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Jeanne Shaw asks the following question ?
>Are there any TODHHs out there who are working with technically hearing kids with CAP problems? If so, do you have info you can send me about CAP and what "works"?
Dear Jeanne and others on the EduDeaf List:
What specifically would be helpful for you to understand ? As a person having worked in the field of CAPD with children having a variety of problems including children with CAPD and hearing losses, I have a lot of concerns when it comes to this question.
CAPD is not a thing or a problem. CAP means:
That last word = processes and should be plural. So, I would be happy to respond to any specific requests either on this list or privately on the topic of CAP with children having hearing losses or not. However, what specifically do you want to know ?
As for the general area of helping children with CAPD problems, since, as I believe and I strongly feel this is important, there is no one thing called CAPD, what specific processes are you concerned about ?
I would be happy to share more information with you. Please let me know.
Dr. J! @ St. John's
I would like to know how one differentiates between a hearing loss causing problems in understanding and CAP causing problems in comprehension. The water is so muddy and vague. If a child has a hearing loss and LD what a challenge. Can you give us more about assessing the problem and therefore discrimination in a professional sense?
Thanks for any info!
Amy posted a question about how one can differentiate between a CAP problem and a hearing loss.
Dear Amy and others on EduDeaf,
Although there are many in my field and working in the area and doing research in CAP and CAPD who would say there is no way to differentiate between a problem in processing due to a hearing loss and a problem in processing due to a CAPD, I, for one, do not agree.
I believe that the experienced evaluator can differentiate between many problems in auditory processing which are related to CAPD rather than hearing loss. Furthermore, one must remember that auditory processing involves the level of input (at least according to my model of CAP), and input involves peripheral hearing.
I will give an overview, but would first like to state that only an appropriately trained evaluator can identify a true CAPD, and only an appropriately trained evaluator with experience testing CAP in people with hearing loss can differentiate between problems which may be auditorily based vs. problems which are central processing based. As a teacher, parent, etc. without the proper controlled tools for assessment, all you can do is describe behaviors which could have a large variety of causal reasons. As such, if you believe there is a child with a CAPD with or without a hearing loss, and if you try various management strategies with the child and they are not successful, then the child needs a complete CAP evaluation by a properly trained professional with the proper experiences to diagnose CAPD and to help you develop an appropriate plan for managing and treating the CAPD problems.
As for how you distinguish CAPD from hearing loss: In order to best understand how it can be done, it is necessary to first understand what is central auditory processing. To begin, as with my own model, there is no one thing as central auditory processing. CAP is really a group of coexisting processes which, I believe, occur concurrently (that is at the same time). CAP processes do not occur sequentially. However, in order to discuss CAP, we need to look at each element one at a time.
The basis of CAP is that we take in auditory/acoustic information and extract the needed cues from this information in order to gain an understanding of what has been presented. As such, CAP is largely cognitive and behaviorally based processes according to my model. In the process of understanding or extracting information from what we receive auditorily, our ears and central auditory pathways undergo a variety of processing to extract meaning and make sense of what we hear.
The best and only way to test CAP is to control the input signal and carefully control the variables being tested. Also, to determine how a person is processing information, you merely compare the person's processing of the same information when the load or task changes by a controlled variable. (Hope you're not getting too lost.)
To make this more concrete, if you believe that one aspect of CAP is listening to a message in the context of distracting noise, then you first need to evaluate the person's abilities to listen to the message without the distracting noise. Then you get a baseline of the person's abilities to take in and process the information without the distractor. *Then* you need to present the distractor under controlled conditions. Furthermore, you need to present the same material under both conditions (that is in quiet and in noise). Thus, the only difference between the two conditions would be the introduction of the noise distractor in the noise condition. For example, if a child can identify correctly 25 words said under controlled conditions either by repeating the words or pointing to a picture representing the word, and the same words (could be in different order) and the same exact pictures to represent these words is presented with the introduction of a specific level of controlled noise and the level of noise and the noise remain constant, then the difference in word identification would be due to difficulties listening under the adverse conditions of noise interference.
Now, would the problem described above be due to poor hearing (as with a sensorineural hearing loss) or with poor processing of the information as with a CAPD? Well, consider that people with hearing losses can still utilize the minimal acoustic cues in order to process the words even under adverse listening conditions. As such, poor (below expected norms) ability to identify the pictures representing the words comparing the listening in quiet vs. listening in noise would account for a CAP problem.
The only argument with what I have just stated is that the cause of the problem of listening in noise may be that the child has not learned to utilize the acoustic cues as received by his/her distorted hearing at the level of the inner ear (cochlea) rather than a problem in the central auditory pathways. However, according to my model, CAP includes all levels of processing begining at the level of the cochlea. This (to me) explains why many children with the same hearing loss function differently auditorily. Some children regardless of the degree of profound hearing loss have learned to utilize every available cue inherent in the acoustic signal, the language signal, the situation etc., and process information extremely well. Others with better peripheral hearing may not be able to utilize the various available cues, and process information very poorly. Still, others, even given the knowledge and skills to use all available cues can not properly process information well. In the first case, you have a person with excellent CAP processing. In the second case of the person not knowing the available cues who does better after being taught how to use those cues, you have a person with a CAPD at a developmental level who is very well remediated. In the third case of the person who still does poorly even though you have trained him/her about and how to use all available cues, you have person with a severe CAPD who needs management strategies to make the situations simplier in which to function because the person's central auditory processing abilities are too limited to overcome the problems, and the person may never be able to overcome these CAPD problems.To me, it is the job of the evaluator, parents, teachers, special educational service providers, to differentiate between child number 2 and number 3. The evaluator can differentiate between child number 1 and number 2.
I know it would be great if there were a simple answer to this question. But, for me, there are no simple answers or explanations to CAPD. To better understand the complexity of CAP processing, just consider all of the things you have to do just to tie your shoes. Try to write down or verbally express step by step every single thing you need to do to tie one shoe. Don't forget to include things like bend down or lift your leg. Also, don't forget to include all that is involved in getting the idea to lift your leg, getting the message from the brain to the muscles of your leg, innervating the muscles, telling the muscles when to stop moving etc. ( I think you get the idea).
I hope that this long winded explanation is helpful. Sorry it is so long, but it is too complex a thing to briefly explain.
I do hope this is helpful. Please feel free to email me privately or through this list about any other questions about CAPD.
Dr.J! @ St. John's
Jeanne Shaw asked for teaching strategies for helping children with CAPD problems. Here's some imput.
Dear Jeanne and EduDeaf'ers,
As I have stated in a recent posting, there is no such thing as *a* CAPD, there are many different CAP problems. As such, how can someone give you management/teaching strategies to help children who may have CAP problems. I have presented many workshops on this topic, and even in full day workshops, I don't complete half of the helpful teaching strategies/management techniques for these children.
I would be happy to assist you if you could be more specific and let me know in what area of Central Auditory Processing would you like more information regarding specific management and teaching strategies. I am guessing that you do not want strategies for helping the children overcome their specific CAPD problems (after these specific problems have been appropriately diagnosed), but you want strategies for managing the children in class.
If you email me privately or on the list of specific areas, I would be happy to give you my input about the specific management techniques which you might try and find helpful in those specific areas. So you will understand, I am writing a book on management strategies for helping children with CAPD and ADD. As such, you can see by the fact that management strategies need an entire book and that I feel there are specific areas of CAPD, that to just mention one or two would not be helpful.
Dr.J! @ St. John's
Uploaded by : Melissa Close/Kent State University/Deaf Education Major