Some 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 Disorder
A 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 Sounds
Nobody 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 Noise
When 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 Cues
Speech 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-morbidity
Like 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.
Symptoms
Children 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:
· Don't respond to speech in a consistent fashion
· Frequently ask for words to be repeated
· Difficulty following speech in noisy surroundings
· Frequently misunderstand what is said
· Difficulty following long directions
· Poor memory for verbal information
· Difficulty pinpointing the direction from which
sound is coming
· History of middle ear infection
School Performance
In addition, children with Central Auditory Processing
Disorders show many of these characteristic deficits in
school performance:
· Difficulty expressing themselves
· Difficulty understanding language
· Poor reading, writing, and spelling
· Poor phonics
· Poor speech sound discrimination
· Difficulty taking notes
· Difficulty learning foreign languages
· Poor short-term memory
· Social or behavioral problems
· Poor language skills
· Poor academic skills.
Diagnosis
An 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.
Treatment Standard 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.
Auditory Integration Training is another effective
technique. This program was developed by the French
otolaryngologist, Dr. Guy Berard, one of Tomatis's students.
Finally, we should mention The Listening Program, a
technique that you can apply at home.
----------------------------------------------------
Anthony Kane, MD has been helping parents of ADHD and
Oppositional Defiant Disorder children online since 2003.
Join over three thousand parents and get help for your
Oppositional Defiant Disorder child
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