![]() ![]() Signs that a Child or Student Might have Central Auditory Processing Disorder Hyperbilirubinemia (i.e., the cause of jaundice) Hypoxic ischemic encephalopathy (i.e., brain damage caused by oxygen deprivation) Hydrocephalus (i.e., fluid accumulation in the brain) Meningitis (i.e., inflammation of the membranes surrounding the brain and spinal cord) Anoxia (i.e., an absence of oxygen, an extreme form of hypoxia).Hypoxia (i.e., not enough oxygen reaching the tissues of the body) The following risk factors are associated with both CVI and CAPD: Many of the risk factors for CVI and CAPD are the same (American Speech-Language Hearing Association, 2019 Boston Children’s Hospital, 2019 Jin et al., 2019 Khetpal & Donahue, 2007) and therefore children with significant multiple disabilities who are diagnosed with CVI may also be at risk for CAPD. Risk Factors Associated with Both Central Auditory Processing Disorder and CVI These tests allow audiologists to make a reliable differential diagnosis between auditory neuropathy and possible CAPD in children who may seem to have features of both CAPD and auditory neuropathy. Tests that measure auditory brainstem responses (called ABRs) and reflexes of the muscles of the middle ear (often called acoustic reflex testing) will be normal in CAPD but abnormal or absent in auditory neuropathy (Morelt, 2010). Unlike CAPD, auditory neuropathy can be diagnosed in young children who may not yet be efficient communicators. With auditory neuropathy, there is damage to the inner hair cells of the cochlea and also possible damage to the auditory nerve. In CAPD, the hearing problem is brain-based, with the peripheral hearing system intact. It is also important to distinguish between CAPD and auditory neuropathy spectrum disorder because these two conditions are often confused but are very different. ![]() What do we do with children who are at significant risk for CAPD but who cannot be accurately tested for a definitive diagnosis? There are evidence-based auditory strategies that can be used with children who are suspected of having CAPD that are similar to the visual strategies used with children with CVI. Unfortunately, CAPD cannot be diagnosed in very young children and CAPD assessments in older children require language acquisition, which many of these children haven’t yet acquired. For students who also experience varying degrees of CAPD, compensating with auditory information, whether speech or environmental cues, may not be possible. Students who are blind or visually impaired-and who have typically developed hearing-depend in part on their hearing to compensate for what they miss visually. With CAPD, the ears may be functioning normally but sound is not reaching the brain in a way that is meaningful. While the peripheral hearing system includes the outer, middle, and inner ear to the auditory nerve, the central hearing system refers to the area from the brainstem to the brain. In these definitions, “central” refers to the site of the problem with hearing and comprehension. Central auditory processing disorder is also called auditory processing disorder (APD), cortical deafness, and central deafness. Central auditory processing disorder (CAPD) is defined as deficits in the neural processing of auditory information in the central auditory nervous system (ASHA, 2019). It is said that central auditory processing disorder is to hearing what cerebral visual impairment or CVI is to vision. What is Central Auditory Processing Disorder and Why Is It Important? ![]()
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