• focusing attention away from other tasks (watching TV, taking test),
• separating out and inhibiting "non-speech-like" sounds (sending down neural messages to reduce nerve activity bringing up traffic or dishwasher noise),
• locating the voice you want to hear (focusing on teacher, ignoring other children)
• conveying speech sounds (not yet words) without distortion to the brain cortex
• organizing sounds into words
• routing information to other centers of thought, action, sight.

Auditory discrimination: ability to notice, isolate, compare, distinguish distinct and separate phonemes (sounds) in words. When sounds cannot be isolated, people may hear "turn left at the wall" instead of "turn left down the hall". Children may find it difficult to:

• Understand spoken language,
• Follow oral directions,
• Remember details.
• Learn to read or spell
• Hear conversations on the telephone
• Hear long conversations
• Hear differences between sounds/voices
• Learn foreign language
• Challenge vocabulary words
• Follow lectures
• Recognize number of sounds in word
• Recognize rhyming words
• Process nonverbal information like music appreciation

Auditory figure-ground discrimination: the ability to pick out important sounds from a noisy background. Children may find it difficult to:

• Separate meaningful sounds from background noise,
• Claims background noise too loud
• Pick out words spoken by teachers in front of classroom from sounds of children playing in room or traffic outside.
• Stay focused on auditory information needed to successfully complete task

Auditory memory: ability to store and recall information (both long term and short term auditory memory) which was given verbally. Children may find it difficult to:

• Memorize and recall telephone numbers
• Remember people's names
• Follow multi-step spoken directions
• Remember lines from songs.
• Recall stories they have been told
• Follow instructions
• Remember spoken information
• Take notes
• Remember specific words/numbers
• Organize

Auditory sequencing: ability to remember or reconstruct order of items in lists or order of sounds in a word or syllable. For example: "ephelant" for "elephant".Children may find it difficult to:

• Put words in the right order in sentences
• Spell in right order

Auditory blending: the process of putting together phonemes to form words. For example, individual phonemes "c", "a", "t" are blended to from the word, "cat".

• Inconsistent responses to auditory stimuli
• Poor attention
• Slow or delayed responses to verbal stimuli
• Says ÔhuhÕ or ÔwhatÕ often
• Blending parts of words together
• Misunderstanding what said
• Poor receptive, expressive language
• Behavior problems
• Poor decoding of new words
• Poor comprehension

Since speech and language skills are developed most efficiently through the auditory sensory modality, speech/language problems and academic problems are not unusual in children with CAPD. If children experience difficulty in processing the brief, rapidly changing acoustics of spoken speech, they likely have problems recognizing the "speech sounds" of language. If there are problems recognizing the sound system of language, then the child encounters difficulties when asked to match speech sounds to alphabetic representations (the foundation for the development of subsequent reading and writing skills). This in turn can lead to comprehension problems and poor academic performance.

What is difference between hearing loss and CAPD?
Hearing loss refers to the process of hearing from the outer ear and ending at the auditory nerve, which carries auditory information to the brain. Since the two processes are different, children may have hearing loss but not CAPD, and vice-versa. Hearing loss may limit the amount and type of auditory stimulation necessary for optimal development of the auditory nervous system. If this happens, CAPD are likely. CAPD can be as debilitating as unidentified hearing loss. If auditory deficits are not identified early and managed appropriately, CAPD children experience speech and language delays, academic failure, underachievement, loss of self-esteem, social and emotional problems.

WORKING TOWARD AN "AUDITORILY FAVORABLE" CLASSROOM
Problems with	Surface Behavior	Tipoff Behavior	Possible Adjustments
Getting the sound in: •too soft •sounds distorted •message not well separated from background sounds	•Says what? a lot, even if hears much of what said •Talks or likes TV loud •Daydreams or acts uninterested and bored •Ignores: oblivious to important sounds •Looks at othersÕ work when shouldn't •Often interrupts with questions •Works fine if kept in at recess or otherwise •Obnoxiously inattentive (mainly older students who polish nails during class discussion) This section is undivided because no one has segmented the job for the student at this stage.	•Claims you said a different thing •Careless errors on exacting tasks •Work quality varies widely on same type of assignment •Misarticulates some sounds	1. Seat near speaker, away from obvious noise sources 2. Supplements with more intact senses (use handouts, manipulatives) 3. Refer to school nurse/doctor to rule out peripheral problems (hearing loss, allergies, ear infections).
Remembering •poor short term auditory memory •poor rote memory or habituation •sequencing problems		•Omits some steps in serial directions •Better math concepts than math facts •Likes background information, mnemonics •Digit reversals, spoonerisms	1. Reduce or space directions. 2. "Capture" fleeting speech on tapes or handouts. 3. Teach logical systems,"story behind the facts," . memory tricks, visualization. 4. Substitute manipulatives for repetitive drill (flash cards/recitation).
Ascribing meaning •doesn't consider alternate meanings •can't access words •can't access scripts •words "don't paint a picture"		•Literal, feelings easily hurt • Can't infer •Asks many questions but proceeds with work if answered •"Silent"- evokes: "Why didn't you tell me?"	1. Teach abstract vocabulary, word roots, synonyms/antonyms. 2. Role play social scripts and other language pragmatics 3. Start others on task, answer extra questions individually 4. Show rather than explain
Linking with other brain centers •poor sound-symbol association •problems reauditorializing when reading •difficulty expressing ideas in writing		•can't sound out unfamiliar words •spelling errors are phonetic •reading comprehension problems based on misread words, not lack of inference •dictated stories OK	1. Use Phonemic Synthesis tapes 2. Borrow exercises from field of Speed Reading 3. Use techniques from edukinesthetics, developmental therapy, or neuro-linguistic programming.

Other Strategies to Help those with CAPD

• Assign "listening buddies"
• Discover and use student learning style; don't insist on adaptation to teacher learning style
• Break down messages into manageable units
• Explain in understandable language
• Teach to strengths and learning styles.
• Listen to studentsÕ explanations about needs and accommodations
• Reduce external visual/auditory distractions like posters/cluttered bulletin boards
• Provide study carrel in the room
• Suggest ear plugs to block out distracting noise from a heater or air conditioner, pencil sharpener, or talking in the hallways.
• Place mats and cloth poster boards on walls to decrease noise reverberation
• Structure classroom setting, a more beneficial environment than open classrooms
• Gain the child's attention before giving directions.
• Use visual aids and write instructions to supplement spoken information.
• Emphasize key words when speaking or writing especially when presenting new information. Pre-instruction with emphasis on the main ideas to be presented may also be effective.
• Use gestures that will clarify information.
• Vary loudness to increase attention.
• Check comprehension by asking the child questions or asking for a brief summary after key ideas have been presented.
• Paraphrase instructions and information in shorter and simpler sentences rather than by only repeating.
• Encourage the child to ask questions for further clarification.
• Make instructional transitions clear.
• Review previously learned material.
• Recognize periods of fatigue and give breaks as necessary.
• Avoid showing frustration when the child misunderstands a message.
• Avoid asking the child to listen and write at the same time.

Examples of Difficulty

"Okay, class, before you open your science book to page 95 for the next lesson, get out your homework from yesterday, and put it in the right hand corner of your desk for me to review; then we'll be ready to start."

Ron takes out his social studies book and stares into space. Why didn't Ron follow the teacher's directions? Not listening? Distracted? Not paying attention? Poor conduct? Hearing loss? Any of these explanations is possible. Or maybe Ron hears the sound, but can't process or understand what is said to him particularly when the language used is complex, spoken rapidly, or is lengthy, and when there's a lot to look at and lots of noise around him. The inability to understand spoken language in a meaningful way in the absence of what is commonly considered a hearing loss is called a central auditory processing problem.

1. Some speech sounds are distorted.
   When you talk to someone with a foreign accent you must make a series of mental adjustments to understand. These are usually based on context (the nearest English word that would logically fit, given the topic you are discussing) or on experience (such as how nationalities usually pronounces an "r"). Decoding gets easier after a few minutes' practice, but it is tiring. What if you were too young to have much vocabulary or general information to help with the guesswork? Some children with persistent speech articulation problems say the words they hear. Imagine how school would be if you couldn't trust your hearing--if you had to deal with different distortions with different speakers but were still expected to follow a classroom discussion.
2. Background noise is too loud.
   When we strain to follow a conversation at a large party we are often experience too many extraneous sounds delivered to our conscious awareness. One way to survive is by pinpointing the location of the voice and neurologically suppressing some sounds coming in from other locations. Now imagine trying to balance your checkbook with the TV going and two other people talking to you. We generally avoid such situations since we can't stay on task, making "silly" mistakes as noise intrudes on the visual-intellectual-motor parts of the operation.
3. Sound combinations (words) are not easily connected with their meanings or uses.
   This category covers many types of auditory dysfunctions affecting the most "human" operations of communications, learning, and empathy. In this population are people who get complex directions wrong, who miss spoken cues in social situations, who don't "speak up" for themselves, who don't infer or "read between the lines." Think about when someone was telling you something elaborate, such as giving you directions to his house, or explaining the new software at work. You may have heard every word yet couldn't visualize the driving route all the parts of the work operation. You could say, "Draw me a map," or "Let me go through this myself while you watch," using visual and haptic/motor systems to help the learning. But what if the teacher in a class of 30 doesn't have time for that? Or what if the students doesn't know what he/she can ask to get help? If you imagine yourself in a foreign culture you may understand what it means to lack easy social scripts (did you learn the polite way of asking for the bathroom in your French classes?), not get the joke (because you haven't picked up alternate word meanings and slang in your travels), or to misunderstand the mood of the person speaking because you didn't know the meaning of their tone of voice. These are some of the ingredients to the social problems we see in children who mean well but have trouble making and keeping friends.

Finally, to fully realize the load CAPD people carry, you need to remember that these problems rarely occur in isolation. A child who cannot suppress unwanted background sound also may not be able to focus his eyes or track smoothly across the page for easy reading. A sound distortion may be compounded by temporary hearing losses from middle ear infections or allergic congestion. The combinations are endless.

source:hier http://www.uncc.edu/~medomoto/4200/general/diversity_disability/auditory_processing.html

http://www.homestead.com/agertner/page2.html
http://www.ncapd.org/
http://www.tri-cityherald.com/HEARNET/disorders.html
http://www.LDinfo.com/process_areas.htm#top

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Chermak, G.D., & Musiek, F.E. (1997). Central auditory processing disorders: New perspectives. San Diego: Singular Publishing Group.

Katz, J., Stecker, N.A., & Henderson, D. (1992). Introduction to central auditory processing. In J. Katz, N.A. Stecker & D. Henderson (Eds.), Central auditory processing: A Tran disciplinary view (pp. 3-8). St. Louis:Mosby Year Book, Inc.

Kelly, D.A. (1995). Central auditory processing disorders: Strategies for use with children and adolescents. San Antonio, TX: Communication Skill Builders.

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August 28, 2001