Central auditory processing is the the ability to process information that develops with age and maturity of the central auditory mechanism. The central auditory nervous system is responsible for processing and interpreting auditory information; and an immature or deficient central auditory nervous system results in central auditory processing difficulties.
A Central Auditory Processing Disorder (CAPD) is a perceptual auditory difficulty that affects the analysis and processing of auditory information. Individuals with CAPD usually have adequate hearing acuity (peripheral hearing) but have difficulty listening in demanding auditory environments. They also have difficulty identifying and locating a sound source, discriminating (differentiating) auditory information, recognising auditory patterns and discriminating relevant from irrelevant auditory information.
With children with CAPD, they are often associated with language, learning and reading difficulties, as auditory processing forms the basis for language development and learning skills. In the preschool years, children develop speech, language and sound awareness through listening; and in the school years, learning takes place through both verbal and written forms. For children who experience auditory processing difficulties, they will often experience language and learning difficulty as well.
Therapy for CAPD
Management of learning difficulties caused by CAPD should be viewed as a tripod. Without all three legs (environmental modification, remediation therapy and compensatory strategies) the tripod cannot stand. Management of specific deficits should focus not on one, but on all three areas including change in the environment, remedying the deficit and improving learning and listening skills.
- Children will gradually need to become aware of their specific auditory processing difficulty. They should be encouraged to become an active listener. They should consider and use appropriate listening strategies and ask speakers to slow down when needed.
- Similarly, they should be aware that they will experience difficulties when they have to divide their attention to more than two things at the same time. They are therefore better off to complete two tasks before proceeding to the next i.e. listen and look, or look and write, or listen and write, rather than three things at the same time.
- An Auditory Training/Therapy programme with an appropriately trained Speech Pathologist to help enhance certain skills.
- Sound discrimination.
- Auditory closure
- Missing syllable exercises
- Missing word exercises
- Long vs. Short vowels
- Auditory Integration
- Compensatory Strategies-Student directed-becoming an active listener
(In regards to specific training, such as auditory training, it is important to note that given that auditory processing difficulties can be multifactorial problem (meaning that they co-exist with other problems) targeting or simulating one area may not necessarily result to significant changes. It is equally important to note that specific therapies, such as the recommended auditory training module, can only introduce areas that require attention to or intervention and its success is also heavily dependent on the implementation of the strategies both at home and in the classroom in addition to the motivation and participation of the student.)
- A home programme practising listening for comprehension is recommended. This would involve listening to a paragraph (eg newspaper, magazine) and answering questions pertaining to detail, sequence and inference. This should be done in the presence of background noise. The intensity of this noise is not as important as its distractibility. Distractibility refers to what the child relates to – you can start with less challenging music (ie classical) graduating to something he/she relates to (his/her favourite music). Equally so, starting with a TV show in the background (no visual) graduating to his/her favourite show. To further practise multi-tasking, he/she may be requested to give a written response instead of answering the question verbally.
