Pediatric+(Central)+Auditory+Processing+Disorder

= (Central) Auditory Processing Disorder =

What is (central) auditory processing disorder?

 * Auditory processing disorder (APD), also known as central auditory processing disorder (CAPD), is a complex problem affecting about 5% of school-aged children. These children are unable to process the information they hear in the same way as others do. This is because their ears and brain don't fully coordinate.CAPD refers to limitations in the ongoing transmission, analysis, organization, transformation, elaboration, storage, retrieval, and use of information contained in audible signals. Individuals with CAPD by definition have normal hearing; during a routine hearing examination there will be no detection of CAPD.


 * CAPD refers to how the central auditory nervous system makes sense of those sounds that we hear. There is a disconnection that affects the way the brain recognizes and interprets sounds.
 * CAPD may involve the listener's active and passive (e.g., conscious and unconscious, mediated and unmediated, controlled and automatic) ability to do the following:
 * 1) attend, discriminate, and identify acoustic signals;
 * 2) transform and continuously transmit information through both the peripheral and central nervous systems;
 * 3) filter, sort, and combine information at appropriate perceptual and conceptual levels;
 * 4) store and retrieve information efficiently; restore, organize, and use retrieved information;
 * 5) segment and decode acoustic stimuli using phonological, semantic, syntactic, and pragmatic knowledge; and
 * 6) attach meaning to a stream of acoustic signals through use of linguistic and nonlinguistic contexts.

__**References **__ http://kidshealth.org/parent/medical/ears/central_auditory.html
 * Auditory Processing Disorder." //KidsHealth - the Web's Most Visited Site about Children's Health//. The Nemours Foundation/KidsHealth®, 2011.Web. 27 Apr. 2011.

[|* http://www.asha.org/docs/html/RP1993-00208.html]
 * "Definitions of Communication Disorders and Variations." //American Speech-Language-Hearing Association | ASHA//. American Speech-Language-Hearing Association.

How is (Central) Auditory Processing tested?

 * <span style="color: #1d0202; font-family: Arial,Helvetica,sans-serif; font-size: 120%;">SCAN-3:C for Children provides you with a valid and reliable test battery to help identify auditory processing disorders and describe their impact on daily life. Screen and diagnose auditory processing difficulties with one co-normed battery of tests
 * ====<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">SCAN-C© (Test for Auditory Processing Disorders In Children-Revised)[[image:imagesCAKQDV6K.jpg width="216" height="186" align="right"]] ====
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">For the Auditory Fusion Test-Revised, Random Gap Detection Test, The Random Gap Detection Test-Expanded, and the Spanish Time Compressed Sentence Test contact AUDiTEC of St. Louis - [|www.auditec.com/] or 1-800-669-9065.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">For information about SCAN-3 for Children Tests of Auditory Processing Disorders and SCAN-3 for Adolescents and Adults Tests of Auditory Processing Disorders go to: [|psychcorp.pearsonassessments.com]
 * "Where to Purchase Tartan Products." //Tartan//. Web. 27 Apr. 2011
 * <http://www.capdtest.com/about.cfm>
 * The SCAN-3 test battery includes:
 * **Screening Tests**
 * **NEW!** Gap Detection—Indicates presence of a temporal processing problem which may infl uence the ability to comprehend running speech
 * Auditory Figure Ground (+8dB)—Tests ability to listen with background noise
 * Competing Words (Free Recall) — Dichotic listening task (poor performance may indicate lack of maturation or abnormality of the auditory nervous system)
 * **Diagnostic Tests**
 * Filtered Words—Indicates ability to process speech when the signal is distorted or compromised by a poor acoustic environment
 * Competing Words (Directed Ear)—Dichotic listening task that indicates a child’s auditory maturation or developmental level
 * Competing Sentences—Provides information about the maturation of the auditory nervous system
 * **Supplementary Tests**
 * Auditory Figure Ground (+0 dB and +12 dB)
 * **NEW!** Time Compressed Sentences

What theoretical approaches guide treatment of this disorder?
====Two theoretical approaches have been proposed to help clinicians better define and guide intervention for clients with Central Auditory Processing Disorder. The two models are the Buffalo Model and Bellis/Ferre Model. Both models are similar in Decoding, Integration and Organization to help define and describe these areas of processing, They also agree on areas of the brain that are linked to the dysfunctions exhibited by individuals with central auditory processing disorder. These areas include the primary auditory cortex and corpus callosum that are responsible for Decoding and Integration Profiles.==== ====Outlined below is the Buffalo Model in more detail. As shown, the Buffalo model includes 4 categories whereas the Bellis/Ferre Model includes 3 primary subtypes and 2 secondary subtypes. The Bellis/Ferre model includes the three primary subtypes which are Auditory Decoding Deficit (communication between the left and right hemisphere), Prosodic Deficit (difficulty understanding the intent of verbal messages) and Integration Deficit (requiring both cerebral hemispheres to coordinate information). The secondary subtypes of the Bellis/Ferre model involve more than just auditory information. The secondary subtypes also deal with language or attention disorders. The secondary subtypes are Associative Deficit (receptive language disorder) and Output-Organization Deficit (attention and/or executive function disorder).====

Decoding

 * ====Linked to the posterior temporal lobe====
 * ====Associated with dysfunctions in the associated auditory cortex====
 * ====Difficulties in this area are processing auditory information rapidly, so individual is likely to respond more slowly====

Tolerance-Fading Memory

 * ====Linked to the frontal or anteriotemporal dysfunction in the cortex====
 * ====Difficulty understanding speech in adverse listening situations, along with short-term memory problems and reduced tolerance to noise====

Integration

 * ====Linked to dysfunctions in the corpus callosum or the angular gyrus====
 * ====Difficulty integrating auditory information and other information, such as visual information====

Organization

 * ====Linked to the "reversal strip"; the reversal strip is a cortical area in the frontal lobe, anterior temporal lobe and post central gyrus====
 * ====Individual will have sequencing errors====

====Foli, K. J., & Elsisy, H. (2010). Influence, education, and advocacy: the pediatric nurse’s role in the evaluation and management of children with central auditory processing disorders. //JSPN//, //15//(1), 62-71.==== ====<span style="font-size: 1.06em; font-weight: normal; margin: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 5px;">Jutras, B., Loubert, M., Dupuis, J., Marcoux, C., Dumont, V., & Baril, M. (2007). Applicability of central auditory processing disorder models. //American Journal of Audiology//, 16, 100-106. ====

<span style="color: #cb2a4c; font-family: Arial,Helvetica,sans-serif;">General Goals and What to Expect From Treatment.

 * <span style="color: #0f0000; font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Some goals for children with APD may involve improving auditory memory of words and phrases. Other goals may focus on picking out a main message while there is background noise present. For social skills a goal may be to improve ability to process intonational patterns and prosody in reading as well as conversationally. Also improvement of figurative language use and comprehension of language in varied frequency ranges. Because treatment is so highly individual what to expect from treatment is based on an individual's abilities as well. There is not one general treatment that is appropriate for all children diagnosed with APD and just because treatment is effective for one child with APD that in no way indicates another child would be successful with the same treatment.


 * <span style="color: #0f0000; font-family: Arial,Helvetica,sans-serif; font-size: 120%;">One of the only skills that is worked on among most with APD is self advocacy skills that help to make the the child feel in power over their own lives.


 * <span style="color: #0000ff; font-family: Arial,Helvetica,sans-serif; font-size: 120%;"> An example of a behavioral objective for a child with APD could be: To increase comprehension of suprasegmental meaning in reading or conversation 85% of the time.

Coen-Cummings, Martha, Ph.D. CCC-S.(n.d.) //Auditory Processing Therapeutic Goal Examples.// Retrieved April 13, 2011, from __[]__ American Speech-Language-Hearing Association. (2005). //(Central) Auditory Processing Disorders// [Technical Report]. Available from [|www.asha.org/policy]. =<span style="color: #cb2a4c; font-family: Arial,Helvetica,sans-serif; font-size: 110%;">**What kinds of techniques/activities might be observed in a typical treatment session?** = <span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 120%; text-align: left;">After screening, testing and reviewing case history is completed and the diagnosis is confirmed, intervention begins shortly after to receieve the best possible outcome of therapy. Some techniques that might be observed in a typical treatment session of (Central) Auditory Processing Disorder are management skills. There are three main management strategies which include: direct skills remediation, environmental modifications, and compensatory strategies. These management skills consist of bottom-up and top-down approaches. Bottom-up approaches include acoustic signal enhancement and auditory training. While top-down appoaches include cognitive, metacognitive and language strategies.
 * __References__ **

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 90%;">
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**Direct skills remediation**- Direct skills remediation is auditory training which incorporates bottom-up approaches. It targets the childs specific difficulties, such as decoding, phoneme discrimination, phoneme to grapheme skills, prosodic deficit (intensity, frequency, and duration discrimination), auditory integration and separation, temporal gap discrimination, temporal ordering or sequencing, pattern recognition, localization and lateralization, and recognition of auditory information presented within a background of noise or competition. It is important to present the clients in a natural setting during intervention, to maximize learned skills. If training did not include everyday noises in a loud environment, then skills might be lost in certain situations.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**Environmental modifications**- Includes both bottom-up and top-down approaches. Environmental modifications teaches the child strategies to improve access to auditory information in the classroom, at home, or other communication settings. Some techniques used to enhance the childs listening environment include seating arrangements, the teacher or parent should gain the childs attention before explaining directions, also the directions should be short and simple to maintain the childs attention, provide visual aids such as notes and outlines, reduction of competing signals and reverberation time, and use of assistive listening systems.
 * <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">**Compensatory strategies**- Compensatory strategies incorporates the top-down approach by teaching the child how to overcome residual dysfunction which was not resolved with auditory training. This is accomplished by enhancing the childs learning and listening skills through vocabulary building, phonological awareness, active listening skills, cognitive problem solving, assertiveness training, and improving auditory memory (repeating, rehearsing, chunking).

<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">__**References**__ American Speech-Language-Hearing Association. (2005). (Central) auditory processing disorders [Technical Report). Available from []

Foli, K. J., & Elsisy, H. (2010). Influence, education, and advocacy: the pediatric nurse’s role in the evaluation and management of children with central auditory processing disorders. //JSPN//, //15//(1), 62-71.

(2009, December 21). In //Health Sciences//. Retrieved April 22, 2011, from http://www.latrobe.edu.au/hcs/resources/capd/intervention.html

__**Video of Therapy Excercies with a child who has (C)APD**__

 * ===media type="youtube" key="6F6fVGg7LLg?rel=0" height="390" width="480"===