Editor’s Note: Last fall, we received an e-mail from Monique Baran of Penn Yan, NY,
regarding the Tomatis Method of Auditory Stimulation. Monique wrote that her 16 year-old daughter, Nina, who has Down syndrome, was having problems with auditory processing,
language, articulation, and social skills. Monique reported that the therapy had helped her daughter. We felt this may be a topic of interest to readers, and askedNews and Notescolumnist, Ann Nobis, who is a Speech Language Pathologist, to address the issue. Below is Ann’s article on Central Auditory Processing Disorder (CAPD).
(Nina received her therapy through an occupational therapist, Angela Sallerson, in Rochester, who can be reached at
. Monique Baran may be reached at
.) Having Down syndrome does not necessarily exclude one from having other learning challenges as well. Central Auditory Processing Disorder (CAPD) is something that might also affect the learning ability in children with Down syndrome, just as it does with the “typical” population. An appropriate and thorough diagnostic hearing evaluation can help to determine if this other challenge may affect learning in a person having Down syndrome.
What is CAPD? Simply put, auditory processing is the ability of the brain to “sort out” or process the information the ear hears. Processing includes such abilities as: focusing attention appropriately; dividing attention between tasks; separating out speech from background noise or competing sounds; remembering information; discriminating between sounds and telling where sound/speech is coming from.
How is CAPD diagnosed? Special tests presented by a licensed audiologist who has experience with CAPD are required to diagnosis CAPD. However, a child must be at least eight years old before the testing can be done. This is because the brain must reach a certain maturity level. This brings up a very important point when one considers a child who has Down syndrome and is suspected of having CAPD as well. Children must have a certain language ability to understand the testing/directions as well as have the attention to complete the rigorous testing. A thorough evaluation takes about 1.5 to 2 hours from start to finish.
It is also necessary to note that there is overlap between CAPD and other disabilities. There is also controversy on the types of assessments used and how accurately they identify the existence of CAPD.
What behaviors or symptoms indicate a possible CAPD?
Forgets directions
Confuses directions
Sensitivity to noises (busy places and loud places)
Confuses similar words
Ignores when someone speaks to them while doing something else
Can’t tell where sound is coming from
More confusion noticed in noisy or busy places
What is the treatment for CAPD? There are many programs out presently that offer treatment for CAPD. Please note that there is still much research that needs to be done regarding the treatment programs. There is not a “cure all” out there; however, there are some strategies that can be used to assist someone coping with CAPD, along with the specific recommendations that come from one’s audiologist following an evaluation.
Your child’s speech-language pathologist is a resource for strategies to help compensate for the presence of some of the above mentioned behaviors or if your child has been diagnosed with CAPD. If your child has been diagnosed with CAPD, your speech language pathologist should be given the information and recommendations from the audiologist.
What are some of the strategies?
Quiet learning environment
Shortened directions
Visual support/show while explaining
Extended time
Communication partner speaking a bit louder
Use of auditory trainer
Drill and practice using manipulatives/visuals
Preferential seating
Teaching child to ask for assistance in challenging situations
