Auditory comprehension of language is a complex process. Even students who understand isolated words or are working to “listen carefully” may struggle to process the meaning of a message that is conveyed through speech. Such deficits in listening comprehension, when combined with normal hearing, may lead to a diagnosis of central auditory processing disorder (CAPD). This chapter will explore CAPD from the viewpoints of researchers, diagnosticians, and teachers. After discussing manifestations, diagnosis, and neurological foundations, the chapter will conclude with a focus on therapies, tools, and classroom strategies that can support the learning of students with CAPD.
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Jill Johnson is a quiet, well-behaved elementary school student who enjoys working puzzles and playing outside. She rarely volunteers to answer questions in class and has difficulty following multiple step directions. Jill loves to be with her friends, but is often on the fringes of conversations with them. Her teacher, Mr. Smith, notes that she withdraws during group activities at recess and is increasingly selecting independent activities that have limited interaction with peers. Ms. Johnson, Jill’s mother, admits to growing increasingly impatient with Jill’s frequent ‘Huh?’ response when she asks Jill a question. “I know she hears me,” says Ms. Johnson. “But she keeps asking me to repeat what I’ve just said.” When asked, Jill admits that she does hear her mother. “I hear all the words,” says Jill. “But I don’t really know what she said.” Although Jill’s grades are usually C or B in class, Mr. Smith notes Jill has had increasing difficulty with some assignments. Jill often daydreams in class. Ms. Johnson and Mr. Smith both have concerns that she may begin to lag academically without strategies or training that can address her auditory issues. Mr. Smith suggests that Jill have her auditory needs evaluated by a specialist, so Ms. Johnson schedules an appointment with an audiologist. The audiologist conducts an initial screening and suggests that Jill have a full-scale assessment for potential Central Auditory Processing Disorder (CAPD).
CAPD, also known as auditory processing disorder (APD) or auditory perceptual disorders (APD), is a relatively rare learning disability in which individuals have difficulty processing sound, particularly speech and language. Occurring in only about 3-10% of the world’s population (Nationwide Children’s Hospital, 2023; Mountjoy, 2021), the disorder can easily be disguised as an attention, listening, or hearing issue (Moore et al., 2010). However, difficulties with attention or language appear to result from, rather than cause, the disability. A diagnosis of CAPD signifies no major hearing deficits. In contrast, individuals with CAPD have normal hearing, even for quiet tones, when auditory cues are presented in isolation. Instead of difficulties in hearing the sounds, those with CAPD may experience difficulties in filtering out background sounds or in understanding the verbal message that is being conveyed (Musiek & Chermak, 2013). CAPD impacts the academic, social, and environmental functioning of those who display the disorder.