What are central auditory processing disorders (CAPDs)? CAPDs are often characterized by a child having difficulty understanding speech or instructions in the presence of normal hearing sensitivity. They usually are noticed when the child is in an atmosphere of sensory overload. Too much is happening around the child and so the child cannot "process" the same information that other children process. This also can occur when the "redundancy" of the auditory information is reduced: when speakers cannot be seen, when the normal frequency content of speech is reduced, or especially when an ear infection produces a mild and temporary hearing loss. How is CAPD diagnosed? There are a number of tests that are used to diagnose the presence of CAPD. Usually, these tests require that a child repeat words, phrases, or tonal sequences when the test signal is presented in the at the same time as a competing messages (background noise) or when the signal has been filtered to eliminate some frequencies from the normal spectral content. Sometimes, children are asked to repeat separate but simultaneous messages directed to each ear. The use of an auditory trainer allows the child to focus his/her attention on the teacher and to reduce the interference of background noise. The child's scores on the tests are compared to normative scores that have been gathered from children of the same age who do not have CAPD. What strategies can be used to help a child with CAPD? Most of the strategies listed below are designed to maximize the child's strengths and to not overload the child. Some strategies may work better than others. Please be flexible and discover which strategies are more appropriate for your child. Place your child in classroom settings that avoid noisy or reverberant environments. Avoid open classroom placement. Preferentially seat your child near the area that the teacher spends most of his/her time.  Teach your child to use visual information: look and listen. Gain your child's attention before giving auditory instructions. You might call your child's name, cue your child by saying "listen" or "ready" before giving assignments. Check your child's comprehension of auditory information before moving on to another topic. Restate important information. When repeating, try phrasing the information in a different way. Teach strategies that compensate for weak areas. For instance, assignments that are given orally could be checked with the teacher at the end of the class period. Teach listening skills. For instance, your child should wait until instructions are completed by the teacher before beginning a task. Give your child enough time to think and to respond to auditory instructions or questions. Give your child information in smaller packets. Rather than giving a multistage instructions, provide instructions in "sound bites". Allow a "buddy" system with another child so that your child can check on homework assignments or other instructions. Will hearing aids help a child with CAPD? Hearing aids would only be recommended if the child with CAPD also has a hearing loss that is suitable for the use of hearing aids. If the child does not have a hearing loss, then it is likely that hearing aids would probably worsen the child's situation by introducing overly loud sound. Auditory trainers, which are a form of Assistive Listening Devices, can be useful for children with CAPD. The teacher wears a microphone/transmitter while the child wears a receiver/headset. The use of an auditory trainer allows the child to focus his/her  attention on the teacher and to reduce the interference of background noise. Children who wear hearing aids also can make use of this technology. Many hearing aids have the ability to be modified for direct auditory input. The input comes from the receiver of an auditory trainer or may be self contained. Neck loops also can be used in combination with the telecoil circuit in the hearing aid. Behaviors of Children with CAPD Says “huh” or “what” frequently Inconsistent responses to auditory stimuli Often misunderstands what is said Requests that information be repeated Poor auditory attention Exhibits extreme distractibility Difficulty following oral instructions Difficulty listening in the presence of background noise Difficulty with phonics and speech sound discrimination Poor auditory memory span Poor sequencing skills Poor receptive and expressive language skills Slow or delayed response to verbal requests and instructions Reading, spelling and other academic problems Learns poorly through the auditory channel Exhibits behavior problems Academic symptoms of children with CAPD Auditory Discrimination Deficit: Child will have trouble understanding verbal directions; will make errors in repeating words and directions; will substitute words, numbers, etc. Will have difficulty learning sounds for letters, letter names, etc. May have trouble learning names of people, places and things. Auditory Memory Deficit: Will have trouble recalling names of things, letters, words, numbers, etc. May not consistently remember addresses, phone numbers, etc. from day to day. May not remember how to pronounce letters and words. Auditory Association Deficit: May have trouble learning sounds of letters and letter names, individual words with categories, etc. May not be able to follow verbal directions, conceptualize the concepts of words, numbers, etc. May have difficulty classifying objects and ideas presented verbally. Auditory - Visual Association Deficit: This skill requires functioning of lower level skills plus relating a visual symbol with a sound for that symbol. This skill is the essence of word recognition. Subjects with this deficit will have trouble recognizing and naming letters, words, numbers, etc. May be able to write what is read, speak what is heard, but will have trouble speaking what is read, or writing what is heard. This manifests as note taking problems in school.