Talk to me about CAPD (Central Auditory Processing Disorder)

[texasmama]

I wonder if one of my kids has this going on, and I would very much appreciate hearing how it presents from parents of kids with CAPD.  One of my kids is a diagnostic conundrum to me, and when I stumbled upon this, it made me look twice.

[Crimson Wife]

There are different sub-types of CAPD and each of them presents different symptoms.

 

Some kids struggle with phonemic awareness. They often have articulation problems when speaking and really struggle with learning to read & spelling. Earobics or HearBuilders software may be very helpful for these kids.

 

Some kids are very sensitive to background noise and have difficulty paying attention to the primary audio stream in a noisy environment. Noise-cancelling headphones can be very helpful. My oldest has this issue.

 

Some kids have trouble with auditory sequencing. My oldest has this problem as well. If you give her dictation, she'll write a paraphrase with the same "big picture" meaning but the items out of order. Following step-by-step oral directions is really hard for her and she frequently ruins things because she did the steps out of order. She often jumbles the order of syllables in multi-syllabic words.

 

I took her for the first part of the CAPD eval 2 years ago and there were enough "red flags" for the Aud.D. to recommend having the 2nd part done. However, I was told that it can be very difficult to tease apart CAPD from ADHD and working memory issues, so a full neuropsych eval was recommended prior to having the 2nd part of the CAPD eval. Long story short, we haven't had the NP eval done so it's been left at suspected CAPD.

[texasmama]

Thanks for talking to me about CAPD.  :)

 

I know my ds does not have ADHD.  He has no working memory issues.  His EF is below what would be expected for his age, though.  I think that makes him present with some ADHD type characteristics (impulsivity, lack of organization). 

 

I have the results of his testing done in May and have recently reviewed it with an eye towards CAPD, but I don't really know enough about it to come up with anything concrete.  I have cognitive and educational testing done by the school (he was dismissed from ST and OT this past year), in addition to the Stanford testing done by our co op.

 

He still (at 13) misspeaks certain words as a young child might (write-ed rather than wrote, as an example).  These mistakes are not frequent enough that they draw attention to him as terribly different, but I do think these are outside the norm.  It's like he never heard the difference or corrected them as most kids do as they get older.  My younger son corrects him at times, and the older says he thought that was what he was saying.

 

When he was a toddler, he had the auditory brain stem hearing test, and it was normal.  His hearing tests on the lower range of normal (hx of ear infections and two sets of tubes) so I don't think he has issues with hearing which would cause the other problems.

 

I have considered paying a professional to interpret the testing for me.  Ds is an enigma to me.  Mostly he is doing really well, but his long-term memory is poor (and this was borne out during testing).  Math is a clear strength for him, but he recently told me he didn't remember how to subtract.  Indeed, when I have him a simple three digit minus a two digit problem with regrouping, he could not do it.  I had to explain it in depth, and it took him some time to grasp it.  I think he eventually memorized the algorithm of "borrowing".  This is a kid who can do complex math in his head, and he could have worked out the same problem in his head, but he could not do it on paper.  He scored PHS on all of the math portions of the Stanford, but he can't do second grade subtraction.  We don't have a diagnosis other than SPD, which is not even a "real" diagnosis. Never have.  He doesn't qualify as LD per the school district, but they have very specific criteria, but his test scores are scattered such that I have always looked at him as having mild LD's. 

 

I periodically revisit these things and search for "what is the deal", if you will.  I am in a period of doing that again at the moment.  :)

[Crimson Wife]

Have you noticed a big discrepancy between being able to do things when he can see them vs. only hear them orally? With my oldest DD, it's like night and day.

 

Give her an oral math problem, and she struggles. Write the problem down for her, and she can solve it easily.

 

Ask her to repeat back a 4 digit number she hears orally, and she'll give you all 4 digits but transpose the order. Briefly show her a 7 digit number, and she can write it down from memory correctly.

 

Something about processing the auditory information correctly is tripping her up.

[texasmama]

I will try that, CW.  That is a good suggestion which might give me some more information.

[merry gardens]

Crimson Wife explained it well.  There are different types and they present differently.  Years ago I read the only book my library had on CAPD (Like Sound Through Water) written by one mother about her experience with her child's CAPD.  Because that mother's experience sounded nothing like my child, I wrongly concluded that we weren't dealing with CAPD.  A better book to give an overview of various types of CAPD is "When the Brain Can't Hear" by Terri James Bellis. PhD. 

 

 

[Tiramisu]

Hi Texasmama! Let me tell you about my dd's CAPD, because, like your ds, she was and is a diagnostic conundrum. Cognitive and educational testing were not enough to catch it, though I can see the significance of some scores retrospectively. Her educational scores were always good but her cognitive subtests were scattered and inconsistent, meaning tests that were supposed to measure the same thing had different results. The np later said there was a pattern in the inconsistencies and does not believe she has ADHD. 

 

As far as the CAPD goes, my dd would appear to not have heard or have misunderstood a lot of the time. We have busy household or it may not have been so evident. However, her auditory skills were good on np testing--because they are fine as long as there is only one signal at a time in a quiet room. She has a problem with background noise but, also, as a distinct problem, her brain cannot process separate signals coming in each ear and won't hear anything that's coming in her right ear if something else is coming in her left ear at the same time. Noisy classrooms and social gatherings are hard for her.

 

Ironically, she learns best by listening and has good attention if the auditory environment is good. She doesn't learn well with visuals. Compared to the auditory scores, the visual stuff was weak on the np report. Not what you'd expect in someone with CAPD.

 

She is somewhat forgetful and disorganized but has learned good compensatory strategies.

 

My gut feeling is that even though you've had the testing done by the school district, you may need a np who will do more specific testing to tease out the issues. I'd think about visual and visual motor stuff after what you said about how he could do math in his head better than by writing. My dd could sometimes be the same. Her memory was funky with math, too.

 

In When the Brain Can't Hear, that merry gardens mentioned above, Terri Bellis includes description of a type of CAPD (that I can't remember the name of) that often has a visual and/or visual-motor component. My dd's CAPD fit the description of that type and that was what made me start looking into the other issues. (Thank you, Terri!) First, we went to a COVD doctor and then the np. They uncovered visual and visual-motor issues that I had no idea existed, but once I knew, it explained a lot. It's basically dyspraxia that's not bad enough for a label. It didn't come up with the np but she probably has some form of SPD, too, because you can't be my child and not have it.  :glare:

 

Wishing you the best as you sort it out!

 

P.S. Even though we didn't get a label besides the CAPD from the audiologist, the np picked up on a significant speed problem caused by the other difficulties and she recommended extra time in her report. She probably would not have been tested or given accommodations in ps if we had ever gone that route because her achievement scores were too high, but with the audiologist's report and the np's report, she is eligible for extra time on tests in college. She has only needed it for one class but it has been very helpful. That might be something to think about since you are also facing the school not recognizing your concerns. 

 

[texasmama]

Thank you, Merry and Tiramisu. You have given me a lot to think about.

[MerryAtHope]

My daughter and I both have mild auditory processing glitches, and a little ADHD mixed in. (I wrote about mine in a humorous blog post recently--Forgetting Plates and Auditory Processing). I put some things that have helped my dd at the end. Things I noticed with my daughter:

 

While my son loved read-alouds (even chapter books) at a fairly young age, she didn't, unless it had lots of pictures and really held her attention. First chapter book she liked was the Wizard of Oz...because she loved the picture of the witch melting!

 

Mixed up syllables much more than the average child (the classic "pisgetti for spaghetti." When I was a child, I know I said "hangerber" for awhile, instead of "hamburger.")  A year or two ago I remember her saying "Deuteromony" instead of "Deuteronomy."

 

Confusing similar word sounds such as /m/ for /n/ and so on.

 

Forgetting instructions or parts of instructions.

 

Listening to a book (even today--she's 14) and asking who such & such character is--and it happens to be the main character in the book but she didn't recognize the name! 

 

Trouble tuning out background noise--when spoken to, she is often spacing off, doesn't realize that she's being spoken to etc...

 

Mishearing strings of words (similar to my examples in my blog entry, like the Jingle Bells "one horse, soap, and sleigh," and so on.)

 

My son had some auditory processing struggles early on, and he really struggled with consonant blends (such as at the beginning and end of the word, "blend.")  He would often leave letters out when trying to read or spell. In his case, noise cancelling headphones help a great deal when he's working (he needs silence, while my daughter often needs to speak or sing what she learns, which is an interesting twist...)  Also interesting in his case--he has a dominant ear. He MUCH prefers it if I sit on one side of him during our 1 on 1 tutoring times than the other--it's easier for him to learn, he gets frustrated less easily, has more patience and stamina--it's very interesting. My daughter doesn't seem to have a preference.

 

 

 

 

[texasmama]

Thank you for those specific examples, Merry. Some of them rang a bell.

 

I know this is a long term issue (and we have been on a path of therapies since his toddlerhood), but I do think there might be a label that ties most of his difficulties together. If there is, I think it would be helpful to find it. I've found myself too busy and exhausted lately, but when I come up for air I hope to look further into this.

 

I appreciate those of you who have shared stories and ideas. It has been helpful. It is also nice to have perspective from some folks who have BTDT.

[merry gardens]

I wonder if one of my kids has this going on, and I would very much appreciate hearing how it presents from parents of kids with CAPD.  One of my kids is a diagnostic conundrum to me, and when I stumbled upon this, it made me look twice.

 

Some days, CAPD in a child presents with parents who look like this: :banghead:

 

I deleted personal details from my previous post out of respect for child's privacy.  I don't remember if I mentioned in it that CAPD can drive a parent crazy?  Sometimes we don't know if the problem is that my son didn't hear/understand/process correctly--or if he's being disobedient, or it's something else. 

 

Following oral instructions can pose a particular challenge for many people CAPD.  Here's a recent example: when a waitress with an oven mitt reached to put down my son's dinner plate she gave the warning, "Don't touch the plate. It's hot." I noticed a lot of background noise and saw my son was reaching out to help with his plate, so I quickly grabbed his hands to prevent a burn injury.  He heard she said something to him, but did not know what.

 

It's easy to fall into the trap of scolding a child to "listen" better.   I did well at the restaurant, but I still often catch myself talking to my son as he walks out of the room or when his back is turned, or I get frustrated when he repeats people or asks a question that was just answered.  My son's CAPD is mild and it shows up only in some situations. My husband and I sometimes forget that he even has an auditory processing disorder, and then we get frustrated when he displays behavior that is typical for CAPD.  When we remember his CAPD, it's still tough to discern sometimes if the underlying cause of his not following directions is CAPD --or something else. 

[Tiramisu]

Another excellent post by Merry! :)

[kbutton]

Just listening in, but thanks for all the information. DS6 may have CAPD--he failed a screening which suggested he has this and/or a language disorder, but he is too young to be tested for CAPD. We thought for a long time that he was ditzy as he is compliant, very nurturing of others, and intuitive. He's usually not defiant, but he does dawdle a lot or space out when he should be doing something. If he is in a noisy group, he misses a lot of what is said, which is sad, because he's very extroverted and loves to play in groups.

[texasmama]

Fortunately, my son is not defiant so that does help to evaluate his other issues.  At 13, he has some teen attitude, but he is usually compliant.  He gets overwhelmed sometimes and ends up crying, usually during math, his strength subject.  He hates this, though, and would not choose it.  It is beyond his control.  Mostly, I don't lose patience because he has always been so sweet and compliant.  I do not take this for granted because not all my children are like this.  :)

[Timberly]

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[MerryAtHope]

Merry, your above idea to use noise canceling headphones doubled my 9 year old's output and success in math, spelling, typing and handwriting, even in our quiet house!

 

Awesome! So glad that's helped!

[Timberly]

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