Auditory Processing

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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 takes place. 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 sounds. However, the ability to detect the presence of sounds is only one part of the processing that occurs within the auditory system.

With that being said, there are many individuals who appear to "hear normally," however, are unable to process auditory information correctly. 
Central Auditory Processing Disorder (CAPD), also called Auditory Processing Disorder (APD), is a neurological condition that may cause a person to demonstrate difficulties in at least one of the following areas:
  • Sound localization (i.e., determining which direction the sound is coming from
  • Sound lateralization (i.e., determining the source of a sound)
  • Auditory discimination
  • Auditory pattern recognition
  • Temporal (timing) aspects of sound

There is no one cause of CAPD. In many children, it is related to maturational delays in the development of the auditory centers within the brain. 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). CAPD can also be attributed to neurological problems or diseases such as: trauma, tumors, degenerative disorders, viral infections, surgical compromise, lead poisoning, lack of oxygen, auditory deprivation, and so forth.


Below is a listing of some of the common behavioural characteristics often noted in children with CAPD. It should be noted that many of these behavioural 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, behavioural problems,  reading/learning disabilities, and language impairments. Therefore, one should not necessarily assume that the presence of any one or more of these behaviours is indicative of CAPD. It is also important to be cognizant of the fact that CAPD can co-exist with any of the above conditions. A definitive diagnosis of a central auditory processing disorder cannot be made until specialized auditory testing is completed by an audiologist, and other etiologies have been ruled out.
  • Difficulty understanding conversation/focusing on a task in noisy environments
  • Difficulty following long conversations
  • Difficulty learning a foreign language or new vocabulary words
  • Difficulty remembering spoken information 
  • Difficulty taking notes
  • Difficulty with organizational skills
  • Difficulty following verbal multi-step directions
  • Difficulty in directing, sustaining, or dividing attention
  • Difficulty with reading and/or spelling
  • Difficulty processing nonverbal information (e.g., lack of music appreciation)
As a result of these problems, many children with CAPD will often struggle academically.

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