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Special Education Articles: Learning Disabled Articles: Diagnosis and Management of CAPD - Part 1


Part I: Definition
Gail D. Chermak, Ph.D.
Washington State University

The brief article below is the first installment of a three part series of brief articles by Dr. Chermak on central auditory processing disorder.

Notwithstanding the primacy of auditory processing deficits in central auditory processing disorders (CAPD), it is a complex and heterogeneous group of disorders usually associated with a range of listening and learning deficits (ASHA, 1996; Chermak & Musiek, 1992, 1997). CAPD "refers to a deficit observed in one or more of the central auditory processes responsible for generating the auditory evoked potentials and the following behaviors: sound localization and lateralization; auditory discrimination; auditory pattern recognition; temporal aspects of audition including, temporal resolution, temporal masking, temporal integration, and temporal ordering; auditory performance with competing acoustic signals; and auditory performance with degraded acoustic signals." (Chermak & Musiek, 1997, p. 3).

CAPD may be broadly defined as an auditory specific deficit in the processing of information, which may be associated with difficulties in listening, speech understanding, language development and learning. These clinical linkages occur because all auditory tasks, from pure tone perception to spoken language processing, are influenced by higher-level, non-modality specific factors such as attention, learning, motivation and decision processes. Central auditory processes involve the deployment of non-dedicated, global mechanisms of attention and memory in service of acoustic signal processing.

CAPD has been observed in a variety of clinical populations, including those associated with known lesions or pathology of the central nervous system (e.g., aphasia, Alzheimer's disease, traumatic brain injury) and others with suspected but unconfirmed central nervous system pathology or neurodevelopmental disorder (e.g., developmental language disorder, dyslexia, learning disabilities, attention deficit disorder). It has been reported in association with a history of chronic otitis media (i.e., middle ear infection) and has been documented in older adults due to neurologic changes resulting from the aging process. The overlapping symptomatology across these diverse clinical populations and the range of listening and learning deficits associated with this complex and heterogeneous group of disorders, demands careful assessment and comprehensive intervention, both of which are discussed in subsequent sections of this series.

Visit the American Academy of Audiology and the American Speech-Language-Hearing Association web sites for additional information and/or to locate an audiologist or speech-language pathologist in your area.

American Academy of Audiology
8300 Greensboro Dr., Suite 750
McLean, Virginia 22102
Phone: 800-AAA-2336
Fax: 703-790-8631

American Speech-Language-Hearing Association
10801 Rockville Pike
Rockville, Maryland 20852
Phone -800-498-2071
301-897-5700 TTY
301-571-0457 Fax


Gail D. Chermak Ph. D., is an Edward R. Meyer Distinguished Professor of Audiology and Chair of the Department of Speech and Hearing Sciences at Washington State University. She earned her doctorate in speech and hearing sciences from the Ohio State University, holds the Certificate of Clinical Competence in Audiology, and is a fellow of the American Academy of Audiology.

Dr. Chermak chaired the ASHA Ad Hoc Committee on Central Auditory Processing which prepared the 1992 report entitled, Issues in Central Auditory Processing Disorders. She served as a member of the ASHA Task Force on Central Auditory Processing Consensus Development responsible for the 1995 report, Central Auditory Processing: Current Status of Research and Implications for Clinical Practice. She was among 14 senior scientists and clinicians who met recently at the University of Texas at Dallas (the Bruton Conference) to reach consensus on best practices in diagnosis of auditory processing problems in school-age children.

Dr. Chermak has published articles and delivered numerous workshops on assessment and management of central auditory processing disorders. Her co-authored articles on central auditory processing disorder and attention deficit hyperactivity disorder have been named by her peers as among the best in diagnostic audiology for the past two consecutive years. Her 1997 book, Central Auditory Processing Disorders: New Perspectives, co-authored with Frank Musiek and published by Singular Publishing Group, has become a landmark volume in the field.

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