I'm curious about something...

[Heathermomster]

How does one diagnose CAPD?  Are there pointers or soft signs that scream, "Hey, screen for this?"

 

Would a NP pick that up?  

 

I don't have any personal concerns, but I am curious about how that is discovered.

 

Thanks, 

~h

Edited June 20, 2016 by Heathermomster

[PeterPan]

NP should have a screening tool like SCAN3. Better to go to audiologist with booth setup.

[kbutton]

Our first (and now favored after trying a couple) education psych did a computerized version of the SCAN 3 when my son was getting his ASD diagnosis--it's one of those, "hey, it's co-morbid, so let's do it" kinds of things. It's not as sensitive as a booth test, but it can help. It also looks at more than CAPD--it can suggest language processing difficulties. My ASD kiddo passed with flying colors (no surprise there). We did that screening with my kiddo who does have CAPD (and we didn't really know anything about it at the same), and he BOMBED THE TEST. He was just about six at the time. It showed all kinds of abnormalities, but it was not definitive for anything. FFW, and he had the booth test last year, and he bombed that too. They could not test all the categories because his speech was so bad they couldn't be sure what he was saying in response. Oddly enough, the computer didn't have as much trouble with that!

 

I think that seeing CAPD was something that would not have happened on our own--I think the screening introduced the idea to us, and then we could see it play out. In between the computer screening and the booth test, I also just happened to befriend an audiologist who did some clinical rotations in college with one of the foremost experts in the country about CAPD. :-) 

 

I think the big deal is to remember that you can have one very debilitating area that checks just one symptom on the list. It's not like ADHD where (usually) the more symptoms = more likelihood of a diagnosis. it doesn't quite play nicely that way.

 

The soft signs are quite soft, honestly. It's a weird thing, IMO. It's weird even when I see it IRL. It's also not cut and dry for audiologists AT ALL. There is no consensus on diagnosis or treatment, though there is a more recent movement to put more shoe leather to things and try to do things that will boost the chances of a child not missing so much.

 

I would be very curious to see if they do some studies on how CAPD plays out--recently the Gifted Development Center published some information about ear infections and IQ scores--among gifted kids (but oddly enough, not among NT kids), ear infections play a huge role in dramatic differences in IQ among siblings. Overall, other indicators of intelligence aren't significantly different among siblings, just the scores. Things like creativity and other behavioral, social, emotional characteristics that come with giftedness remain intact. The differences, in some cases, were up to five and six standard deviations! (IOW, a profounded gifted child whose sibling showed similar traits but had recurrent ear infections/fluid would test as very high normal, on the cusp of gifted designation!) Neither of my kids had more than one to two ear infections, but my kiddo with CAPD deviates more than the typical deviation IQ-wise from his brother (on the lower side). The first psych to test him has spent time with both kids, and she expected my CAPD kiddo to test higher, probably by an entire standard deviation. Since ear infections are a risk factor for CAPD and create a scenario kind of like CAPD, I would love to see more research on this. We can't just give a non-verbal IQ test to my CAPD kiddo because he has visual processing deficits and ocular motor issues. It's intriguing to me overall.

 

I do see that my CAPD kiddo is turning inward a lot. He seems content, but it's starting to cause a problem. He's really missing stuff, while simultaneously becoming more aware of his issues and asking for people to talk slower, etc. But he is tired of asking people to repeat themselves. He's also tired of repeating himself (speech issues),and I think the layers of problems he has just reinforce that fatigue.

[Crimson Wife]

Psychologists and SLP's can screen for it, but you would need an audiologist to do the full eval.

 

The SLP clinic in my area that specializes in CAPD treatment uses the following screening tests: Test of Auditory Processing Skills (TAPS-3), Auditory Processing Abilities Test (APAT), SCAN-C-3 (Auditory Processing Screening Test), Test of Phonological Awareness, Goldman-Fristoe Test of Auditory Discrimination, CTOPP-2 (Comprehensive Test of Phonological Processing 2).

 

I think my little one probably has some CAPD issues in addition to the physical hearing impairment (she showed symptoms even when her pure tone hearing thresholds were normal) but unfortunately the CAPD tests are not considered reliable for someone with the degree hearing loss that she has. There's no way to tease out what is due to the dysfunctional inner ear and what is due to faulty processing in the auditory cortex of the brain.

 

 

[monstermama]

Is there a general age range or level of speech needed for that?  My SLP suspects DS may have it, but says he's too young to be screened for it yet.

[Crimson Wife]

Is there a general age range or level of speech needed for that? My SLP suspects DS may have it, but says he's too young to be screened for it yet.

Many clinics will not test until age 7 or 8

[Tiramisu]

The np saw no signs at all of CAPD, only because she was in a quiet room with one person speaking during the testing, with no other stimuli.

 

She cannot do competing signals or hear in noise, and honestly, I'm convinced competing visual input messes up her auditory processing, too.

 

My DD was diagnosed by an audiologist at a children's hospital.

 

She was constantly misunderstanding things and mis-remembering things she'd heard. It became more obvious in the teen years when I wasn't managing her life as much and when my expectations changed to expect her to understand better.

 

It's still the same, even though she's an adult and very independent and doing well in her field of study, which actually can make it harder to deal with.

 

I really have to remind myself of her difficulty to not become frustrated. If it's quiet and she has time to process, it's manageable. But often our lives are chaotic with dh running out the door to take kids one place and me taking someone another place. We announce when we're coming and going but she usually misses it and then wonders where everyone is. Or we call everyone to dinner and she never comes. It seems sad but sometimes if she doesn't show up, I forget to get her because since she's gone to college, I've become used to her place being empty. I remind myself now to get her and make sure food is left for her if she gets to the table last.

 

She often seems confused in group interactions and isn't clear of what's going on when we make plans as a group. I'm sure that triggers a lot of anxiety in her, and the anxiety was there long before we ever heard of CAPD.

[kbutton]

We announce when we're coming and going but she usually misses it and then wonders where everyone is. Or we call everyone to dinner and she never comes. 

 

She often seems confused in group interactions and isn't clear of what's going on when we make plans as a group. I'm sure that triggers a lot of anxiety in her, and the anxiety was there long before we ever heard of CAPD.

 

Yep, we have a lot of that here too. And it reinforces his not listening and daydreaming because it's just so hard to attend when you're going to miss half of it anyway.

 

 

 

I don't know what the deal is for speech and CAPD, but the child has to respond and be understood. I know that the audiologist who tested my son had trouble understanding his speech. If you plug his ears (or put ear phones on him like they did in the audiology booth), he can't hear himself, and then his speech goes downhill. He has speech motor issues and learned to kind of speak by ear because he didn't form the sounds the right way. So, it kind of makes sense that when he can't hear himself, he doesn't speak correctly. At least that is what I am assuming happens to him.

[PeterPan]

Not that you asked, but the TAPS3 isn't my fav.  It flagged 1/2 on ds, and I think it was because of the dyslexia.  Definitely wouldn't take *just* that test as authoritative.