[/url]


_________________
Spectrumite ... somewhere.


GroovyDruid
Deinonychus
Deinonychus

User avatar

Joined: 31 Oct 2005
Gender: Male
Posts: 384
Location: where I decide

07 Jan 2006, 4:58 pm

I'm going to save these descriptions to hand to people when I need them. I have APD in a big way, and it has made life very difficult at times. Thanks for putting this up here!


_________________
Whatever you can do,
Or dream you can do,
Begin it.
Boldness has genius,
Power and magic in it.

--Goethe


Sophist
Veteran
Veteran

User avatar

Joined: 23 Apr 2005
Age: 42
Gender: Female
Posts: 6,332
Location: Louisville, KY

09 Jan 2006, 10:32 am

That's another good article, Lottie. I also find trouble with understanding people on phones, too. The phone line only muffles their words even more. :?


_________________
My Science blog, Science Over a Cuppa - http://insolemexumbra.wordpress.com/

My partner's autism science blog, Cortical Chauvinism - http://corticalchauvinism.wordpress.com/


Last edited by Sophist on 11 Jan 2006, 10:22 am, edited 1 time in total.

parts
Veteran
Veteran

User avatar

Joined: 2 Sep 2005
Age: 56
Gender: Male
Posts: 1,579
Location: New England

09 Jan 2006, 11:01 am

GroovyDruid said

Quote:
I'm going to save these descriptions to hand to people when I need them. I have APD in a big way, and it has made life very difficult at times. Thanks for putting this up here!


Thats a great idea I have the same problem and am tired of being thought of as stuipd,rude or just not listering when it a stuggle to hear what is being said.Asking some people to repete their words is like pulling teeth. By the way phones are evil.



Musical_Lottie
Veteran
Veteran

User avatar

Joined: 14 Sep 2005
Age: 34
Gender: Female
Posts: 656
Location: Bedfordshire, East of England

09 Jan 2006, 1:58 pm

Yup, phones are indeed evil. I spent half an hour one time trying to establish whether I was being asked if I had a 'cable' or 'table' for our laptop ... but the other person wouldn't say 'c for computer' or 't for time' he'd use a word that could quite easily begin with both, eg cap/tap. I never did find out what he was asking me ... :roll:


_________________
Spectrumite ... somewhere.


medianmistermustard
Yellow-bellied Woodpecker
Yellow-bellied Woodpecker

User avatar

Joined: 6 Jan 2006
Gender: Male
Posts: 69

10 Jan 2006, 10:03 pm

Hm, I've always had trouble processing rapid strings of verbal information, like instructions, I just chalked it up to having a bad short-term memory. I've never liked phones either but less because it's hard to hear and more because you're expected to communicate in a spontaneous way with someone with no cues of any kind.



MsTriste
Veteran
Veteran

User avatar

Joined: 7 Dec 2005
Age: 60
Gender: Female
Posts: 3,307
Location: Not here

11 Jan 2006, 12:31 am

I have quite a few of those manifestations on the list Sophist posted. I agree with you guys, phones are the worst. Especially cell phones. Invariably the sound quality is poor and I just HATE talking on cells. So I try to limit the length of the calls, but people think I'm rude. Argh. For the most part I don't use one - I just borrow my BF's when I go into town.



Cade
Veteran
Veteran

User avatar

Joined: 6 Aug 2005
Gender: Female
Posts: 894

11 Jan 2006, 1:12 am

I have trouble with hearing and focusing on someone talking in noisy environments and following conversation or verbal instrructions. However I have an aptitude for prcessing both visual and auditory non-verbal information, including music appreciation.



GroovyDruid
Deinonychus
Deinonychus

User avatar

Joined: 31 Oct 2005
Gender: Male
Posts: 384
Location: where I decide

11 Jan 2006, 2:04 am

Sophist wrote:
That's another good article, Groovy. I also find trouble with understanding people on phones, too. The phone line only muffles their words even more.


Yep. Me, too. I turn the volume on my earpiece up to the max on my cell. That helps.

I could do an article on this. Usually with articles, though, I like to have something concrete to offer, suggestions and things. I'll have to think about it...

I have to tell people to please "say that again" all the time. I feel like a moron. With certain people, it happens every sentence or two. It starts to appear as I'm badgering them for bad diction or something, and it can be very embarrassing.

Never could listen in lectures or take notes at all. My dysgraphia contributed to that, I think.

Because of my APD, I speak in a very clear, resounding voice myself. People tell me I have excellent diction. I wish they'd get the hint and follow suit! :)


_________________
Whatever you can do,
Or dream you can do,
Begin it.
Boldness has genius,
Power and magic in it.

--Goethe


Sophist
Veteran
Veteran

User avatar

Joined: 23 Apr 2005
Age: 42
Gender: Female
Posts: 6,332
Location: Louisville, KY

11 Jan 2006, 10:26 am

I find my magic number for a string of verbal directions is about 3 (2 or even 1 would be prefered though). And usually I sit repeating these three instructions over again. If the number is greater than 3, you might as well forget it. I'm lost. :?

That's the point where I say "Whoa, whoa, whoa. I'm never going to remember these. Write 'em down for me." And most people comply.


_________________
My Science blog, Science Over a Cuppa - http://insolemexumbra.wordpress.com/

My partner's autism science blog, Cortical Chauvinism - http://corticalchauvinism.wordpress.com/


Musical_Lottie
Veteran
Veteran

User avatar

Joined: 14 Sep 2005
Age: 34
Gender: Female
Posts: 656
Location: Bedfordshire, East of England

11 Jan 2006, 10:47 am

Interesting that you mention the number 3 - I think I've heard somewhere that the human brain remembers things better in 3s. I know I certainly do - I also do things in 3s too, though that seems to be an obsessive thing lol.


_________________
Spectrumite ... somewhere.


Sophist
Veteran
Veteran

User avatar

Joined: 23 Apr 2005
Age: 42
Gender: Female
Posts: 6,332
Location: Louisville, KY

11 Jan 2006, 10:50 am

Musical_Lottie wrote:
Interesting that you mention the number 3 - I think I've heard somewhere that the human brain remembers things better in 3s. I know I certainly do - I also do things in 3s too, though that seems to be an obsessive thing lol.


I'm not sure if it's that, but three is just about the maximum my processing centers can seem to hold, hehehe.

I'd have an easier time with two and a far easier time with one though. ;)


_________________
My Science blog, Science Over a Cuppa - http://insolemexumbra.wordpress.com/

My partner's autism science blog, Cortical Chauvinism - http://corticalchauvinism.wordpress.com/


Musical_Lottie
Veteran
Veteran

User avatar

Joined: 14 Sep 2005
Age: 34
Gender: Female
Posts: 656
Location: Bedfordshire, East of England

11 Jan 2006, 10:59 am

Sophist wrote:
Musical_Lottie wrote:
Interesting that you mention the number 3 - I think I've heard somewhere that the human brain remembers things better in 3s. I know I certainly do - I also do things in 3s too, though that seems to be an obsessive thing lol.


I'm not sure if it's that, but three is just about the maximum my processing centers can seem to hold, hehehe.

I'd have an easier time with two and a far easier time with one though. ;)


Ja, I entirely agree! And I have to repeat them aloud continuously until I've completed them too :)


_________________
Spectrumite ... somewhere.


redvelvet
Deinonychus
Deinonychus

User avatar

Joined: 1 Dec 2005
Gender: Female
Posts: 356
Location: England

12 Jan 2006, 4:22 am

I borrowed Claires mobile phone to call home and was nearly deafened, because she has it on max.
She can't follow when someone is reading allowed and she can't follow conversations. Also she can't have a one to one with other noise around. Yet she can hear people breathing and gets annoyed when we eat saying it is too loud.
Fortunately we learned sign language. But that doesn't help when listening in class.
She had to explain to her teachers that if they want her attention they have to face her, she can lip read a bit.
Her whole life has been "Again, please repeat, what did you say?"
Thanks guys now we know why, :roll:
Well informed articles and another to tell the DX person.



nirrti_rachelle
Veteran
Veteran

User avatar

Joined: 21 Jul 2005
Age: 49
Gender: Female
Posts: 1,302
Location: The Dirty South

12 Jan 2006, 9:15 pm

I think this may have contributed to my being fired from my job. My supervisor, whenever I asked for details about information I needed for a customer I was assisting over the phone, would say, "Didn't you hear me say..." whatever it was she taught in training class. And I could never remember exactly what was said due to her talking very fast and then not being able to absorb all she was teaching.

I was afraid many times to ask the trainer to go over it again in class as I would've been looked at as not paying attention or worse, being incompetant since my position as a temp worker was tenuous. Even when I did, it was a two week class that was normally taught in six and was cut short due to deadlines. So it was impossible to absorb so much information in a protracted period of time. What's worse, whenever we asked a customer to repeat what they said while on a call, we were docked points off our quality score.

Since I was a temp employee and could be let go at will without legal ramifications, they didn't think they needed to make any extra consessions for me to catch on. So they fired me even though my performance would've surpassed seasoned employees if given enough time.


_________________
"There is difference and there is power. And who holds the power decides the meaning of the difference." --June Jordan