Coping with CAPD

Parents discuss how they found out their daughter had central auditory processing disorder — and how they cope with it

By Jennifer Fecio McDougall and Alex McDougall

(Editor’s note: The authors are the parents of Maeve, aged 15, who has CAPD).

When Maeve was in seventh grade, she told us that she was having trouble with her hearing. We focused on the issue for a few days and realized what she was talking about.

When we called her name, she didn’t always hear us, especially if there was background noise. We also noticed that she sometimes spoke very loudly, but she didn’t realize that her volume was higher than normal.

We called Michael Pizzuto, her otolaryngologist, to make an appointment. Maeve had hearing tests in his office, and the results showed that her hearing was perfect. Pizzuto said he thought she might have central auditory processing disorder and he referred us to Buffalo Hearing and Speech Center for an evaluation.

Pizzuto explained to us that when a child behaves as if he or she has a hearing problem, the first thing to do is check the hearing. However, if that testing comes back normal, parents should consider CAPD. “If undiagnosed, it can have a significant impact on learning, and the child may even be misdiagnosed with another condition, such as ADHD or dyslexia,” Pizzuto noted.

Maeve was nervous, but everyone at Buffalo Hearing and Speech was very nice. The evaluation was painless and not invasive, and the audiologist told us that Maeve has CAPD. Since that time, we’ve learned a lot about CAPD, how it affects Maeve, and how to help her deal with it. There are a few specific things that we’d like to share to increase awareness of CAPD and how it can affect those who have it.

CAPD is not a hearing problem — it’s actually a processing problem. It interferes with the person’s ability to process auditory input, or sound. Based on Maeve’s experience, we have a few tips for speaking with someone who has CAPD.

— Face the person.

— Don’t cover your mouth.

— If the person’s back is to you, he or she may be unaware that you are speaking. It may be helpful to tap the person on the shoulder or otherwise get his or her attention before you begin speaking.

— If the person asks you to repeat yourself, you may want to try saying the same thing in a different way. It may be that he or she heard you but is taking a moment to process what you said.

Problem involves processing

Remember that people with CAPD do not have issues with intelligence, hearing or listening. The problem is with processing sound.

Maeve sometimes speaks very loudly, but she’s not being rude or trying to get attention. The disorder can make it more difficult for her to monitor her own volume. When people are unaware of this, they may be startled or assume she’s being rude.

CAPD can affect learning in several different ways first, it interferes with reading comprehension. Maeve may read things more than once, read them aloud, highlight keywords, or incorporate other techniques to help her retain information. Second, it can affect short-term memory, so last-minute cramming isn’t the way to go. It helps her to go over material repeatedly to commit it to her long-term memory.

Third, it can affect organization. Even when others suggest organizational methods, this can still be a huge obstacle. We’ve found that it’s best for Maeve to be part of devising her own methods for staying organized; what works for someone else might not work very well for her. What works for her may not work for someone else with CAPD.

Maeve has had a 504 plan for school. This document outlines the services that will help put her on an equal footing with students who do not have CAPD. In her case, the 504 plan allows her to be seated near the teacher, ask questions to increase understanding, have directions repeated as needed, take tests in a quiet location, and have extra time on tests.

Central auditory processing disorder, as the name implies, is an auditory processing problem, but its effects go beyond processing sound. Many people are unaware of it, and we’ve worked hard to increase awareness.

If you’d like more information about CAPD, visit,, or and search for CAPD.

CAPD At a Glance

• What is the cause of central auditory processing disorder (CAPD)?

“Often, the cause of a child’s APD isn’t known. Evidence suggests that head trauma, lead poisoning and chronic ear infections could play a role. Sometimes, there can be multiple causes.”

My daughter Maeve had frequent fevers in sixth grade and the beginning of seventh grade. They were classified as “fevers of unknown origin,” and her ENT recommended removal of her tonsils and adenoids. The fevers got better; the CAPD was diagnosed several months later. It’s possible that one or more of the fevers was an ear infection, but we’ll never really know.

• How many people suffer from the disorder?

“Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is a hearing problem that affects about 5 percent of school-aged children.”

Anecdotally, though, we’ve come across several people who have it. It makes me suspect that the number is higher.

• What are the treatment protocols?

Speech therapy can help kids with auditory processing disorder make those sounds better and more clearly. Speech therapists can also help kids learn to:

• Improve perception of individual sounds (phonemes) in words, which can help with reading skills

• Develop active listening skills, like asking a person to repeat directions

• Use language appropriately in social situations

Kids with auditory processing disorder might get frustrated about school. Imagine not being able to understand what the teacher is saying! If your child is dealing with frustration, you might want to explore educational therapy. This can helps kids with different kinds of learning and attention issues develop strategies for working around their issues and dealing with frustration.

Auditory training therapy (sometimes called auditory integration therapy) is an alternative treatment for kids with auditory processing disorder. This includes auditory training programs like the Berard Auditory Integration Training Services and Fast ForWord. A main goal of these programs is to improve listening comprehensionthrough various activities or games.

Keep in mind that auditory training therapy is somewhat controversial. There isn’t a lot of research that shows it works. But there is anecdotal evidence that it’s helpful for some kids.

• Is there a cure?

“There is no known cure or remedy other than environmental support, such as facing a speaker and sitting close to a lecturer in order to catch more of what is being said (and possibly unconsciously read lips), helping to fill in gaps in perception of what is being expressed. Depending on the degree and exact nature of the problematic neural connections, some APD’ers may opt to try an amplification system as an aid, although others may be hypersensitive to sound and need to a far greater degree than the average person quiet settings to be comfortable and able to think calmly.”