Central Auditory Processing
Auditory processing (or Central Auditory processing - CAP) is the name given to a set of ‘sorting out’ processes which take signals picked up by the ear and make them into a form which is understandable by the brain. Quite a few professionals are interested in CAP disorders (CAPD), including speech therapists, psychologists, paediatricians and teachers. As audiologists we use carefully controlled listening conditions in ‘sound proof’ rooms and regularly calibrated equipment. We receive referrals from many professionals as well as concerned parents, and CAP testing is a natural extension of our other work.What is a CAPD? Not a hearing problem, not a behaviour problem, not an intellectual handicap and definitely not ADHD. Yet children with CAPD often appear to have these conditions. CAPD’s are disorders of the auditory system which relate to the ability of the brain to prepare auditory input for comprehension and executive action. Here are some of the behaviours which lead people to believe that a CAPD may be present:
- Difficulty in following instructions
- Short attention span
- Low reading ability particularly for phonics
- Difficulty learning in background noise or group environments
- Poor verbal abilities including low vocabulary
- Low self esteem
- Distractibility
Unfortunately many of these are also indicative of other disorders, so we need to do special tests. We assess whether your child has a CAPD by using a test battery designed at the Royal Children’s Hospital in Melbourne (RCH) and/or a test battery designed in USA called SCAN. Here is a short description of the main tests in the RCH battery:
- Speech discrimination in quiet, each ear separately and both together. This is to be sure that listening to speech under good conditions is unimpaired.
- Auditory figure/ground testing means testing speech discrimination in a background noise. All classrooms are noisy places and we want to know how well the child can sort out speech from background noise.
- Short term auditory memory (STAM) is the measure of how much information the child can take in through hearing alone at any one time. It is a vital skill for learning to read and following instructions. STAM problems are the single most common group of CAPD’s. We have a few tests to establish whether STAM is developing normally or not.
Management and Reporting
After the tests we explain the results to you. This is actually the most important part of the procedure, as it is an opportunity to discuss the meaning of each test and how we believe this contributes to sorting out the problems with which you came to us. Management suggestions, possible treatment – both medical and functional (non-medical) and suggestions for further appropriate professionals to assist the child; these and all related concerns are addressed at this time. What is more, in most cases you will be present at all stages of assessment and will know first hand how your child has been treated and how she/he reacted.
You are always welcome to take a copy of the findings and to have a copy of reports sent to you. Your doctor or other referee, such as school teacher or speech therapist, will automatically receive reports unless you tell us otherwise. These reports will include management suggestions wherever appropriate. We are happy to talk directly with other family members who could not attend with the child and with his/her teachers or health workers. Our aim is to assist everyone to assist your child, so if you think we may be able to help, please ask; if we think we can help it is our job to tell you – and we will!