Central Auditory Processing Disorders

Perry is a 10-year-old boy who was struggling academically in school, despite having received years of school-based interventional services. 

He’d been to a neurologist, a developmental pediatrician, a psychologist, and an ophthalmologist, but none was able to determine the nature of his problem. He was diagnosed with mild Attention Deficit Disorder and short-term memory issues, but neither of these could account for the severity of his academic problems.

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Then Perry was referred to the Donald R. Reed Speech and Hearing Center at Phelps for a comprehensive language evaluation by a speech-language pathologist. The results indicated that he had significant language delays, which had not been previously
identified. Intensive speech-language therapy was recommended.

In addition, Perry’s difficulty with following directions, poor recall of auditory information, and reading and writing weaknesses suggested that he might have a central auditory processing disorder. He was referred to one of the center’s audiologists for evaluation. The results indicated that the auditory centers in his brain had not matured appropriately for his age. He had difficulty integrating auditory information (such as recognizing that the written letter “b” makes the sound “buh”) and separating competing auditory information (such as being able to hear the teacher’s spoken instructions over the hustle and bustle of a busy classroom).

The audiologist made recommendations to improve Perry’s access to auditory information in the classroom. Whenever possible he is seated in the front of the room. He uses an FM system: Perry wears wireless headphones and his teachers wear a microphone, so their speech is delivered directly to him. His teachers also check with him periodically to ensure comprehension and use visual cues such as hand gestures while speaking.

Today, Perry receives speech-language therapy services in school and benefits from these listening modifications in the classroom. He has made great strides in reading and writing, and his teachers and parents are thrilled with his progress.

What Is a Central Auditory Processing Disorder (CAPD)?

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Central auditory processing refers to how a person’s central nervous system receives and processes sounds. Incoming sounds must be analyzed by the brain in order for them to be understood.

There is no specific cause for a central auditory processing disorder (CAPD), but some of the possible causes are a trauma, a viral infection or a neurological condition. Auditory processing problems in children resulting from delayed development of the auditory centers in the brain may resolve as the child matures. Disorders that may be confused with or coexist with auditory processing disorders include attention deficit hyperactivity disorder (ADHD), autism, dyslexia, and learning or language disorders.

A child with a central auditory processing disorder may have normal hearing but may:

  • Have poor listening skills
  • Be easily distracted by surrounding or irrelevant stimuli and background noise
  • Have difficulty following verbal directions
  • Have a short attention span
  • Have poor short-term and long-term auditory memory
  • Be unable to pay close attention to detail
  • Have difficulty processing, sequencing and integrating units of information
  • Have difficulty telling the difference between similar sounding words (bat/cat)

Diagnosis of CAPD

To diagnose CAPD, a multidisciplinary team approach – including audiologists, teachers, psychologists, speech-language pathologists, and parents – is crucial. A thorough case history, academic profile, and descriptions of school and home behaviors provide important information regarding a child’s strengths and weaknesses.

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Specialized testing is typically administered by an audiologist to children who are at least seven years old. The diagnostic process begins with a complete audiological evaluation to rule out hearing loss. If no hearing loss is detected, the audiologist will administer a number of behavioral tests.


Once a child has been diagnosed with CAPD and the nature of the deficit has been identified, individualized management and treatment activities will be recommended. One or more of the following three measures may be implemented:

1. Changing the child’s learning environment to improve his or her access to auditory information. Examples of this approach include:

  • Having the teacher speak clearly and rephrase what has been said
  • Seating the child closer to the teacher
  • Having the child use an assistive listening device that enhances relevant auditory information over surrounding noise
  • Reducing classroom noise
  • Providing visual aids to supplement auditory information

2. Language therapy provided by a speech-language pathologist to strengthen a child’s cognitive-linguistic skills needed for problem-solving, memory and attention.

3. Auditory training provided by an audiologist to improve a child’s ability to identify the origin of a sound, differentiate spoken words and focus listening when in a noisy environment.

Testing and treatment for central auditory processing disorders are offered at the Donald R. Reed Speech & Hearing Center. A physician referral is required. For information or to schedule an appointment, call 914-366-3010.

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