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Auditory Processing & Natural Methods for Treating the Problem

Sue, a vibrant 6 year old, has suffered from Central Auditory Processing Disorder (CAPD). She, and many children like her, typically have normal hearing and intelligence. However, they have trouble paying attention to and remembering information presented orally, problems carrying out multi-step directions, confuse syllable sequences, have problems developing vocabulary, difficulty with reading, comprehension, spelling, and overall poor listening skills and therefore, low academic performance.

Life is complicated these days for children like Sue. There are a lot of new social and scholastic demands, bombarding them with a multitude of information to remember. So, the seemingly simple problems with learning to read and write, following directions and hearing in noisy environments are often not all that alarming to parents and school teachers because they appear quite logical. However, sometimes, parents like Sue’s, do become a bit concerned because their child may seem to be more than simply distracted by the complexity of his/her life.

Yet uncertain of what to do because the child’s hearing has been deemed as healthy, they often feel they are left without a resolution to their fears and concerns regarding their child’s development.

Although a child’s hearing ability may be diagnosed as average and normal, he/she can still be suffering from central auditory processing disorder. This is because a child with CAPD can hear in the sense that there is not damage to the ear’s ability to receive and perceive sounds. The problems lies in that the child can't fully process the information he/she hears in the same way as others because their ears and brain are not communicating properly, which provokes many of their learning and communication difficulties. Human beings hear when energy that we recognize as sound travels through the ear and is changed into electrical information that can be interpreted by the brain. Auditory processing disorder indicates that something is adversely affecting the processing or interpretation of the sounds received by the brain. Again, children with CAPD typically have normal hearing and intelligence. Nor does their difficulty lie in developmental intelligence. Rather, their trouble lies in paying attention to and remembering information presented orally, problems carrying out multi-step directions, confusing syllable sequences, problems developing vocabulary, difficulty with reading, comprehension, spelling, and overall poor listening skills and therefore, low academic performance. At a fundamental level, these language and communication disorders can be linked to an under-developed ear. It is worth noting that CAPD goes by many other names; auditory processing disorder, auditory perception problem, auditory comprehension deficit, central auditory dysfunction, central deafness, and so-called "word deafness."

What are the Causes?

CAPD is a physical hearing impairment. However, as stated it is not one that shows up as a hearing loss on routine screenings or an audiogram. Instead, CAPD affects the neurological system beyond the ear, which identifies and separates meaningful messages from non-essential background noise and sends that information to the intellectual centers of the brain. A constant interference in the processing of information (CAPD) can be hereditary in families, a result of a difficult birth or the disorder can be acquired from a head injury or a severe illness during the child’s first years. Frequently, the exact cause is unable to be identified.

What Are the Specific Signs and Symptoms?

Of course, the following exemplary symptoms of CAPD can range from mild to severe and can take many different forms, depending on the child. If you think there may be a problem with how your child 2 processes information or what he/she is able to hear and pick up, you can ask yourself these questions, but ultimately you will need to have him/her diagnosed by a qualified professional:

• Is he/she easily distracted or unusually bothered by loud or sudden noises?

• Do noisy environments upset him/her?

• Does he/she have difficulty following directions, whether simple or complicated ones?

• Does he/she have reading, spelling, writing, or other speech-language difficulties?

• Is abstract information difficult for him/her to comprehend?

• Does he/she have difficulty following conversations?

These, as well as other behaviours, may be signs of a central auditory processing disorder. However, it is often-misunderstood or misdiagnosed because many of these symptoms may also be indicative of other conditions such as learning disabilities, attention deficit hyperactivity disorder (ADHD), and other related developmental difficulties.

So, What Is The Next Step If You Suspect That Your Child Meets Many Of The Criteria For CAPD?

Diagnosis & Therapy. Audiologists, professionals specialized in the hearing sciences, can determine if your child has CAPD, by performing a central auditory processing test to determine if there is a legitimate problem. Nonetheless, many of the skills a child needs to be fully and correctly evaluated for central auditory processing disorder do not naturally develop until 8 or 9 years old. Therefore, when many children are tested for CAPD during their early primary schools years, the auditory centre of their brain has not fully developed and would naturally face some difficulty in receiving and processing a lot of information because the brain has not yet fully matured. Therefore, many children diagnosed with CAPD can improve many skills with time.

Once diagnosed, children with CAPD most often work with a speech therapist. For example there are exercises to improve language-building skills, which can increase the ability to learn new words and increase a child's language base. Also, auditory memory enhancement tasks are effective in reducing detailed information into more basic chunks of information. Another exercise is informal auditory training techniques, which can be used by teachers and therapists to address specific difficulties or auditory integration training which retrains the auditory system and decrease hearing distortion. Or yet another popular approach is environmental modifications such as classroom acoustics, the location of the child’s desk and chair or seating in social group situations may help.

There are a variety of commercially available strategies available to help children with auditory processing difficulties. Some of these commercially available methods have been well researched while others may have not been. Consequently, any therapy selected should be used under the guidance of a team of professionals, and the effectiveness of the method needs to be evaluated on a regular basis. One common commercial approach to treating CAPD is with the use of an auditory trainer, which is an electronic device that allows the child to focus his/her attention on the speaker and reduce the interference of background noise. They are often used in classrooms, where the teacher wears a microphone to transmit sound, while the child wears a headset to receive the speech sounds.

However, one effective form of treatment among parents, to support the work done with the speech therapist, is the Tomatis Method’s listening program. The Tomatis Method uses sound through an electronic device that exercises the whole ear through bone and air conduction to strengthen language, learning and the processing of sounds under an essential principle; “the voice can only reproduce what the ear hears”. Overall, the Tomatis Method is related to strengthening the effects of the middle ear, the inner ear, the auditory system as a whole and the central nervous system and helps in rewiring the connections needed for the brain to process auditory information.

Case Study: Sue’s Success in Battling CAPD & The Tomatis Method

Our vibrant Sue, introduced at the beginning of the article, is an exemplary case of how the application of the Tomatis Method, enabled a young girl’s to overcome her CAPD limitations and mature. In May 2004, Sue, had a listening assessment and consultation with her mother at Australian Tomatis Method’s EARobic Centre in Sydney, headed under the direction of Françoise Nicoloff, to address her auditory processing. Sue immediately began her first listening therapy program, which consisted of 30 hours at a rhythm of 2 hours a day, for 5 days over a period of 3 weeks. Sue’s mother also went through the same listening program as her daughter at no extra cost, in order that she was able to experience what her daughter was going through.

In spite of suffering from various ear infections during her Tomatis Listening program, which resulted in a ruptured eardrum and the need for antibiotics, Sue’s stages of progress were noted both at home and at school by the end of June 2004. A mere four weeks after starting the program. For example, her teacher commented that Sue started to distinguish between sounds much better and was able to reproduce those sounds better than before. In general, her speech improved in clarity, with less hesitations and even her concentration improved. Consequently, she was definitively less cranky and frustrated in class and at home as she was able to keep up with what everyone else was doing. Additionally, her writing improved and she began to finish tasks that she started, which was a totally new behaviour for her. Also, in class, she was putting her hand up to answer questions, which was very much unlike Sue. Her teacher was pleased and her mother relieved and full of hope for what Sue might be able to achieve.

Sue’s mother was so pleased with her daughter’s progress that Sue came back at the end of July 2004 for a second program of 8 days and her mother commented that even after the first program ended, Sue continued to evolve positively. The program seemed to still be affecting her development even though she had finished the program about a month prior. Sue continued to be less fidgety and more in control of herself as the weeks went by.

When Sue came back to start her third program, Sue’s mum reported that the speech therapist was even impressed and said “she had not seen such a huge improvement in a child after four weeks of break”! Sue’s mum recognized that there was a tremendous change in Sue’s behavior and was much more cooperative. Sue’s mother attests that it was the Tomatis Method which was directly related to strengthening the effects of her daughter’s auditory system needed, improving her processing verbal information. Sue is a “classic case” of what the application of the Tomatis Method can do for a child with CAPD.

Adults with CAPD: people who were not identified when they were children

When a child with CAPD grows up, they do not simply ‘grow out’ of the disorder. If it hasn’t been treated when they were young, they will suffer from the same symptoms and difficulties when they grow up. Adults whose auditory problems have not been recognized and dealt with when they were young are forced to invent their own solutions to cope with the demands of adulthood. The subsequent behaviors often mask the real problem and provoke difficulties at university, in the work place and in their close personal relationships.

Case Study: Phillip and his Encounter with the Tomatis Method

Put yourself in Phillip’s position, a 29 year old man who was working for an international shipping company in their Customer Service Call Centre. How could the customers on the other end of the phone or his supervisor and co-workers possibly know that his all too frequent mistakes were not a result of lack of interest or stupidity? No one had identified his problem during childhood because he grew up at a time when CAPD wasn't as widely recognized and his ‘deafness’ and ‘confusion’ were passed off as the result of him being a ‘late bloomer, but he never ‘bloomed’.

Phillip first contacted the Australian Tomatis Method’s EARobic Centre in Sydney to help him improve his concentration and possibly help reduce his stress at work, which was caused by his 4 inability to follow directions and keep up with his departmental team. When Phillip had his listening assessment and initial consultation, it was clear to Francoise Nicoloff, the director, that much more was going on than Phillip’s inability to concentrate, rather he was not capable of fully processing the sounds he received. Francoise suggested that he may be suffering from CAPD, as he displayed many of the signs and symptoms. She offered that he may wish to obtain an official diagnosis from an audiologist, but that aside, A Tomatis Listening Program would certainly alleviate many of his communication and concentration difficulties.

Phillip never did get an official diagnosis, but he did follow a 30 hour Tomatis listening program at a rate of 2 hours a day for 15 days. Phillip was amazed at the few, but very significant changes, in his ability to get information and direction correct at work. Overall, he was making fewer errors, which reduced his stress level. Phillip subsequently followed two other 30 hour programs within a 4 month period and not only had his own accounts to show that the Tomatis Method had helped his communication and concentration skills, but he had a bi-annual performance review from his employer that he was able to compare to his previous ones, indicating his professional improvement in the workplace.

Summing Things Up

Usually the easiest and most time efficient way to communicate with someone is to simply say something. However, if the your listener has CAPD your comment or question might be received with some words drowned out by other noises, or with some words sounding like different words or maybe, even a string of meaningless verbal noise. You might begin to suspect that something is wrong if they respond with an expression indicating that he/she didn't register much understanding, or if he/she provides an answer to a question you didn’t ask or when he/she requests additional information for clarification. Most of us aren't very knowledgeable about the specifics of CAPD and are more likely to wonder if the listener is just not very intelligent or doesn't really care about what we are saying. However, children and adults with CAPD do care about what you are saying; they are probably working twice as hard to try to capture the meaning of your information, but are physically incapable of processing the detailed meaning of your message properly.

Françoise Nicoloff is the founder and director of The Australian Tomatis, Registered Certified Tomatis Consultant and Professional Trainer. She is also President of the International Association of Registered Certified Tomatis Consultant. She is a registered Psychologist in NSW, WA, Victoria and Queensland. She has been using the Tomatis Method for 30 years in France, Tahiti and Australia and initiated the training and development of the Japanese Centre and New Zealand and Philippines. She has helped thousand of families and people to overcome their difficulties and access their potential. Article written by, Kara Mac Donald, who was doing her doctorate at Sydney University in Applied Linguistics, researching English as a Second Language (ESL) pronunciation. She teaches ESL pronunciation at Sydney University’s Centre for Continuing Education and has worked with ESL clients at the Australian Tomatis Method’s centre for about a year and a half. Kara has recently come to work with the children, as well as the adults, at the centre, being trained to work particularly with children who have language and learning developmental difficulties. For more information on Auditory Processing Disorder Symptoms and other Language and Learning Difficulties contact Francoise Nicoloff on (02) 9326 1650.

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