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"Helping you with
Central Auditory Processing Disorders"by Anthony Kane, MD
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Central Auditory Processing Disordersby Anthony Kane, MD
IntroductionSome children have normal hearing ability but have difficulty using information they hear in academic and social situations. These children may have a Central Auditory Processing Disorder. Children who have this difficulty are able to hear well, but have trouble paying attention to, remembering, and utilizing auditory information for academic and social purposes. Central Auditory Processing Disorders may have a very negative impact on their language acquisition, social skill development, and school performance.
Some researchers feel that many children are misdiagnosed with ADHD and actually have a Central Auditory Processing Disorder. This condition is particularly common if the child has other sensory integration disorders, such as touch sensitivity. In addition, children with ADHD may also have a Central Auditory Processing Disorder.
What is a Central Auditory Processing DisorderA Central Auditory Processing Disorder is an impaired ability to attend to, discriminate, remember, recognize, or comprehend auditory information in individuals who typically exhibit normal intelligence and normal hearing.
When a person is exposed to a sound, the ears detect the sound and transmit the information to the auditory part of the central nervous system. In various parts of the central nervous system the sound stimulus is processed. In the end, the listener will know the direction from which the sound comes, identify the type of sound, be able to separate the sound from background noise, and interpret the sound. The listener stores the memory of this sound stimulus and develops a mental sound library, which he uses to help him evaluate, interpret, and utilize new sound information that he experiences in the future.
When a child has a Central Auditory Processing Disorder he has an impaired ability to attend to, discriminate, remember, recognize, or comprehend auditory information. These processing difficulties become more pronounced in challenging listening situations, such as noisy backgrounds or poor acoustic environments, great distances from the speaker, speakers with fast speaking rates, or speakers with foreign accents.
What the Child Experiences
Distorted Speech SoundsNobody talks the same way. There are always slight variations in pronunciation and emphasis that makes one person’s speech patterns differ from those of another. In order to understand the speech of other people, a child must make a series of mental adjustments. First he hears words. Then based upon his memory of similar sounds, he places the sounds of the words in context and decodes the meaning that is being conveyed.
In a child with a Central Auditory Processing Disorder there is a break somewhere in this decoding process. The child isn’t able to derive the correct meaning from words because he cannot accommodate the different distortions of different speakers.
Excess Background NoiseWhen we are in a noisy room, we need to block out the extraneous noise in order to distinguish and understand words that are being spoken to us. One way we do this is by pinpointing the location of the voice of the speaker and neurologically suppressing the sounds coming in from other locations. A child with a Central Auditory Processing Disorder may have difficulty pinpointing sounds. With this in mind it is understandable why he can’t block out extraneous noise. As a result a child with a Central Auditory Processing Disorder appears to be easily distracted.
Misses Social CuesSpeech can be very complicated. Beyond understanding simple instructions there are the nuances of language usage that help convey the true meaning of the message being transmitted. It is these nuances that allow for social interactions. A child with a Central Auditory Processing Disorder may have a deficit in receiving and understanding the meaning of sounds. Such a child will be very slow to follow the complexity of the message that is conveyed by particular word usage and tones of speech.
Co-morbidityLike other sensory motor defects, Central Auditory Processing Disorders rarely occur alone. A child who cannot effectively suppress extraneous noise may also not be able to use his eyes to track words across a page or co-ordinate his fine muscles in his hand to write easily.
Since a child with a Central Auditory Processing Disorder may not be able to block out meaningless noise, he may appear to the observer to be easily distractible. This is one of the reasons children with a Central Auditory Processing Disorder may be misdiagnosed with ADHD. However, if a Central Auditory Processing Disorder child also has ADHD and so that he already has a deficit of inhibition, then the effects of his Central Auditory Processing Disorder are much worse.
SymptomsChildren who have Central Auditory Processing Disorders may behave as if they have a hearing loss. Here are some of the common behaviors displayed by children who have Central Auditory Processing Disorders:
School PerformanceIn addition, children with Central Auditory Processing Disorders show many of these characteristic deficits in school performance:
DiagnosisAn audiologist uses a battery of tests to evaluate the peripheral and central auditory systems. Peripheral hearing tests are used to determine if the child has a hearing loss, and, if so, the degree to which the loss is a factor in the child's learning problems. Central auditory tests evaluate the child’s ability to understand and respond to mild distortions of speech. It is also helpful to have a speech pathologist evaluate the child's perception of speech and receptive-expressive language use.
TreatmentStandard treatment focuses on remedial help and splinter skills to expand upon the child’s strengths.
There are now a number of new treatment techniques that directly address the hearing deficits. The pioneer of these techniques was Dr. Alfred Tomatis, who began treating Central Auditory Processing Disorders over forty years ago.
I have already focused on Auditory Integration Training, the technique developed by French otolaryngologist, Dr. Guy Berard, one of Tomatis’s students.
In the second part of this article I want to discuss, what I feel is the most practical and readily available of all the treatments for Central Auditory Processing Disorder, The Listening Program.
Anthony Kane, MD
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