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My 12-year-old daughter has CAPD. She is going into seventh grade this fall and hasn't completely learned her multiplication tables yet, so her division skills are also behind grade level. She has trouble getting the "main idea" from reading also. I was wondering if these problems are characteristic of CAPD kids and if so, why?

When I spoke with the head of the school district speech and language department, he gave me the impression that there wasn't very much the school could really do to help her with this disability. I figured it all out this year when I realized that the school had just been passing her along every year without substantial academic progress.

I've decided to try her in a better school district and have a meeting this summer with the school psychologist about implementing her existing IEP. Do you have any suggestions about particular speech therapies that I could try to get her into? Educational strategies?

Let me take this opportunity to help our readers understand CAPD a bit better, since this condition often goes unrecognized or is misdiagnosed as ADHD. The American Speech-Language-Hearing Association (ASHA) established a task force in 1996 to gain a better understanding of central auditory processing disorders (CAPD) in children. They defined CAPD as "a deficiency in one or more of the following phenomena (my explanations in parentheses):
  • Sound localization (telling where a sound comes from; who's talking and where),
  • Auditory discrimination (telling two or more sounds apart), auditory pattern recognition (hearing the "beat" of a sound pattern and knowing whether two rhythmic patterns match or not), recognition of temporal aspects of audition (knowing which sound in a word or word in a sentence came first, second, etc.),
  • Auditory performance decrease with competing acoustic signals (the ability to hear and process information when there are lots of voices or similar sounds, like the principal talking over the teacher on the public address system in a school), and
  • Auditory performance decrease with degraded signals (the ability to hear and understand something when something breaks up the quality of the sound: like an air conditioner or traffic noise).
These kinds of problems, which are a form of learning disability, quite often coexist with attention deficit disorder (ADHD). When this condition (CAPD) exists early in a child's life, which may be the case when auditory processing is affected by repeated ear infections (otitis media), then the way a child's brain processes auditory information is affected. This includes what your daughter hears "in her head" when she reads silently or orally. This helps to explain why she's having trouble getting the main idea. The words (even when she's reading well) get all jumbled up and this affects the meaning.

Learning multiplication tables involves auditory pattern recognition, and temporal factors (the order of the language). Differentiating 8 x 7 = 56 from 6 x 7 = 42 is very difficult, since these are abstract symbols for a particular quantity. If she just says them over and over again, she may remember one...until she hears the next one. Your daughter has to be instructed in a concrete visual, hands-on way to understand ("see" in her mind's eye) that a number represents a quantity. Otherwise, the times tables are just another jumble of numbers.

There are generally two ways of dealing with CAPD. One has to do with training your daughter to process information more effectively. The other has to do with creating a classroom that is set up in a way that gets the messages sent by the teacher and others into the ears (and brains) of children with this condition. Drapes, carpets, acoustic tiles, and study carrels (personal "offices") help to keep down the level of background noise and echoing in a classroom. Teachers have to be aware that talking into surfaces that reflect sound can add to the confusion. This means that they should refrain from lecturing while writing on the chalkboard (and there's that chalk noise, too; felt markers are better). They should always let your daughter sit in the place in the room where the sound is the best (not next to the door to the hallway or an air conditioning vent). Teachers can use a wireless FM sound projecting device (like a little microphone that they wear) so that their voices go right in a headphone your daughter is using. An audiologist can help you determine whether this would be helpful and can help the school set it up.

A speech and language pathologist should be working with your daughter to help her improve her auditory processing skills and to teach her compensatory strategies (ways to deal with or work around the problem of poor auditory processing). This might involve teaching her how to get clarification from the speaker or to do a better job at "guessing" what sound element is missing or distorted by being more aware of the visual cues that she's getting. If your school says they can't do much to help your daughter, they need to be better educated about this condition, which can make learning an absolutely miserable experience for many kids.

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