"The audiologist indicated he has auditory processing disorder. What is that?" Mary inquired.
"It has many names and interpretations," I noted.
Central Auditory Processing, CAP, Auditory Processing Of Speech Stimuli, APSS and Auditory Processing Delay, APD, are all terms related or referred to by audiologist. It is a term discussed when the "brain does not hear" or understand the information coming in.
It is similar to a blind man touching various parts of an elephant. Determining the whole elephant from just the trunk or tail is difficult. The information travels from the outer ear to the middle and inner ear through the auditory nerve, then from the nerve through the brainstem and to the auditory cortex.
There are many areas which may be miscued or misdirected. Another way of describing it is having a destination sight (auditory cortex) and traveling down the interstate with all the various off-ramps. If the incorrect ramp or exit is taken, the message doesn't arrive correctly at the destination.
Children will often say they were not told all that information such as a three-step command. They claim to have heard or performed step 1 and 3 but missed step 2. The information did not all arrive correctly. When the patient is asked to repeat a series of words or speech stimuli, a complex network is triggered that must work in a precise way in order for the information to be correctly processed. It requires information to be stored in memory and then be transformed or be reproduced back out. Audiologists will often perform a series of tests to determine what region of the hearing process is not working. The test battery may require I.Q. testing as well as visual and sensory testing.
It may be of interest that the characteristics with CAP and ADHD may be shared by individuals. A male to female ratio about 2:1 is in both. Depressed academic performance is also a characteristic.
"Appears to not be listening" is what others may say, or "easily distracted" during conversations. CAP can influence reading abilities. Often, the CAP person has a greater difficulty with retaining/remembering the sounds of the printed symbols for the names of the printed word, such as whole words, similarity with words (fat/pat), unable to "hear" consonant blends (st/sl/bl), cannot break up words phonetically, difficulty with rhyming or detecting rhyming elements of words, lack of retention of sounds/syllables to match, inability to relate the visual with the auditory components of words or their counterparts and inability to analyze unfamiliar words.
The audiologist is only one member of the team in the determination of CAP. Others may include a speech-language pathologist, neuropsychologist, special educators, neurologist, otolaryngologist, teachers, parents, family and advocates/friends.
In South Dakota, we are fortunate to have the head of the Communication Disorder Department at the University of South Dakota. Dr. Teri Bellis is a knowledgeable leader and researcher on CAP testing and treatment strategies.
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Patricia Larson Shields, AuD FAAA MA CCC-SP/L is a doctor of audiology with her degree from The School of Audiology of the Pennsylvania College of Optometry in February, 2003. She has been in business in Mitchell, SD since September, 1991.