Tuesday, June 12, 2012

More on CAPD

I am researching in preparation for the final report from Brenner's Children's Hospital regarding my oldest daughter's evaluation for Central Auditory Processing Disorder (CAPD). All I have to go on, for now, is that my oldest has trouble with auditory closure and inter-hemisphere exchange. At the beginning of my research, auditory closure meant nothing to me and inter-hemisphere exchange translated to a problem between the hemispheres of the brain communicating with each other.

Now, I understand quite a bit more about CAPD. First of all, it is a brain-related auditory disorder. It can be genetically related, it can be caused by a trauma, or a natural process of aging. There are some links between CAPD and the presence of multiple ear infections. My oldest had a lot of "silent" ear infections as a toddler. She showed no signs of infection, but eventually, she would start to defiantly misbehave, I would take her to the doctor and EVERY time, she would have an ear infection. (This could be an inkling into why she has CAPD, but we'll never really know.)

CAPD is different in every person. No two people are alike, so it is difficult to diagnosis. In a lot of children, it masks itself as AD/HD. For others, they just feel like they are stupid or slow. They don't get what is going on around them and essentially go through life with an empty smile and will put up with just about anything just to be accepted by others.

While I am scared of the diagnosis of CAPD, and while I was not expecting it, I am relieved. At least, I know that is going on with my daughter and she has a great psychiatrist who is willing to advocate for her and make sure that she gets the treatment/therapies that she needs.

Auditory Closure
Auditory Closure is the ability to "fill in" missing pieces of a message. The average person will use, what my daughter's teachers refer to as, context clues to fill in words that they missed during a conversation. A child who is unable to do this easily will often misunderstand what they are hearing, especially when there is competing noise.

Inter-hemisphere Integration What I thought was called Inter-hemisphere Exchange is actually Inter-hemisphere Integration. It is the ability of the two hemispheres of the brain to cooperate and it decreases significantly with age. This deficit affects binaural hearing abilities (the ability to hear through both ears). As you hear through both ears, both hemispheres of the brain are being forced to work together.

Children with dysfunctions in the inter-hemispheric pathways have difficulty linking social communication and tone-of-voice cues with semantics and syntax.

So, not only does my oldest have difficulty missing information, but is unable to make both ears listen . . . Wow.

CAPD affects not only hearing, but other areas as well. Spelling is one example. If a child can't process sounds properly, then of course they can't sound out and spell those words properly. Unfortunately, my child's Developmental Pediatrician mistook her spelling problem for "creative spelling" rather than a clue into CAPD.

Most people with CAPD have no problem with straight arithmetic calculation, but many do have great difficulty with verbal or written math word problems (which my child does).

Children with CAPD are often mistaken for AD/HD due to their distractibility. But, distractibility due to CAPD arises from the way that competing noise interferes with the ability to understand what is being said. Some children may tune out once they lose the thread of what is being said. Others may just give up after constantly having to fight to understand what is going on around them. They may just need a break.

For an individual with CAPD, social communication is frequently a chore rather then a pleasure. They often misunderstand what is being said, so their response/input into a conversation is off-topic or inappropriate. They are often mistaken for being slow, dim, or stupid.

For the child with CAPD, social communication is even more difficult. Think about it. When is a school child expected to talk to their peers? On the playground or in the cafeteria. I don't know if you have been to either place lately, but they are quite possibly some of the noisiest places around. For someone with CAPD, this has to be a nightmare.

Children react differently to their social difficulties. Some tune out and withdraw. Others attempt to gain attention in other ways. They may become a class clown, or try to entice others to join in their off-task play. And still others may react by lashing out with anger. My child, has reacted in all of these ways. She often withdraws and convinces herself that she does not need friends. Repeatedly, in school, she makes noises in class and tries to get others to respond to her. In 2nd grade, she threatened to take an axe to some boys that were teasing her. This year, she turned her anger on herself/her situation and had suicidal ideations.

While all of this seems very scary, my daughter is very good at compensating for her CAPD. She is typically and A/B average child. This is due in part to her own hard work, guidance with homework by my hubby, and her teacher’s assistance as well.

The most difficult part is figuring out how to help her socially.


  1. Wow-- great article! Some of the symptoms of CAPD are very like some of the symptoms of autism my girls deal with. The overwhelming input they receive through their ears and other senses, coupled with the trouble distinguishing tone of voice in conversation makes it very hard to them to get along socially with their peers at times. I will say, though, that they are learning ways of coping, even if they are mostly out of sync with their peers.

    I found you through the Favorite Things blog hop. :) Glad I clicked on your link!

    1. ChaCha,

      Thanks for reading! And thanks for the feedback. It seems that a lot of disorders seem simular, even if for different reasons. It's amazing that doctor's can decipher them!

  2. Thanks so much for sharing this information! I know it is scary but having a diagnosis will help you do what is best for your daughter!

    Thanks for linking up with Best Day EVER (this week)! I can't wait to hear about your best day this week!

    Also, please consider allowing us to feature you on our Sunday Sip one Sunday! You can email us at morethanmommies@gmail.com if you are interested!

    Have an amazing Friday!

    1. I would love to be featured on a Sunday Sip!