I lack the words to describe the negative effects of central auditory processing disorder on the life of a young man trying to enter the workforce. Likewise, I find it difficult to fully express the changes in a client’s life after the completion of 2 to 3 auditory integration training programs with vision therapy and cognitive exercises. Thus, I would like to share a testimonial from a young man who never gave up on himself despite the negative effects of CAPD that followed him into the workforce.
CAPD’s Negative Effects Pushes a Young Man to Never Give Up
What is Central Auditory Processing Disorder?
Central Auditory Processing Disorder (CAPD) is oftentimes referred to as a hidden hearing loss. The hearing loss is hidden because people with CAPD pass a typical hearing exam. Additional hearing tests help you learn how your hearing is affecting your ability to process what you hear, gain skills essential for learning, and express yourself.
When there are negative effects and difficulties resulting from CAPD, people of all ages are unaware of what to share with the audiologist. One is unable to miss what is their norm. Additionally, many audiologists have a limited amount of time to review a checklist and ask additional questions. As a result, many children, teens, and adults with behavioral characteristics of hearing loss leave without a referral to an audiologist specializing in CAPD. Equally challenging, clients and parents are unaware of behavioral characteristics associated with mild hearing deficits. A Moore Auditory-Visual Questionnaire Report improves communication with doctors, audiologists, and professionals.
CAPD is Negatively Effecting My Life, Now What?
So many emotions are experienced when one learns that hearing loss explains one’s difficulties. These emotions are even more intense when a parent learns about their child’s hearing loss. Parents, it takes time to grieve a loss. Additionally, there are feelings of guilt as memories of scolding and lost patience are felt. I encourage you to seek counseling to work through your feelings. Give yourself time to read and think about behaviors from a new perspective.
One book that greatly helps is Don’t You Get It? Living With Auditory Learning Disabilities: A Guide for Parents and Professionals. It was written by three experts in the field, led by educator and speech-language pathologist Dr. Jay Lucker, along with Dr. Loraine Alderman, a school psychologist, and Harvey Edell, a former teacher. All three co-authors have Auditory Processing Disorder. The book shares important information about the disorder. But even more so, it gives several real-life accounts of how APD actually manifests itself. Also, the book addresses the inherited nature of APD, through the intergenerational stories by Edell, his daughter Alderman and Alderman’s teenage son Andrew.
Another great resource is the National Coalition of Auditory Processing Disorders.
Understanding Emotions and Behaviors
Over time, a lack of answers and intervention results in emotional distress such as depression or anxiety. One of the hardest negative effects of CAPD to empathize with prior to a diagnosis is the difficulty to socialize. Many of my teen and young adult clients frequently misunderstand what they are hearing. As a result, they start to avoid group conversation due to fear of embarrassment. When there is a hearing deficit, competing background speech or noise makes it very difficult to correctly understand a conversation. Either they listen without joining the conversation or walk away. Both responses result in feelings of social isolation.
People with central auditory processing deficits need:
- Brief directions with examples and practice help
- More time to respond
- One or two directions and no more
- Short term memory games teaching visualization
- Patience when they fatigue resulting in brain breaks that are not chosen
- One-on-one conversations where they can do most of the talking
- Ability to check for understanding with words like, share with me what you understand…
- Help or extra time to figure out how to accomplish a task
- Permission to share emotions, frustrations, distress, fears, and anxiety
Why Does Auditory Integration Training Help?
It is important to realize that twenty or more sessions of Berard Auditory Integration Training (AIT) with ten sessions of speech stimulation in only the right ear is the beginning of changes within the brain. According to Norman Doidge (2015), brain plasticity enables the brain to change, but real change is a process taking 12 to 16 weeks (Doidge, 2015). Also, the brain must reorganize that stronger sound energy input results in stronger integration with other parts of the sensory system. As the brain is changing, the negative effects of CAPD begin to lessen.
Some of the improvements shared by parents were:
- Improved sound tolerance
- Asserted independence
- Joined group conversation instead of taking it over
- Independently followed directions
- Looked forward to school
- Shared their thoughts more easily
- Copes emotionally better with small frustrations
Psychological Improvements after Auditory Integration Training (AIT)
Researchers Edelson and Rimland reviewed 28 reports concerning the effectiveness of Dr. Berard’s Auditory Integration Training (AIT) with individuals affected by CAPD, autism, and attention deficit with hyperactivity. Edelson and Rimland reminded readers of the ethical challenges of withholding filters needed by participants in addition to being able to track improvements objectively.
Dr. Edelson and Rimland summarized the strength, weaknesses, and biases of all 28 studies. They also responded to the criticisms of Patricia Howlin, revealing her misunderstanding of measurement scores. Researchers Edelson and Rimland emphasized the responsibility of Berard practitioners to provide auditory integration training using safe listening levels. Their review shows evidence of psychological improvements.
Excerpts From Their Paper:
“Of the 28 research studies that evaluated physiological, behavioral, and cognitive changes in the subjects, the authors of 23 (82%) studies concluded that their data supported the efficacy of AIT, three (11%) claimed to have found no evidence of efficacy, and two (7%) report ambiguous, contradictory results.” “We recognize at the outset that no research study is perfect–all have flaws and shortcomings of various kinds. However, the 23 studies with positive outcomes, by and large, exhibited fewer and less serious shortcomings than the subset of three supposedly negative studies. All three of these studies demonstrated an alarming bias favoring negative results [Mudford et al. (Section B, #1), Yencer (Section B, #2); and Zollweg et al. (Section B, #3)].”
Edelson and Rimland
Edelson and Rimland’s literature review supports the effectiveness of auditory integration training for individuals diagnosed with CAPD, autism spectrum disorder, and attention deficit with hyperactivity. Another study, Reducing Auditory Hypersensitivities in Autistic Spectrum Disorder, found evidence that sound tolerance improved after individuals with a diagnosis of autism completed auditory integration training. I have consistently seen AIT’s ability to decrease hearing sensitivities, improve expressive speech, and improve academic progress when combined with vision therapy. AIT combined with vision therapy results in improved instinctive motor responses and speech fluency.
A Doorway to Change
Auditory integration training opens a doorway for change to occur cognitively and emotionally. Parents are often surprised when their child becomes more confident and independent. I have received many phone calls from parents complaining that their easy-going child is now more assertive and difficult. I assure them that this is good news. Why? Because their child is developing their identity, their autonomy. A strong sense of self helps a person become a leader versus a follower. Parents, have courage. The next stage of development leaves them pondering trust, guilt, and initiative.
Remember, development is not a straight line; there are periods of progression followed by a plateau, a period of regression, then another period of progression. Research shows that trauma, like untreated hearing loss, often causes one to get stuck indefinitely in a specific stage of emotional development. Thus, one of the negative effects of CAPD is that little ones can get stuck in a stage of development. Below are Erikson’s stages of development.
- Babies–Trust vs. Mistrust
- Toddlers—Autonomy (sense of self-confidence) vs. shame
- Preschoolers– Initiative vs. Guilt
- Children–Industry vs. Inferiority
- Teens–Identity vs. Role Confusion
- Young adults–Intimacy vs. Isolation