Sunday, August 13, 2006

One of Izzaks biggest problems is CAPD let this explain

Jennifer, 9, seems to pay attention when the teacher works with her one-on-one. But when there are group discussions, she spends most of her time looking out the window. The teacher is complaining she doesn't participate in class and is giving Jennifer lower grades as a result.

Shawn, 12, was supposed to be home in time for his dentist's appointment at 3:30 PM. But when he finally walked in the house at 5:00, he was surprised to hear about the appointment and that his mother had reminded him about it that morning.

Normal kids? Or is something else going on?

Life is complicated these days, for children as much as adults. There's a lot to remember and a lot to do. But sometimes a child may seem to be more than simply distracted by a complex life. Although their hearing may be normal, kids with central auditory processing disorder (CAPD) can't process the information they hear in the same way as others because their ears and brain don't fully coordinate.

What Are the Signs and Symptoms?

Symptoms of CAPD can range from mild to severe and can take many different forms. If you think there may be a problem with how your child processes what he or she hears, ask yourself these questions:

* Is your child easily distracted or unusually bothered by loud or sudden noises?
* Are noisy environments upsetting to your child?
* Does your child's behavior and performance improve in quiete settings?
* Does your child have difficulty following directions, whether simple or complicated ones?
* Does your child have reading, spelling, writing, or other speech-language difficulties?
* Is abstract information difficult for your child to comprehend?
Are verbal (word) math problems difficult for your child?
* Is your child disorganized and forgetful?
* Are conversations hard for your child to follow?

These, as well as other behaviors, may be signs of a central auditory processing disorder (CAPD). It's an often-misunderstood problem because many of the behaviors noted above may also appear in other conditions such as learning disabilities, attention deficit hyperactivity disorder (ADHD), and even depression. But kids with CAPD can have a coexisting disorder - the most commonly seen is ADHD. Although CAPD is often confused with ADHD, it is possible to have both.

What Causes It?

The possible causes of CAPD are varied and can include head trauma, lead poisoning, chronic ear infections, and unknown reasons. Because there are many different possibilities - even combinations of causes - each child has to be assessed on an individual basis.

How Is It Diagnosed?

Audiologists (specialists in hearing) can determine if your child has CAPD. Although speech-language pathologists can get an idea by interacting with your child, only audiologists can perform central auditory processing testing and determine if there really is a problem.

However, some of the skills a child needs to be evaluated for central auditory processing disorder don't develop until 8 or 9 years old. The auditory center of the brain isn't fully developed at age 7, 8, and 9 - the most common ages audiologists see for the central auditory processing test. These kids' brains just haven't matured enough to accept and process a lot of information. Therefore, many children diagnosed with CAPD can develop better skills with time.

Once diagnosed, children with CAPD usually work with a speech therapist. The audiologist will also recommend that your child return for yearly follow-up evaluations.

What Are the Problem Areas for Kids With CAPD?

Here are the five main problem areas that can affect both home and school activities in children with CAPD.

* Auditory Figure-Ground Problems: This is when the child can't pay attention when there's noise in the background. Noisy, low-structured classrooms could be very frustrating to this child.
* Auditory Memory Problems: This is when the child has difficulty remembering information such as directions, lists, or study materials. It can be immediate (i.e., "I can't remember it now") and/or delayed (i.e., "I can't remember it when I need it for later").
* Auditory Discrimination Problems: This is when the child has difficulty hearing the difference between sounds or words that are similar (COAT/BOAT or CH/SH). This problem can affect following directions, reading, spelling, and writing skills, among others.
* Auditory Attention Problems: This is when the child can't maintain focus for listening long enough to complete a task or requirement (such as listening to a lecture in school). Although health, motivation, and attitude may also affect attention, among other factors, a child with CAPD cannot (not will not) maintain attention.
* Auditory Cohesion Problems: This is when higher-level listening tasks are difficult. Auditory cohesion skills - drawing inferences from conversations, understanding riddles, or comprehending verbal math problems - require heightened auditory processing and language levels. They develop best when all the other skills (levels one through four above) are intact.

If your child has CAPD, there are strategies that can be used at home and school to alleviate some of the problem behaviors associated with CAPD.

How Can I Help My Child?

Difficulty with following directions is possibly the single most common complaint about children with CAPD. Some of things you can do that may help:
* Reduce background noise.
* Have your child look at you when you're speaking.
* Use simple, expressive sentences.
* Speak at a slightly slower rate and at a mildly increased volume.
* Ask your child to repeat the directions back to you aloud and to keep repeating them aloud (or to himself or herself) until the directions are completed. Make certain your child understands the directions and isn't just copying your words. You can be more certain of this if your child is able to rephrase the directions. For example, "Take the garbage to the side of the house," may be restated as, "You want me to take the garbage to the side of the house, not to the front."
* For directions that are to be completed at a later time, writing notes, wearing a watch, and maintaining a household routine also help. General organization and scheduling also seem to be beneficial for many children with CAPD.

It's especially important to teach your child to be responsible and actively involved in his or her own success. Your child can be encouraged to notice noisy environments, for example, and move to quieter places when listening is necessary.

These other home strategies may also be helpful:

* Provide your child with a quiet study place (not the kitchen table).
* Maintain a peaceful, organized lifestyle.
* Encourage good eating and sleeping habits.
* Assign regular and realistic chores, including keeping a neat room and desk.
* Build your child's self-esteem.

These are all very important goals. Your modeling of these behaviors goes far toward encouraging them in your child.

It's also important to keep in regular contact with school personnel about your child's progress. Kids with CAPD aren't typically put in a special education class. Instead, techniques are used to make the child's regular classrooms more "friendly" for him or her. For example, it's important to discuss seating plans with teachers (a child with CAPD should sit toward the front of the room with his or her back to the windows). Also, talk to your child's teacher about specific plans for problem academic areas and provide your child with whatever aids may help in class, such as an assignment pad or a tape recorder.

One of the most important things that both parents and teachers can do is to realize that CAPD is real. Symptoms and behaviors are not within the child's control. What is within the child's control is recognizing the problems associated with CAPD and applying the strategies recommended both at home and school.

A positive, realistic attitude and healthy self-esteem in a child with CAPD can work wonders. And kids with CAPD can go on to be just as successful as other classmates. Although some children do, however, grow up to be adults with CAPD, with coping strategies and by using techniques taught to them in speech therapy, they can be very successful adults.

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