Wednesday, October 29, 2014

Central Auditory Processing Disorders and ACC

Understanding my CAPD opened up an entirely new world for me, and it explained a lot of what I have been experiencing my entire life, but could not put language to. Unlike the ability of the auditory nerves to hear pure tones in a quiet room CAPD is concerned with how the brain processes this stimulus.  

All children and adults with this problem can pass a standardized hearing test, and so it can go unnoticed and lead to many problems.  I discovered my own issues with this when I went through two week long neuropsychiatric diagnostic testing sessions.  Specifically a test was done that I believe was called a didactic hearing test.  How this test is performed is interesting.  The subject wears stereo headphones, and two completely different words are spoken into the left and right ears.  I know that they also discriminate with the type of words and language, like nouns and verbs etc...

In my case I had no processing error when words were spoken individually to each ear, however when words were spoken into both ears simultaneously I could not "hear" one of them.  The doctors determined that my brain particularly chose to process the right side stimulus almost all the time under these conditions.

It was actually quite distressing to take the test.  They pressure you, and it gets more difficult, and at a certain point I underwent real physical pain and extreme anxiety.

CAPDs are common with those who have a collusul disorder, also found commonly in ADHD and ASD as well.

Those with CAPD do not recognize subtle differences between sounds in words, even when the sounds are loud and clear enough to be heard. Subjectively, I can tell you that if there is any kind of background noise, especially other conversations, I get easily confused and frustrated trying to understand what I am hearing.

Some symptoms of CAPD are:
  • Being easily distracted or unusually bothered by loud or sudden noises
  • Noisy environments are found to be upsetting
  • Behavior and performance improves in a quieter setting
  • Difficulty following directions, whether simple or complicated
  • Reading, spelling, writing, or other speech-language difficulties
  • Abstract information is difficult  to comprehend aurally 
  • Difficulty with word  problems in math
  • General disorganization and forgetfulness
  • Conversations can be hard  to follow

There are five main areas that affect those with CAPD:

  1. Auditory Figure-Ground Problems: when you can't pay attention if there's noise in the background. Noisy, low-structured environments are very frustrating.
  2. Auditory Memory Problems: Difficulty remembering information such as directions, lists, or study materials. It can be immediate ("I can't remember it now") and/or delayed ("I can't remember it when I need it for later").
  3. Auditory Discrimination Problems: Difficulty hearing the difference between words or sounds that are similar (COAT/BOAT or CH/SH). This can affect following directions, and reading, spelling, and writing skills, among others.
  4. Auditory Attention Problems: The inability to stay focused on listening long enough to complete a task or requirement (such as listening to a lecture). Those with CAPD often have trouble maintaining attention.
  5. Auditory Cohesion Problems: When higher-level listening tasks are difficult. Auditory cohesion skills — drawing inferences from conversations, understanding riddles, or comprehending verbal math problems — require heightened auditory processing and language levels. They develop best when all the other skills (levels 1 through 4 above) are intact.

CAPD is similar to developmental dyslexia. Some  reading problems may be downstream consequences of difficulties in rapid auditory processing. It has also been suggested that CAPD may be related to cluttering; a fluency disorder marked by word and phrase repetitions, and echolalia; the automatic repetition of vocalizations made by another person 

Some common treatments for CAPD include:

Lindamood-Bell Learning Processes (particularly, the Visualizing and Verbalizing program)
Physical activities that require frequent crossing of the midline, especially effective for those with ACC. (physical therapy)


It is important to understand that if you have a child with ACC and CAPD, the child is unaware of this disorder.  Verbal interchanges can be confusing, frustrating, and downright distressing for them. (Adults too ;)  It is important that your child with CAPD when showing anxiety or frustration, their external stimulus and environment should be such that it is quiet, and not overly visually stimulating either.   You will have a much better chance at getting through to them.  And by all means do not raise your voice and shout at them, as it will only increase their anxiety and frustration.

Being an adult with ACC and having this auditory dysfunction, life has changed tremendously for me understanding it.  As an adult, I have better control over my environment and stimulus.  Earplugs are my BFF.  I can still hear quite well even when wearing them, but it cuts down on the background stimulus.  

I remember being punished as a child, because I was putting cotton in my ears in the classroom.  I was asked "do your ears hurt?" but I didn't have the ability to explain the pain, frustration and anxiety I was experiencing, and neither did my parents or teachers.

I hope you have found this introduction to CAPD interesting and useful, if so, please share my post with others.



  1. Yes, yes, yes :) Thank you for bringing awareness Joseph!!! This is good stuff!

  2. This has helped me greatly. I exhibit signs of all these things, and at 34 y.o. I have struggled with life a lot before realizing this is a possibility. Everyone always just thought I was "slow" or "shy". School was torture for me and I always thought there was something wrong with me. Learning was very hard for me until I hit college. I would get yelled at by my father for not understanding homework or directions. I would get confused easily. I am very forgetful, and moreso as time goes on. My son may be missing his CC. We need to get him an MRI.

  3. thank you for writing this, joseph. This is exactly my condition and no one EVER bothered to go deeper into it as if it wasnt important. not even my neurologist. i needed this. I can make them read this and show them tis is so me...anxiety with backgroundsounds all the way.

    1. Yes, and, they should know, there are verifiable clinical tests that can be performed for SPD/CAPD (Sensory Processing Disorders/Central Auditory Processing Disorders) should they care to research it. Thank you for caring, I'm so glad you found this helpful :D