The hearing problem known as Central Auditory Processing Disorder, or CAPD (also called Auditory Processing Disorder, or APD) is based not on an inability to hear sounds correctly with the ears, but on the brain’s inability to process and interpret these sounds. The person with Central Auditory Processing Disorder hears sounds correctly but something adversely affects the way their brain recognizes and interprets the sounds, especially the sounds associated with speech. As a result, Central Auditory Processing Disorder has been described as a breakdown of coordination between the ears and the brain.

Central Auditory Processing Disorder affects as many as 2% to 5% of school-age children, and as many as half of the children are diagnosed as having a learning disability. Children with Central Auditory Processing Disorder often fail to recognize subtle differences between the sounds of different words, even though the words are clear and loud enough for them to hear. This problem often is exacerbated by the presence of background noise, so that children who can hear and understand words perfectly well in quiet environments have difficulty doing so in noisy environments.

CAPD is often difficult to detect, because when children’s hearing is tested in a quiet room, they can clearly hear the pure tones they hear through the testing equipment, and they similarly have no apparent problems hearing and interpreting speech in non-noisy environments. As a result, their audiogram results may appear normal, but they may nevertheless have difficulties distinguishing similar words, locating where sounds are coming from, recognizing repetitive patterns in high and low sounds, or hearing more than one person’s voice at a time.

The symptoms of CAPD also tend to appear in other areas of life, as the child struggles to deal with not being able to understand people speaking to them or around them. Children with Central Auditory Processing Disorder may have difficulty following directions or following conversation, may develop reading and language problems, may appear forgetful and disorganized, and may be easily distracted by sudden noises. When given standard hearing tests, these children appear to have normal hearing, so these symptoms are often confused with or mistaken for signs of other problems such as depression or Attention Deficit Hyperactivity Disorder (ADHD). In reality, CAPD can be present alone or combined with these other disorders, presenting a difficult diagnostic challenge.

It is important for these children’s development that problems with CAPD be identified early so that treatment and correction of the difficulties can begin as soon as possible. A standard hearing test doesn’t rule out CAPD. If you detect any of these signs in your children, schedule a professional hearing test that can replicate the conditions where the child struggles.

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