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Central Auditory Processing Disorder

What is CAPD?

CAPD also often referred as APD or Auditory Processing Disorder. In general, Auditory Processing Disorder (APD) refers to how the brain as the Central Nervous System (CNS) has difficulty to process and use auditory information to find meaning. Thus CAPD often been related closely to a hearing problem which the brain can’t hear.

However, APD is an auditory deficit that is not the result of other higher-order disorder such as autism, mental retardation or attention deficit, though it often occurs with impairment of language, literacy and attention (Witton 2010). It is important to understand that they are not similar at all. CAPD only means something is blocking the brain’s ability to properly process sound reaching the ear.

Though CAPD is frequently said in children, it can affect adults as well. Those with CAPD may not be able to understand what someone is saying in a noisy environment, but they might not have problem to comprehend conversation in a quiet place.

What are the signs and symptoms of CAPD?

It is not easy to identify CAPD, as the symptoms are often masked by other behaviour as well. Person with CAPD might be having:

  • Poor concentration and difficulty understanding speech in the presence of competing background noise
  • Poor listening skill, easily distracted and difficulty to stay focus on listening task for long
  • Difficulty following rapid speech
  • Poor auditory memory such as remembering direction or list
  • Difficulties in linguistic sequencing; difficulty in differentiating similar sounds; /catch/ and /match/.
  • Difficulty to understand higher level listening task like understanding humours, riddles, technical language, novel speech material and many more
  • Academic difficulties, including reading, spelling and/or learning problems

What causes CAPD?

  1. It can be in the family history
  2. Brain injury due to traumatize event
  3. Long lasting hearing difficulties due to ear disease such as otitis media

How to diagnose CAPD?

There are things to consider before diagnosing CAPD:

  • They shall have normal intelligence, no problem with language
  • They do not have hearing problem
  • They have no attention problems with other major developmental problem like autism

The test shall be conducted only by Audiologist in a sound treated room. It requires listener to attend to a variety of auditory signal and to respond to them. Most of the test requires that an individual to be at least 7 or 8 years old, due to mature function of the brain. Even there is no a gold standard assessment, CAPD shall be assessed through standardized test of auditory perception.

Once diagnosed, those with CAPD usually work with Speech Therapist or Audiologist to assist them according to their individual auditory deficits or specific areas of difficulty.

How to treat CAPD?

Many research and guideline recommended that treatment and management of CAPD is highly individualized, with the main target is to improve the individual primary complaint. There is no one of the treatment approach will appropriate for all. A multi-professional approach to the diagnosis and management of CAPD, such as Speech Therapist, Psychologist as well as Audiologist, is essential to ensure they have access to the most appropriate range of support and intervention (Witton 2010).

How can we help?

  1. Changing the listening and communication environment
    • Usage of Assistive Listening Device : to improve method of conveying information via reducing background noise
    • Sitting closer to the source of auditory information, so then they can hear clearer
    • Breaking instructions into simple steps, like giving the next instruction once the first direction has been completed
  2. Mastering compensatory strategy in assisting listener to improve their higher brain function. They have to increase the listening activity that is known to be in deficit, into their daily routine.
    • Activity to improve auditory memory skills
    • Activity to improve attention skills
    • Activity to improve problem solving skills
  3. Direct therapy or auditory training to the specific auditory deficit via
    • One to one training with therapist
    • Home- based, school-based or centre-based program
    • Computer assisted training

Further information on above discussed issue, kindly find nearest hospital or health centre that provide Audiological services.


  1. American Academy of Audiology (2010) American Academy of Audiology Clinical Practice Guidelines. Guidelines for the Diagnosis, Treatment and Management of Children and Adults with Central Auditory Processing Disorder.
  2. American Speech-Language-Hearing Association: Understanding Auditory Processing Disorder in Children. Retrieved from: http://www.asha.org/public/hearing/Understanding-Auditory-Processing-Disorders-in-Children/
  3. British Society of Audiology. 2011. Practice Guidance. An Overview of Current Management of Auditory Processing Disorder (APD). British Society of Audiology
  4. Central Auditory Processing Disorder. Retrieved from: http://www.learningrx.com/central-auditory-processing-disorder.htm
  5. Child and Youth Health : Auditory Processing Disorder Retrieved from: http://www.cyh.com/healthtopics/healthtopicdetails.aspx?p=114&np=306&id=2330
  6. Jane R. M.& Carol F: (2008) Pediatric Audiology: Diagnosis Technology & Assessment. New York: Thieme
  7. Kids Health : About Auditory Processing Disorder. Retrieved from: http://kidshealth.org/parent/medical/ears/central_auditory.html
Last Review : 10 March 2014
Writer/Translator : Khadijah Azura bt Salim
Accreditor : Nur Azyani bt. Amri