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What is Central
Auditory Processing?
Central
auditory processing is the series of tasks done by parts of the auditory
nerve pathways in the brain to sort out and refine the raw data
delivered by the ear. This processing provides the recognizable sound
message we use in thinking and communication.
When
some of these tasks are done incompletely, a central auditory processing
disorder (CAPD) results. It is a hearing disorder just like a peripheral
(ear) hearing loss, in that it keeps a clear message from reaching the
intellect.
CAPDs
(also referred to as auditory processing disorders or APD) are physical
inefficiencies with physical causes such as genetics, minor birth difficulties,
illness, or injury. Often the cause is unknown. Most CAPDs are mild compared
to other physical problems, but they can have a large impact on listening
and analyzing what we hear (at school, at work, or socially).
When might I
suspect a CAPD in my child or myself?
I
believe that people want to do the right thing, to develop their skills,
to love and feel appreciated. Before we assume that a child is not
very bright or a behavior problem, that a teenager is
lazy, unmotivated, just not college material, or an adult
lacks talent or self discipline, I think we owe it to them
to first assume they are doing the best they can and to check for problems
that are getting in their way.
CAPDs
present such a barrier to taking in ordinary classroom instruction, accurate
messages in the workplace, and the nuances of social conversation. CAPDs
can masquerade as the descriptions mentioned above, or as poor focus,
or as an ADD (attention deficit disorder).
Most
important, there is help available when the problem is recognized.
See
CAPD Symptom Checklist for common signs and
subtypes.
How
can CAPD testing by an audiologist help?
- By
checking for auditory system problems before it is assumed that
the person is simply not trying.
- By
describing to normal-hearing family and professionals what it is
like for this person to hear, and what can be done to help.
- To
confirm the physical disability which brings the
child or adult under the protection of educational and civil rights
laws.
- By
getting beneath the surface of the auditory disorder suggested by psycho-educational
or speech/language testing; to break the problem down into its basic
parts (subtypes), so that therapy is more individualized
and the job more manageable.
- To
help distinguish CAPD from ADD or other disorders producing similar-looking behaviors.
The central auditory test tasks used by audiologists differ from IQ
or academic tests, in that they were originally designed to check functions
in the various regions of the auditory pathways. As such, they are backed
by decades of research in peer-reviewed journals confirming their accuracy.
Because they are sensitive only to auditory problems, they can help
distinguish CAPD from problems of attention, language, or emotion.
- By
uncovering possible ways of helping when
the child is not progressing as expected in speech/language
or educational therapy, or school Special Education programs.
- To
gain a clearer picture of the exact problem, to help with
decisions about a lengthy or expensive therapy of a particular type.
Is it too late
to seek help for a CAPD if you are an adult?
Not
at all. There is now a wealth of scientific research showing that we
can still make changes in our brains even into old age. Moreover, adults
bring to the process a rich life experience to help them strategize
and overcome problems which are lifelong, or which are caused by a devastating
life event like injury or illness.
The
adults who come to my practice are usually at the point of making a
life change in some way large or small.
They might be working in a job beneath their true ability, or afraid
to work at all. Perhaps they may have to learn anew who they are
after an injury or illness alters their hearing. Often they want a chance
to solve problems that were never recognized and helped in school so
that they can now complete their education. They are often the parents
of children with CAPD and other learning problems.
My
contribution as an audiologist is to give you a map of the
CAPD, to let you know why you are not hearing well, to correct misinformation received
from uninformed adults in the past, and to help you choose what to
do to change the old patterns. Whether I am
drawing from modern brain research or from the knowledge shared with
me from other people with CAPD Ive seen over the past twenty-five
years, I can lead you to sources of help with other skilled professionals
in many areas of therapy and health science.
To
learn more about how adults can successfully cope with CAPD, read Ms.
Patons article on Living
and Working with CAPD.
Back
to CAPD
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Who can benefit from
AIT?
AIT
can help people with hyperacusis (unusual sensitivity to specific
sounds) and certain other problems associated with CAPD. Hyperacusis may
accompany CAPD, learning disability, ADD, injury, or disorders of the
autism spectrum. Symptoms include:
- Marked
discomfort, aversion, or startle to ordinary sounds
the rest of us tolerate (hair dryers, vacuums, other children crying
or shrieking, loud movies or shows, reverberant crowd situations)
- Distraction
and inability to concentrate on work due to very soft, distant sounds most people
dont notice
- Striking
behavior changes (coming unglued
or unavailable) when noise levels become high (parties,
school assemblies, indoor sports events, etc.)
Here
are examples of other features of CAPD where AIT has helped in my caseload:
- Problems
functioning in noisy classrooms or offices which are not solved by accommodations
like preferential seating or FM amplification.
- Slow
processing speed, limiting ability to clearly discern normal-paced
speech for long periods, affecting social relations on the playground,
or slowing progress in speech/language therapy.
- Some
difficulties with language perception or
accessing which do not respond
to skilled teaching and therapy.
- Poor
working memory which has limited ability to stay on task, attend
to details, or recall basic facts and routines.
How can AIT (Auditory
Integration Training) help?
It has now been scientifically
confirmed that highly repetitive stimulation done intensively over a short
period of time can train the brain to do certain jobs that it couldnt
do as well under ordinary conditions. AIT uses a ten-day, twenty half-hour
program of modulated music, individually filtered for each persons
sound sensitivities, to accomplish this stimulation of the auditory system.
AIT is almost unique among
therapies in its ability to reduce the highly distracting, sometimes even
painful, inability to temper or moderate the sound brought in by the ear.
(In parallel, imagine how it would feel if your pupil couldn't constrict
to protect you from bright light.)
Unlike most other music therapies,
the painful frequencies are filtered out. This makes it a very kind therapy,
unlike crude attempts to desensitize the person through noxious
noise.
AIT
is training the auditory system, and thus addresses the CAPD component
in a variety of disorders. These may include LD (learning disabilities)
and ADD (attention deficit disorder).
To read
about a mothers experience with AIT for her autistic child, go to
the Connors
Corner website including Ms. Patons explanation.
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