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Central Auditory Processing Disorder, or CAPD, is a hearing disorder in which the trouble lies not with the ears, but with the brain. The person with CAPD hears sounds correctly but something adversely affects the way their brain recognizes and interprets the sounds, especially the sounds associated with speech. As a result, CAPD has been described as a breakdown of coordination between the ears and the brain.

Central Auditory Processing Disorder is a condition that afflicts an estimated 2% to 5% of children of school age, and as many as 50% of children who have been diagnosed as having a learning disability. One of the characteristics of CAPD is that children who have it have difficulties recognizing subtle differences between the sounds of similar words, even though they have no problem hearing the words. This inability to understand words often becomes worse in noisy environments, but is not as present in quiet environments.

Diagnosing CAPD is difficult, because they can often hear and interpret speech well in quiet rooms. When the children’s hearing is tested, however, this is also done in quiet rooms where they have no problem hearing the pure tones generated by the test equipment. As a result, their audiogram results may appear normal, but they may nevertheless have difficulties distinguishing similar words, locating where sounds are coming from, recognizing repetitive patterns in high and low sounds, or hearing more than one person’s voice at a time.

The symptoms of CAPD also tend to appear in other areas of life, as the child struggles to deal with not being able to understand people speaking to them or around them. For example, they may become easily distracted by sudden noises, have difficulty following directions, develop reading, spelling, and language difficulties, become disorganized and forgetful, or have trouble following conversations. These symptoms are often confused with symptoms of other conditions such as Attention Deficit Hyperactivity Disorder (ADHD) or depression, especially because when given standard hearing tests, the children often appear to be normal. In reality, CAPD can be present alone or combined with these other disorders, presenting a difficult diagnostic challenge.

Early detection of CAPD is critical, because to ensure the child’s proper social and educational development, the sooner the problems are diagnosed, the sooner they can be treated. A standard hearing test doesn’t rule out CAPD. If you detect any of these signs in your children, schedule a professional hearing test that can replicate the conditions where the child struggles.