Broken Telephone

A child with a central auditory processing disorder can hear, but can’t process what is being heard
By Vanessa Papas

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Is your child distracted by background noise? Are you constantly met with a “huh?” when you ask them a question, even though they’re not hard of hearing? Do they battle to read, spell and write? If so, your child could have a central auditory processing disorder (CAPD). Often confused with other learning disabilities, a child with a CAPD can’t process the information they hear in the same way as others because their ears and brain don’t communicate effectively with each other.
“Central Auditory Processing (CAP) is best described as ‘how the ear talks to the brain and what the brain does with it’. The brain must accurately decode what the ear tells it in order for the brain to attach meaning to the sound coming in. When a child’s CAP skills are weak, they may experience ‘auditory overload’, making communication and learning a challenge. This impacts on their listening, speaking, reading, writing and, in turn, their ‘doing’. It can also affect a child’s confidence as they can’t function effectively in the classroom and socially,” says Heidi Allan, a Durban-based audiologist and speech therapist. “To learn language one needs to be able to listen to and separate important speech from all the other noises of daily living,” explains Allan.
Cape Town mom Lianne Kelly’s 10-year-old son was recently diagnosed with a CAPD. “I have always known there was something wrong but doctors couldn’t conclusively diagnose the problem,” says Lianne. “He battled to hear even though tests confirmed his hearing was perfect. His vocabulary was not as extensive as his peers and his language, spelling and reading were very poor. Even after extensive remedial work, there was no real improvement. Earlier this year, an audiologist at his school suggested I take him for a CAPD test, which revealed he had a central processing disorder.”
Lianne says her biggest challenge is making her son understand that he has to work so much harder than his peers just to accomplish the same task. “He gets very confused with vowels, which makes doing homework a nightmare as it takes so long and he gets angry, frustrated and tired from the ongoing battle of deciphering every word. We have developed our own coping mechanisms when we communicate with each other. I have learnt to talk slower and constantly ask him if he understands what I’m saying. I make every effort to reduce background noise when he’s doing homework. This includes turning down the TV, moving away from the dishwasher that’s running and not having a discussion with him in the car when the radio is on.”
Pietermaritzburg-based Debbie Risk’s six-year-old daughter Katie also suffers from a CAPD. At first, her teachers thought she had attention deficit hyperactivity disorder (ADHD) but, after being assessed by a professional, she was diagnosed with multiple sensory integration disorder (which is a dysfunction in all seven senses).
“One of my most difficult challenges at first was having to explain Katie’s condition to other parents. She can come across as rude or disinterested when in fact she has ‘zoned out’ or is very distracted by sounds, smells or sights and is trying to cope with all the sensory input she cannot process. Since her diagnosis, we have made changes at home and are now far more aware of noises that might be distracting her. Because I understand her needs now, and her need for her own space, I don’t experience a sense of personal rejection, which is something I felt before her diagnosis. We have even made a ‘special place’ in a section of her room where she can go with her beloved cats when she has to ‘regroup’ and have some quiet time.” Both Lianne’s son and Katie are undergoing extensive occupational and speech therapy and their conditions continue to improve.
Allan continues to say that if your child lacks listening behaviour and auditory attention, it is vital that a peripheral hearing assessment is conducted first to exclude hearing loss. If hearing is not the problem, your child should be assessed by an audiologist and, based on the findings, remediation and management strategies will be discussed.
According to Gauteng audiologist Tammy Henen, treatment for a CAPD is age and severity dependent. “The auditory system only fully matures around 12 years of age so one can’t really establish the degree of a CAPD until then. While a CAPD can be improved with treatment – which often involves a speech therapist, audiologist, educational psychologist, teachers, doctors and parents – one must remember that a CAPD is a disorder and not a disease. Each individual may have co-morbid issues (often individuals with a CAPD may have attention deficit disorder or other influencing factors). Some children with a CAPD experience a total improvement of their difficulties or seem to ‘grow out’ of their disorders, while others may be left with some residual degree of deficit forever. However, with appropriate management, all children can become active participants in their own listening, learning and communication environments.”
Signs your child could have a CAPD
  • Behaves as though there is a hearing loss even if a hearing assessment has indicated normal hearing thresholds.
  • Has difficulty learning songs and nursery rhymes.
  • Battles to read, write and spell.
  • Mishears words.
  • Doesn’t participate in class discussions.
  • Cannot tolerate noisy rooms or places.
  • Has trouble understanding stories read aloud.
  • Has trouble with maths word problems.
Strategies to help a child with a CAPD
  • Reduce background noise at home and school.
  • Keep eye contact with your child while speaking to them.
  • Use simple, expressive sentences.
  • Speak at a slightly slower rate and at a mildly increased volume.
  • Provide your child with a quiet study place.
  • Provide additional aids for study, like an assignment pad or a tape recorder.
  • Build your child’s self-esteem.
Good to know
  • Three to five percent of school-aged children are affected by a CAPD.
  • An audiologist is the only person who can correctly diagnose if your child has a CAPD.
  • Auditory deficits need to be identified and managed early to prevent speech and language delays and academic problems.
  • A CAPD is often confused with other disorders like autism, ADHD and even depression.
  • The causes of a CAPD are unknown, but evidence suggests links to head trauma, lead poisoning and chronic ear infections.
For more information
  • South African Speech-Language-Hearing Association – 0861 113 297, or visit
  • South African Association of Audiologists – 082 727 5977 or visit


Anonymous wrote 8 years 14 weeks ago

My Son (10) also has CAPD and we have done all the doctors and therapists, and we are 120km from the nearest town. I can tell the whole sad story, but I would rather share the positive. I have stumbled upon Indigolearning, which has a computer programme that helps to rewire the brain for these kids. We have been doing it for a month and the results are amazing. If this might help somebody, please Google them. They are based in Cape Town, but you can get the programme to work from home on your computer, while they monitor your child via internet connection. For the first time I have so much hope.

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