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Central Auditory Processing

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  • Subject: Re: CAP
  • From: Lezlie Steffen LadyLLS2@AOL.COM
  • Date: Wed, 7 Jun 1995 20:09:46 -0400
  • Reply-To: A Practical Discussion List Regarding Deaf Education EDUDEAF@UKCC.UKY.EDU
  • Sender: A Practical Discussion List Regarding Deaf Education EDUDEAF@UKCC.UKY.EDU
  • With CAP testing the students have to have a lot of language... right???

    I had a student (who moved last year), he was diagnosed with PDD and deaf..... but could respond to a lot of noises.... very confusing child.... we considered possible CAP but to be honest I don't know a lot about CAP...... Do you have any references for me and the group????

    Thanks in advance,


    Document 2 of 3

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  • Subject: Re: CAP
  • Date: Tue, 6 Jun 1995 23:26:57 EDT
  • In-Reply-To: In reply to your message of TUE 06 JUN 1995 07:49:14 EDT
  • Reply-To: A Practical Discussion List Regarding Deaf Education EDUDEAF@UKCC.UKY.EDU
  • Sender: A Practical Discussion List Regarding Deaf Education EDUDEAF@UKCC.UKY.EDU
  • Dear Jeanne,

    You asked about finding an audiologist who is able to test for CAP problems in children with any type of hearing loss (deaf or HoH). I must admit that most of my fellow (male and female) audiologists are very narrowminded when it comes to testing for central auditory processing. Most look only at the tests and not at what it means to evaluate central auditory functioning and processing abilities.

    I, unfortunately, do not know of many audiologists in B.C. However, if there is a good, competent audiologist willing to learn and grow and try to do CAP evals on kids with hearing losses, I'd be happy to discuss this with them. It all comes down to the model or basis by which they are making their assessment.

    Here in New York (I am in a suburb North of New York City, and the University is in New York City), I get most referrals because other audiologists are not willing to test these kids. I am the only audiologist I know of in this metropolitan area who will test kids with hearing difficulties for CAP functioning and processing.

    Again, my only recommendation is to ask if any of your good audiologists who you feel really understands children's behavior and development would be willing to communicate with me, I'd be happy to share and discuss.

    As for your second question, what specific aspects of CAP do you need assistance with regarding remediation and management strategies. This is one of my areas of expertise, and I have been doing work in CAP management and remediation for over too many years to count, now. (I only mention this to tell you I have many resources, and would be happy to help you !)

    Let me know how I may be of help. What specific areas of CAP are you most concerned about ?

    Dr. J! @ St. John's

    Document 3 of 3

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  • Subject: Re[3]: CAP
  • Date: Thu, 8 Jun 1995 09:31:36 EDT
  • In-Reply-To: In reply to your message of WED 07 JUN 1995 12:09:46 EDT
  • Reply-To: A Practical Discussion List Regarding Deaf Education EDUDEAF@UKCC.UKY.EDU
  • Sender: A Practical Discussion List Regarding Deaf Education EDUDEAF@UKCC.UKY.EDU
  • Lezlie,

    I think that too many audiologists and those involved in evaluating CAP abilities are so "test bound" that they feel that the test "drives" or determines the diagnostic procedure. Interestingly, I have found that most of you as teachers may agree that just watching the behaviors of children and observing them gives more information than formal tests in many cases. Because I strongly believe in this method of evaluation (i.e., evaluating behaviors and not test results), according to my model and approach to CAP, you can test a child who has very little language and determine factors related to his/her central auditory processing abilities.

    For example, mostly all of the children with hearing loss with whom you work have had audiological evaluations in which the child was tested for sounds in the "sound field," that is, through loud speakers rather than through earphones. This technique is most traditional for testing young children, infants, toddlers and the difficult to test populations. Yet, when we as audiologists test a child of any age in the sound field, we are not just testing the child's hearing, but also his/her auditory processing abilities. To better understand, let me explain. In order for a child to look towards the loudspeaker from which the sound is coming, the child not only has to HEAR the sound, but the child has to do the following processing:

    1. Recognize that the sound is meaningful from all of the other stimuli in the child's environment and internally (within the child);

    2. Identify and associate that the sound is going to come from one of two directions (from the right or left loudspeakers);

    3. Localize from which loudspeaker the sound is coming;

    4. Anticipate the next sound will be coming;

    5. After getting a pattern that first the sound is coming from the right, then the left, then the right, then the left, the next sound would be expected to come from the right side - and if it doesn't, be surprised;

    6. Associate the toy/light or whatever stimulus the audiologist uses to reinforce or condition the looking response with the sound.

    Notice all of the above auditory processing tasks related to decoding of sound and to attention! Yet, not once did we consider the language because the task described above was not evaluating language processing. Thus, for an audiologist who truely understands psychoacoustics (the field of audiology related to behavioral responses to sound and language), observations of a child's (regardless of age) behaviors to the above standard sound field testing for hearing give a great deal of information regarding auditory processing at the levels identified.

    Yes, to look at other aspects of central auditory processing, we need to evaluate other factors. So as not to make this posting too long, I'll give one more example:

    Consider the child you mentioned who can respond well to sounds and noises, but may not be able to discriminate speech auditorily. Some areas of auditory processing we need to evaluate include:

    1. Decoding: Can the child identify a pattern of sounds, discriminate the differences in sound patterns, reproduce sound patterns, etc. (Note: we are testing his/her memory, discrimination, identification, etc.)

    2. Attention/Distractibility: Does the presence of a second sound interfere with the child's abilities to identify a target sound (figure-ground, distractibility, attention, etc.).

    I hope you see that CAP skills CAN be evaluated in children regardless of their language abilities. It just takes the right audiologist to understand what I would call Auditory Neuropsychology.

    You asked about readings. Since this message is getting soooooooo long, I put some suggestions for readings on a second posting. Hope this is helpful to you, Lezlie. Please contact me on the list or by private email (if it is personal) if I can be of further help.

    Dr. J! @ St. John's

    Uploaded by: Melissa Close/Kent State University/Deaf Education Major