Evaluation for children who have normal hearing but difficulty processing what they hear

Central auditory processing is what the brain does with what the ears hear. Our auditory system is complex—it first must detect the sound and then process the information before we can understand it.

Children with central auditory processing disorder (CAPD) typically hear normally, but have a difficult time processing what they hear. They often have trouble recognizing the slight differences in the way similar words sound, especially when there is background noise.

The symptoms of CAPD can look similar to other conditions, like learning disabilities or attention deficit hyperactivity disorder (ADHD). It’s important that children with CAPD are accurately diagnosed so they can receive the therapy that best meets their needs. The audiology team at Johns Hopkins All Children’s is experienced in diagnosing and treating children with CAPD.

Signs your child may have CAPD include:

• A tendency to be easily distracted
• Academic difficulties, including reading, spelling and/or learning problems
• Difficulty determining the source of a signal or sound
• Difficulty following directions
• Difficulty following rapid speech
• Difficulty learning a foreign language or novel speech materials, especially technical language
• Difficulty maintaining attention
• Difficulty or inability to detect the changes in rhythm, stress, and intonation in speech
• Difficulty understanding speech when there is competing background noise
• Frequent requests to repeat or rephrase information
• Inconsistent or inappropriate responses to requests for information
• Poor singing, musical ability and/or appreciation of music

Evaluation and treatment

Central auditory processing disorder is typically diagnosed as young as 6 years old. Some additional criteria for referral to our program include:

• English is the main language spoken in the home
• The child has no greater than a mild articulation and/or language disorder
• The child has an IQ within the normal range (80 or above)
• The child has normal hearing

We use a battery of tests that allow us the most complete picture of your child’s processing abilities. The testing takes two to three hours, and a report and counseling are usually completed the day of testing.

The report covers the specific auditory processing skills your child is having difficulty with, and includes recommendations for school and home success. We will make recommendations for further testing as needed and refer your child to the specialty that best fits his or her treatment needs, which may include speech-language pathology, occupational therapy, psychology or neuropsychology.