I need fresh insight on CAPD

[MyLittleBears]

I'm not trying to start any wars here. Just need some clarification. I had my ds tested by a reputable, homeschool friendly neuropsychologist who diagnosed him with moderate dyslexia and a broader language disorder with mild articulation difficulties. Receptive language being the dominate trait after dyslexia. What she explained was that dyslexia is a language disorder that affects receptive and expressive language, as well as written language, in variable degrees.  My ds does a lot of "huh?", "what?", type of things if language comes at him to fast. Her recommendation was just accommodating him by slowing down a little when speaking. This sounded suspiciously like CAPD to me so I asked her about it. She said that is a new label given to a language disorder that already exists. In other words, CAPD is a new term used for an old label (receptive language disorder) in order to "market" it better, and offer more services for $.  Can this be right? We have an audiologist in our area who seems to diagnose a LOT of kids w/CAPD and offer therapies, one being FAST FORWARD.  Has anyone found CAPD therapies effective? Ds had chronic ear infections a an infant which I suspect caused most of the problem but we also have a history of this type of behavior in the family(Dh) and older brother w/ASD. Can it actually be remedied.

I'm confused now ! :/

[geodob]

It's a shame when a neuropsych can't admit they don't know enough about something, to give constructive advice.

Yet on the other hand, if the audiologist that you mentioned is the only one your area?

Given that they offer Fast Forward, which has no creditable scientific research to support it.

This could explain her statement ?

 

Chronic ear infections in infancy, are the primary cause of CAPD.

Which is primarily caused by inefficient draining of the fluid from the ears.

This normally occurs every time that we swallow. 

 

Though this can cause a range of different problems, which first need to be clearly identified.

[Heathermomster]

So, can CAPD be remediated?  

[PeterPan]

My dd does the "Huh?" thing and has no CAPD, just very low overall processing speed.  My ds does not do the huh thing but is really odd with directions and had sentence comprehension at the 25th percentile with a gifted IQ.  I need to call the psych and ask what in the world that means.  

 

The labels change because their understanding changes.  That whole explanation seems odd.  Our psych is on the advisory board for the state dyslexia association and he described it as a phonological processing disorder.  They're narrowing and shifting how they use particular terms so labels are more targeted.  

 

A psych wouldn't diagnose CAPD anyway.  Half the APD screening our SLP did was stuff that was low because of the dyslexia.  I took ds in to the state university for a hearing eval because he hadn't had one (my bad, now corrected) and because I didn't want to go to a psych saying such and such if there was a physical explanation.  They won't do the full CAPD testing till 7 but he doesn't have any indication of it.  They said they would do it at 7 if the psych says.  (They sort of worship this psych's feet.)  So I'll be curious to see if that extremely low sentence comprehension is enough to send him over.  That to me is receptive language and yet if he doesn't send us over that's receptive language without the CAPD.  

 

Btw, I've been around two kids with CAPD and they don't present like my ds.  So there you have receptive language issues *without* CAPD.  I think?

[Mukmuk]

My son has CAPD. He has stealth dyslexia, which seems to stem from his visual processing issues. But he has no receptive language disorder. In fact, he's highly verbal with off the charts comprehension.

 

No psychologist can dx CAPD; only an audiologist can, and even then, it has to be an audiologist who is specifically trained in this area. I've read that in certain countries, the CAPD dx is still highly controversial. The problem is that it has among the highest comorbidity rates with other learning differences (I read this in a pubmed research but lost the link, sorry), which is why it's difficult to tease apart. But it can exist on its own. I have a scientist friend who found out she has CAPD when her husband insisted she test alongside her son (CAPD too, no other dx).

 

That said, my son's CAPD presents itself as "auditory fatigue". His capacity for listening is very small and he automatically blanks out when it's filled. He had difficulty telling apart certain sounds ("b" and "d"), and voices would get lost among background noises) so that classroom listening or even watching TV was impossible. Over the years, his capacity has improved, but it's still discernible. I think he's improved to his maximum, ie, it isn't a huge problem socially. He loves discussion. Passive listening is probably out though. What he gets from TV is improving steadily. He loves documentaries now, and movies too. Audiobooks are good in a sealed environment (car or covered headphones).

 

Has any therapy worked? Well, we tried a lot! What *i think* worked best: playing the violin. He found music to be very soothing, and he had to practice listening, which helped a lot. Possibly Interactive Metronome- again, there was a beat to pay attention to. Fast Forword seemed to work too - this is the pre-reading segment which trains the ears to differentiate among letter sounds. Ds used this well after he was reading, so the program helped specifically with listening. Bal-a-vis is good for overall rhythm and coordination, possibly because it improves the vestibular system (ear related).

 

The listening therapies (we tried Samonas and one other, I forget) didnt do anything except get him annoyed, but it worked for another friend. An ear filter (touted by one audiologist as the *only* solution that works) was rejected by ds as it made voices sound tinny and artificial.

 

The difficulty is that there is no universal agreement as to what works, and even within my limited experience, kids have different responses to the same therapies. We were told that between the ages of 10-12yo, there is a huge developmental leg up within the auditory system, although it may not necessarily get to what is considered as "baseline normal". I feel that we definitely helped improved ds' odds, so it's less of an issue now.

 

Good luck to you and your son on your journey!

[kbutton]

That said, my son's CAPD presents itself as "auditory fatigue". His capacity for listening is very small and he automatically blanks out when it's filled. He had difficulty telling apart certain sounds ("b" and "d"), and voices would get lost among background noises) so that classroom listening or even watching TV was impossible. Over the years, his capacity has improved, but it's still discernible. I think he's improved to his maximum, ie, it isn't a huge problem socially. He loves discussion. Passive listening is probably out though. What he gets from TV is improving steadily. He loves documentaries now, and movies too. Audiobooks are good in a sealed environment (car or covered headphones).

 

This behavior/way of functioning sounds so familiar with my DS 7. My son has hit the magic age for testing, and we need to get on the waiting list. Reading a lot and reading widely have helped him realize that he doesn't hear stuff correctly. We were hardly into phonics when he realized that he'd been hearing and saying a lot of words incorrectly. (No significant history of ear infections--he had exactly one, which cleared up with no problems, though he did have some neck problems when he was little, and I know that if my neck is out, I can't hear diddly-squat.)  

 

He has no clearcut anything to pinpoint--he has anomalies with everything. Even when he has a clear cut problem with something OT-related, for instance, he will also be able to do things that make no sense developmentally. They attribute it to his motivation when this happens. It's very odd. 

[Mukmuk]

 

He has no clearcut anything to pinpoint--he has anomalies with everything. Even when he has a clear cut problem with something OT-related, for instance, he will also be able to do things that make no sense developmentally. They attribute it to his motivation when this happens. It's very odd.

Hi kbutton,

 

Ack. The trials and tribulations of compensation! Compensation is supposedly a good thing. It allows a kid the ability to accomplish a task without having the actual skill or fundamental ability to do so. But oh my, at what cost! It takes so much energy and effort, which is why when fatigue sets in, the child can no longer do what seemed effortless the day before. Hence we have spectacularly good days and bad days.

 

I recently had to tell our VT that the super high TVPS scores (for visual processing) were completely unreal. I just don't see it at home. Our therapist (bless her) took me seriously and after administering a series of non standard tests, found out that ds could not not order different sizes! We're working on that now and it seems easy to fix. But ds had developed splinter skills to cope so that more complicated tasks are easier than fundamental ones). Do egg your your therapists on. Push them to try different things. They may find something that is entirely correctable!

[MyLittleBears]

Well, ds does in fact have low processing speed, although not as significantly as his ASD brother, so that I guess would account for some of the "huh?" stuff.  He has been through the first 3 levels of Barton with some phonemic lessons repeated but still sometimes has difficulty differentiating certain vowel sounds like in end and and. I have to enunciate those. Also, I know if a rapid fire shoot words at him, everything goes haywire. If I speak clearly and slow down just a little bit, he had NO issues at all. I just don't want to start down the CAPD path if there is nothing that will actually help. Watching TV does not present a problem but he does often mishear some words. He told me once, that Audrey Meadows (from the Honeymooners) sound like blubbery meadows. We watch a lot of old shows. Our cats are named Trixie and Norton! :)

[PeterPan]

Mukmuk mentioned trouble distinguishing speech from background noise and that's the thing the university audiologists said too.  It's not *always* present in APD, but if it is present I think they're saying it's almost always APD.  

 

Yes, our OT showed us how to do BalavisX during our eval and I got the manual to do some with him.  She has done the training multiple times and it was fascinating to watch.  They want you to be very quiet and get into the rhythm and hear the swishing of the bags as you toss them. 

[kbutton]

Hi kbutton,

 

Ack. The trials and tribulations of compensation! Compensation is supposedly a good thing. It allows a kid the ability to accomplish a task without having the actual skill or fundamental ability to do so. But oh my, at what cost! It takes so much energy and effort, which is why when fatigue sets in, the child can no longer do what seemed effortless the day before. Hence we have spectacularly good days and bad days.

 

I recently had to tell our VT that the super high TVPS scores (for visual processing) were completely unreal. I just don't see it at home. Our therapist (bless her) took me seriously and after administering a series of non standard tests, found out that ds could not not order different sizes! We're working on that now and it seems easy to fix. But ds had developed splinter skills to cope so that more complicated tasks are easier than fundamental ones). Do egg your your therapists on. Push them to try different things. They may find something that is entirely correctable!

 

They are able to pinpoint areas of weakness and work on them in OT; it just doesn't correlate to a specific diagnosis. Thankfully, they look for those holes and work on them based on what is most important functionally. He likely has ADHD inattentive type, CAPD, some language glitchiness (some dyslexia symptoms, but not anything like what most people talk about), and definite issues with processing speed, sequencing tasks, etc. His vision issues don't seem to be ocular motor (we see a COVD, and it's more developmental in that he should have been corrected earlier with a whopping astignmatism, but he really had almost no symptoms when he saw her at 4). Our OT calls him an "all of the above kid" on a multiple choice question (she said her grown son is like that, and she is to some extent as well). OT has helped and been a good experience--it's just odd to not have something clearcut like with our older one (ASD, SPD, etc.).

[PeterPan]

 OT has helped and been a good experience--it's just odd to not have something clearcut like with our older one (ASD, SPD, etc.).

I'm not sure every dc who has CAPD gets an ADHD label.  He literally might not have any other labels. 

[kbutton]

I'm not sure every dc who has CAPD gets an ADHD label.  He literally might not have any other labels. 

 

ADHD (inattentive) is looking more likely all the time. He even talks about how he has a hard time concentrating and gets upset about it. We'll see. 

[PeterPan]

ADHD (inattentive) is looking more likely all the time. He even talks about how he has a hard time concentrating and gets upset about it. We'll see. 

Compared to your other, your younger is so placid. :) But you're right, it can be subtle.  

[kbutton]

Compared to your other, your younger is so placid. :) But you're right, it can be subtle.  

 

Uh, huh, lol! Still waters run deep though...right into ditches and caverns in the ground so deep that you spend all your time pulling them out instead of taking the hike that you'd planned.  :lol: