Central Auditory Processing Disorder (CAPD)

Central Auditory Processing
Disorder (CAPD)
What is CAPD?
Central Auditory Processing Disorder (CAPD) - also
known as Auditory Processing
Disorder (APD) - is an umbrella term for a variety of
disorders that result in a breakdown in the hearing
In short, our brain cannot make sense of what our ears hear because
the auditory signal is distorted in some way. As a result, one of the
biggest problems experienced by individuals with CAPD is difficulty
listening in background noise. For children, this generally means
problems adequately understanding the teacher in the presence of
competing classroom sounds.
CAPD and Spatial
Spatial processing is the ability to use the cues that tell
us where sounds are coming from. This ability allows
us to focus on one sound while ignoring sounds
coming from other directions and is one of the main
skills we rely on when trying to listen in noise.
Spatial Processing Disorder (SPD) is a type of CAPD that leads to a
difficulty understanding speech in noisy situations. Australian Hearing’s
CAPD program focuses on identifying SPD, but other areas of CAPD may
also be assessed.
Assessing for
CAPD at Australian
A number of central auditory processing tests can be
used to assess CAPD.
At Australian Hearing, we focus on identifying auditory deficits that are
likely to lead to listening difficulties and poorer performance in the
classroom. This includes how well your child hears in background noise.
We aim to tailor our tests to suit the individual child and as such, what is
included in each assessment may differ slightly between children.
If we find that your child has a difficulty in an area of auditory processing
we will then discuss management and auditory training options with you.
If you decide to proceed with any of these management or training
options, we will arrange further appointments to implement these
Australian Hearing’s CAPD assessment and management service is
provided on a fee-for-service basis. For more details on the fee structure,
contact your Australian Hearing centre.
Prior to your assessment appointment, a Pre-Appointment
Questionnaire on the family, educational, behavioural, developmental
and medical history of your child is sent. Please bring the completed
form with you to your appointment.
The assessment appointment is carried out by an
audiologist to rule out peripheral hearing loss and
to assess a range of auditory processing skills. The
appointment takes about one hour and 15
At the appointment, your audiologist will go through the information
supplied in the pre-appointment questionnaire and also conduct a
range of tests. At the end of the appointment we will explain the test
results and discuss a range of management options.
A CAPD assessment includes:
Hearing screening
Your child’s hearing will be tested to establish whether it is within the
normal range.
Listening in Spatialized Noise – Sentences test (LiSN-S)
The LiSN-S is a breakthrough in the acoustic assessment of children
because it allows clinicians to measure how well a child uses the
spatial information in sound to understand speech in noise. The
inability to use spatial information has been found to be a leading
cause of listening difficulty in noisy situations.
LiSN-S was developed by Australian Hearing’s research division, the
National Acoustics Laboratories (NAL) and further information on
LiSN-S is available at http://capd.nal.gov.au
Depending on the results of these tests we may also assess:
Dichotic Digits Test (DDT)
The DDT is used to assess the ability of your child to process different
information being presented to each ear at the same time. The ability
to integrate information is important for effective classroom listening.
Number Memory Forward (NMF)
The Number Memory Forward subtest of the Test of Auditory
Processing Skills – Third Edition is designed to show how well a child
can remember simple sequences of auditory information. This ability
is commonly referred to as short term auditory memory. Deficits in
short term memory have been found to be associated with poorer
academic performance and increased reports of listening difficulty.
Number Memory Reversed (NMR)
The Number Memory Reversed subtest of the Test of Auditory
Processing Skills – Third Edition is designed to show how well a child
can remember and manipulate simple sequences of auditory
information. This ability is commonly referred to as auditory working
memory. Deficits in this area can affect a child’s performance in the
classroom and lead to flow on effects such as listening fatigue.
The assessment
Training and
The management options recommended for
your child will depend on the results of the
assessment appointment. If your child is
diagnosed with deficits on any of the above
tests, your audiologist will discuss the most
appropriate management or training option
with you.
For instance, a child with SPD can be supported through three
different approaches:
Environmental modifications to improve access to
auditory information.
Remediation of deficient auditory abilities through
auditory training.
Teaching coping strategies to enhance auditory abilities.
Deficits identified in other areas can be supported through:
Environmental modifications to improve access to
auditory information.
Teaching coping strategies to enhance auditory abilities.
Environmental modification and classroom strategies
These are selected, practical management suggestions which can
be used in the classroom setting to improve the immediate
listening environment. They may include:
Providing preferential seating
Securing the child’s attention prior to being addressed
Undertaking regular check on the comprehension of
verbal instruction
Use of an FM system which provides amplification of the
teacher’s voice to the child, thereby giving the child
better access to teacher instructions and directions.
These strategies as well as other strategies will be discussed with
you at the time of the appointment.
Remediation Programs
Auditory remediation (auditory training) activities aim to
strengthen weak or deficient hearing abilities. To be most
effective, auditory training activities should be practiced regularly
and intensely and be sufficiently challenging.
At Australian Hearing we offer the LiSN & Learn auditory training
software for children who are diagnosed with SPD. The LiSN &
Learn was developed by Dr Sharon Cameron and Dr Harvey Dillon
at the National Acoustic Laboratories.
LiSN & Learn is designed to train children who experience
listening difficulties in the classroom due to SPD, to attend to
target speech while suppressing spatially-separated background
noise. It is recommended that children train with the software for
15 to 20 minutes per day, five days per week, for 10 weeks.
Additional information on the LiSN & Learn auditory training
software is available at http://capd.nal.gov.au
We also offer memory booster software as a remediation program.
Memory Booster software is used to train children to use memory
strategies and practice these skills. This helps children develop good
memory strategies, organise information efficiently and practice the
skills necessary for effective learning and recall of information.
It is recommended that children train with the memory booster
software for 20 minutes per day, three days per week for an eight
week period.
Compensatory strategies
These aim to teach the child skills so they can operate more
effectively in listening and learning situations. These skills aim to help
the child to identify difficult listening situations and to apply
strategies that will help their learning and comprehension. They also
aim to help the child become confident so that they can make a
difference in their own listening and learning.
Whole-body listening approach. Have the child to sit up
straight in an alert mode, incline the upper body and head to
the speaker, maintain eye contact and keep attention on the
Self-regulation and problem solving. Alert the child to his/her
listening strengths and weaknesses, identify potential
situations where listening may be difficult (e.g. in the canteen)
and encourage the child to think of possible solutions to
improve his/her listening (e.g. move to a quieter corner) and
then evaluate its effectiveness in the circumstances.
Verbal rehearsal. Encourage the child to repeat information to
him or herself to remember it better.
Auditory processing disorders can co-exist with a
number of other disorders (for example cognitive,
language or attention disorders). Therefore your
audiologist may recommend other assessments
depending on the child’s history and presenting
difficulties. For example:
Assessment by a speech pathologist: A qualified speech pathologist
assesses the child’s receptive and expressive language abilities.
Speech Pathology Australia
Assessment by an education psychologist: A qualified psychologist
tests the child’s cognitive skills and mental abilities.
Australian Psychological Society
These assessments can further identify the individual’s strengths and
help explain how a child’s difficulties are affecting his or her learning
and communicative skills.
Other assessments
that may be of
About Australian
Australian Hearing has 65 years’ experience in
providing the community with the best hearing
We are the largest provider of hearing services for children,
young adults, veterans, pensioners and Indigenous people in
The National Acoustic Laboratories (NAL) is the research division
of Australian Hearing. Since 1947, NAL’s research into hearing has
opened new ways in which people with hearing loss can be
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Bellis TJ. (2003) Assessment and management of central auditory processing disorders in the educational setting. From Science to
practice. New York, NY: Delmar Learning.
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Australian Hearing Head Office:
126 Greville Street
Chatswood NSW 2067
Tel: (02) 9412 6800
TTY: (02) 9412 6802
Fax: (02) 9413 3362