Central Auditory Processing Deficit (CAPD)

Auditory Processing (AP), Auditory Processing Disorder (APD), Central Auditory Processing (CAP), Central Auditory Processing Dysfunction (CAPD), or Central Auditory Processing Deficit (CAPD).

Children with this disorder may demonstrate difficulties in speech, language, and/or learning, especially in the areas of spelling and reading.  They may also appear hearing impaired, be inattentive, easily distractible, and have difficulty following oral directions.

A list of some common issues:
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A student with CAPD student has normal hearing, but difficulty analyzing or making sense of what they hear.

Diagnosis of CAPD would be evaluated by an audiologist and speech/language therapist. While the speech and language therapist can determine the areas of language the child has difficulty with, the audiologist can determine hearing acuity and middle ear function.  Your child needs to be 7 or older to get an evaluation for CAP.

Regular audiologists do not have the training or equipment for this; an audiologist who specializes in CAPD evaluations is necessary. You can find a list of CAPD audiologists.

A CAPD evaluation can determine CAPD subtype (s).
This website has a
checklist of the CAPD symptoms and five subtypes.
Learning About CAPD (for a chart of five subtypes, scroll down 1/4 way down the page) and has some helpful links.

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Types of therapies / programs available for children with CAPD?

Two types:
Sound Therapy or Auditory Integration Training (AIT)
Auditory integration training addresses hearing distortions, hyperacute hearing, and sensory processing anomalies which cause discomfort and confusion in persons suffering from learning disabilities, including autism (Stehli, 1995). The theory that human behavior is largely conditioned by the manner in which one hears (Berard, 1993).   The therapy is harmless and does not require an evaluation so it can be used on anyone 3 or older.

Links on Auditory Intervention Techniques (AIT):

These three programs have been around for 20 years, they use an older technology.  (The majority of the research on AIT's involve autistic children.):
Berard - Earducator
Samonas - Spectrally Activated Music of Optimal Natural Structure

Related AIT method links:
Neuro Therapeutics (Overview of AIT methods, and give some comparisons of the therapies, located in Oregon.)

Project Child (Occupational therapy services and sound training.  Center for Holistic Integration, Listening and Development located Beverly, MA).


These programs use the newer technological sound production:
Earobics - Computer based program with speech games to improve listening skills.  Can be useful for students with decoding (phonemic awareness) deficits. It is a bargain out of the other auditory therapies.  Recommended 15-20 min/day; 3 levels, ages  4-7, ages 7-10 and older.

The Listening Program (TLP) - Enhanced classical music on 8 CD's with a specific listening order and intensity.  Good prep for FFW,  for severe cases, TLP prep can make FFW much easier to get complete the program.

FastForWord (FFW) - Computer based program with games that teaches processing of speech sounds and works on short term auditory memory and auditory sequencing.  The program essentially attempts to correct neural pathways with process the sounds of language through an intensive set of drill and practice. FastForWord trains the auditory system to process the sounds of speech more efficiently. It can be a good choice for increasing auditory processing speed and auditory memory. (It seems to works for those who have a specific subtype of auditory processing problem, sometimes called "auditory decoding deficit".  (100 min/day, 5 days/week; 4-8 weeks; requires a provider).


Holistic Therapies - Music Therapy:
The Mozart Effect® - Is an inclusive term signifying the transformational powers of music in health, education, and well-being. It represents the general use of music to reduce stress, depression, or anxiety; induce relaxation or sleep; activate the body; and improve memory or awareness. Innovative and experimental uses of music and sound can improve listening disorders, dyslexia, attention deficit disorder, autism, and other mental and physical disorders and injuries.

Hemi-Sync® - helps alter brainwaves with multi-layered patterns of sound frequencies. When you hear these through stereo headphones or speakers, your brain responds by producing a third sound (called a binaural beat) that encourages the desired brainwave activity.

Throat Tones - Variety of chanting links from various cultures.  Gregorian Chants are used with music therapies
(i.e. Tomatis Method) and support AIT and can be used as a follow up or supplement to other therapies.

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2. Body Work
Bodywork is a fundamental therapeutic approach to CAPD.
Usually bodywork is provided in the form of Occupational Therapy (OT).
Severe CAPD often interferes with vestibular system development (timing, rhythm, balance) and often contributes to sensory integration (SI) disorder.

An Occupational Therapy approach that specifically addresses the issues of CAPD children:

NeuroNet is a sensory and motor therapy program.  Creating rhythmic integration of vision, hearing, balance and movement.  (It is new and not widely available.)  Can be helpful for children with certain types of auditory processing disorder that interfere with vestibular development (Vestibular problems could include: balance (difficulty learning to ride a bike), rhythm (difficulty clapping hands in time to music), timing (very slow processing, could be motor, auditory, visual, thinking, etc.)

  is a system of materials and activities that use balance therapy and sensory integration to stimulate the neural networks in the brain.  Also aimed at development of the vestibular system. Brain Gym and Balametrics stimulating both sides of the brain to work together.  Balametrics can be done as a home program.  (A form of bodywork that is incorporated into NeuroNet.)

Brain Gym® educational kinsesiology, movement exercises to access the whole brain, works to get the right and left hemispheres of the brain working together and accessing some parts of the brain that are not readily getting accessed. Is a program of physical activities that enhance learning ability.  Works on increasing relaxation, blood circulation and oxygenation of the brain, stimulating both sides of the brain to work together, etc.   (Can be provided by Occupational Therapist (OT), Brain Gym.  It is probably a good follow on to SI therapy or done in conjunction with SI OT as it helps to fuse together some of the Sensory Brain connections.  It combines techniques "borrowed" from many places including Tai Chi, sensory/motor and vision therapy.

Interactive Metronome (IM) - works on motor planning and coordination; done through a provider (15 hours).  This program can be helpful for motor problems (child poor at sports, motor coordination in general, or handwriting).

After sound and bodywork therapies have done all they can to reduce the sensory-motor deficit (s), cognitive training might be the next step:

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Cognitive training programs:

PACE = Processing and Cognitive Enhancement
It is a cognitive training program.  A brain-training program for enhancing mental skills.  BrainSkills is a "Do-It-Yourself" version of the PACE training program. It is intended for people who will dedicate themselves to the discipline and intensity required.  It can be used at home, BrainSkills starts with exercises at the age 6.  It has a strong auditory processing component (Including segmenting, blending or phoneme manipulation skills.)

Audiblox is a system of cognitive exercises, aimed at the development of foundation learning skills.  Audiblox can help with word memory (less sounding out the same word repeatedly during the same page) and visual memory.  Does work on digit span and auditory memory.  Audiblox despite its name, does not have a strong auditory processing component (No segmenting, blending or phoneme manipulation skills).  was initially developed as a preschool readiness program, so it includes exercises suitable for 4 years and up. (cost much less then PACE.)

Therapies that usually help develop attention skills are Audiblox, PACE, and Interactive Metronome.

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For reading remediation  (Decoding subtype), students with Phonemic Awareness (PA) deficits and decoding issues:

A decoding deficit means difficulty with the discrimination of speech sounds which has a certain impact on learning to read.

The Lindamood Phonemic Sequencing™ (LiPS™) Program stimulates phonemic awareness.  (The original name was the ADD Program, Auditory Discrimination in Depth).  The program which has been proven by research to help this area.

Telian Learning Concepts (TLC) and Wisnia-Kapp Reading Programs, Inc. (WKRP)  Both these programs teach phonemic awareness and phonics. Both developers are located in Massachusetts.

Earobics - Computer based program with speech games to improve listening skills.  Can be useful for students with decoding (phonemic awareness) deficits. It is a bargain out of the other auditory therapies.  Recommended 15-20 min/day; 3 levels, ages  4-7, ages 7-10, and older.

Reading Reflex,  by McGuiness is a how-to guide for the reading instruction method they've developed called Phono-Graphix.  Their approach, stresses the 43 sounds of the English language, treating letters as symbols of these sounds. Phono-Graphix teaches children to separate each phoneme in a word so that the phonemes can later be blended back in the right order to work on segmenting, blending, and phoneme manipulation skills (often lagging in those with auditory processing problems).  The book is written for parents who want to tutor a child at home.
Phono-Graphix has an excellent auditory processing component.

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When the Brain Can't Hear : Unraveling the Mystery of Auditory Processing Disorder (2003)
by Terri James Bellis, Ph.D

Like Sound Through Water: A Mother's Journey Through Auditory Processing Disorder (2002)
by Karen J. Foli, (forward by Edward M. Hallowell)

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Here some related links:
Berard auditory integration training (AIT), (AIT FAQ, several Mass. providers)
Society for Auditory Intervention Techniques (SAIT) (Lots of good articles on therapies, located in Oregon.)
Innovated Development for Education Achievement (IDEA), (AIT FAQ, located in Connecticut.)
The Georgiana Institute (FAQ, compares Berard and the Tomatis methods, located in Connecticut.)
Parents who have children with CAPD have found this Auditory Processing Yahoo group
extremely helpful.


One of our original webpages, created November, 2003, by Melody Orfei
Webpage last modified on December 16, 2011 - V12 by Melody Orfei