Treatment for Central Auditory Processing Disorders (CAPD)
Auditory processing itself, as well as auditory processing disorders, are not simply one thing. Rather, they refer to how the brain processes what the ear hears, and disruptions to this process. As such, there is no there is no one treatment for this disorder. There are a number of treatments or kinds of treatments for auditory processing disorders. Let's discuss what these are:
- Environmental modifications We always ask teachers to give preferential seating to children with this diagnosis. That is, the teacher should have the child seated near the teacher's desk. The problem here, of course, is that teachers often walk around the room while teaching, especially in classrooms where the children sit at tables rather than desks. FM units are also helpful at school. An FM unit consists of a transmitter that the teacher wears, and a receiver that the student wears, which essentially cause the teacher's voice to go right into the student's ear without any interfering or distracting sounds. (These may be used for children with hearing losses as well.)
- Linguistic modifications Whether at school or at home, commands or directions should be given in segments. So, for example, if the teacher says, "Take out your worksheet, write your name at the top, then take out your history books and open them to page 237," that teacher should look right at the student with APD and say, "Here is your worksheet, write your name at the top. Now take out your history book. Open it to page 237." Parents should likewise break all directions down to their individual parts and provide lots of repetition too. Increased volume helps as well, even though children with CAPD do not have hearing losses. Increased volume helps too, even though children with CAPD do not have hearing losses.(not sure how you want to fix this-looks like you left out some words)
- Speech and language therapy This can facilitate auditory processing skill development as well as areas that have been affected by lags in development of the auditory processing system. For example, one kind of auditory process is sound discrimination. If this area is problematic, the child can be shown pictures of rake/lake, hair/pear, for example, to sharpen this skill. If hearing through noise is the processing skill that is affected, a session may be done with the radio playing in the background. There is also some software, such as Earobics ®, that is sold as a program to help develop the auditory processing system that incorporates hearing through noise as part of one of the "games" in the program. Auditory processing disorders can also impact a child's ability to learn to read. Here again, the speech-language pathologist can include activities that facilitate optimal acquisition of literacy skills.
- Software There are many software programs available whose developers make claims that their programs develop the auditory processing system. Programs like FastForWord® and Earobics® are examples of these. While the latter may be purchased by anyone, the former must be administered by a trained professional such as a speech-language pathologist.
- Auditory training programs Programs such as auditory integration therapy (AIT) as well as other programs (Tomatis, The Listening Program) which claim to retrain the auditory processing system are espoused by some as being extremely effective, and criticized by others as being ineffective. At our center, we have seen some excellent results from AIT in children who exhibit hyperacusis (a hypersensitivity to sound) most commonly seen in the autistic population. Otherwise, AIT is not a proven protocol for treating auditory processing disorders.
To summarize, there are five primary modalities used in the treatment of children with auditory processing disorders. There is no one remediation that works for everybody. Using audiological testing and speech and language testing (as described in September's article) along with input from parents and classroom teachers, we determine which protocol is most appropriate. In addition, children should be regularly re-evaluated to ensure that they are continually making adequate progress in treatment.