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(Central) Auditory Processing Disorder (C)APD

Auditory processing disorder refers to how the central nervous system (CNS) uses auditory

information. CNS is vast and also is responsible for functions such as memory, attention and language etc. To avoid confusing APD with other disorder that can affect a person’s ability to attend, understand, and remember, it is important to emphasize that APD is an auditory deficit that is not the result of other higher-order cognitive, language, or related disorder. APD is applicable to any child or adult who has difficulty listening or understanding spoken language. There are many disorders that can affect a person’s ability to understand auditory information.

Central auditory processing disorders are deficits in the information processing of audible signals not attributed to impaired peripheral hearing sensitivity or intellectual impairment. This information processing involves perceptual, cognitive, and linguistic functions that, with appropriate interaction, result in effective receptive communication of auditorily presented stimuli. Specifically, CAPD refers to limitations in the ongoing transmission, analysis, organization, transformation, elaboration, storage, retrieval, and use of information contained in audible signals. 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:

  • attend, discriminate, and identify acoustic signals;

  • transform and continuously transmit information through both the peripheral and central nervous systems;

  • store and retrieve information efficiently; restore, organize, and use retrieved information;

  • segment and decode acoustic stimuli using phonological, semantic, syntactic, and pragmatic knowledge; and

  • Attach meaning to a stream of acoustic signals through use of linguistic and nonlinguistic contexts

Recommendations for training deficits specific areas such as working memory, auditory

discrimination, auditory sequencing, etc., do not functionally transfer into practice and fail to create generalization affect.

Auditory deficits don’t cause speech, language, and academic learning difficulties. Numerous non-linguistic based disorders can be misdiagnosed as (C)APD without differential diagnosis. (C)APD testing is hugely influenced by non-auditory factors grounded in higher order cognitive and linguistic processes. Presently there’s no clear performance criteria to make the (C)APD diagnosis. The diagnosis of (C) APD is appealing because it presents a more attractive explanation than the diagnoses of language and learning disabilities for children with processing deficits


Causes of APD in children are not well understood.

  • Historically, brain lesions were thought to be the underlying cause of APD.

  • One sub group of CAPD were thought to be having neuro physiologic and neuro anatomical etiologies (Musiek, 1996).

Nature of (C)APD:

  • (C)APD is a deficit in neural processing of auditory stimuli that is not due to higher order language, cognitive, or related factors.

  • However, (C)APD may lead to or be associated with difficulties in higher order language, learning, and communication functions.

  • Although (C)APD may coexist with other disorders (e.g., attention deficit hyperactivity disorder [ADHD], language impairment, and learning disability), it is not the result of these other disorders.

  • For example, children with autism or ADHD often present with listening and/or spoken language comprehension difficulties; however, these difficulties are not due to a deficit in theCANS, but rather to their higher order, more global disorder.

  • Thus, it would not be appropriate to apply the diagnostic label of (C)APD to the listening difficulties exhibited by these children unless a co-morbid deficit in the CANS can be demonstrated.

  • In addition to their primary auditory processing problems, individuals with (C)APD may experience a number of other difficulties.

  • For school-aged children, (C)APD can lead to or be associated with difficulties in learning, speech, language (including written language involving reading and spelling), social, and related functions (Bellis & Ferre, 1999; Chermak & Musiek, 1997; Katz, 1992).


  1. Difficulty listening skills.

  2. Difficulty performing multi step direction

  3. Slow processing auditory speed

  4. Language problems – Developing vocabulary and understanding spoken words.

  5. Problems with reading, verbal and reading comprehension, spelling and vocabulary.

  6. Poor academic performance

Common characteristics of (C)APD:

Persons with APD often:

  • have trouble paying attention to and remembering information presented orally; cope better with visually acquired information

  • may have trouble paying attention and remembering information when information

  • is simultaneously presented in multiple modalities

  • have problems carrying out multi-step directions given orally; need to hear only one direction at a time

  • They have poor listening skills, and need people to speak slowly.

  • need more time to process information.

  • develop a dislike for locations with background noise such as bar, clubs or other social locations

  • prefer written communication (e.g. text chat).

  • It appears to others as a problem with listening. Somebody with APD may be accused of "not listening".

  • have behavioral problems.


  • Handbook of central auditory processing disorders- Musiek and Chermak

  • Assessment and Management of CAPD- Bellis

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