Central Auditory Processing Disorder (C)APD

Auditory processing of spoken language requires rapid recognition, discrimination, and integration of what we hear in order to understand the intended message. Accurate auditory processing is dependent on appropriate functioning of other systems such as arousal, social/emotional, attention, memory, linguistic, and executive function. Those with normal auditory processing ability know who and what to listen to, what and who to ignore (background noise), understand the tone of the speaker, hold on to long and multiple step auditory information in an organized and sequential manner, and integrate what we hear with other sensory input. Those with impaired auditory processing may manifest the inability to accurately process and interpret auditory information. Auditory processing has been described as “what the brain does with what the ear hears,” by renowned researcher and scholar Jack Katz, Ph.D. The disorder commonly impacts listening, spoken language, and learning. Individuals with (C)APD may experience difficulty sorting auditory information, which may present in various ways. Some of them being difficulties listening to, comprehending, and/or remembering the information heard. Individuals with (C)APD may also experience difficulties interpreting the subtle meaning of what has been said, such as sarcasm, irony, and humor.

Comprehensive Evaluation of (C)APD:

Evergreen Speech and Hearing Clinic provides a comprehensive evaluation process for (C)APD that involves a thorough assessment of the peripheral hearing system, behavioral testing for assessment of auditory processing, and a communication needs assessment. The Central Auditory Processing evaluation is broken down into three parts and requires three separate appointments.

1. Pre-Auditory Processing Evaluation

The first appointment is called “Pre-APD” and consists of the following evaluations:

  1. Case history
  2. Audiogram
  3. Tympanogram, acoustic reflexes and acoustic reflex decay
  4. Otoacoustic emissions
  5. Auditory Brainstem testing

2. Auditory Processing Evaluation

The second part of the assessment is called the Auditory Processing Evaluation and is done entirely in the sound booth using standardized testing materials. Five core tests are administered, in which the patient is asked to repeat back information (words, numbers, and pitches) presented to either ear. The tests are designed to assess the auditory skills of decoding, integration, and prosody. After this testing, the audiologist will have specific results regarding the patient’s auditory processing ability. These results will be shared with the patient/parents. The audiologist and speech-language pathologist will then collaborate to determine the next steps.

It is important to note that each testing session spans from one to two hours depending on the amount of supplemental tests that may be used. Additional testing may be required based on the individual performance of the child.

3. Communication Assessment & Treatment Planning

During the third appointment, the speech-language pathologist will determine what additional testing is required to optimize their communication performance. Additional assessments may include tests of spoken language (receptive and/or expressive), written language (reading and/or writing), executive function, working memory, and/or articulation. The selection of tasks and tests will be based on the profile of each patient and is decided after a review of the case history, APD test results, and parent/patient report of specific areas of difficulty.

Your speech-language pathologist will provide a customized and prioritized treatment plan for each patient based on information obtained through audiology and speech-language pathology findings, as well as patient/family preference and availability of resources.