UNDERSTANDING CENTRAL AUDITORY PROCESSING DISORDER
How my middle child achieves success despite the diagnosis
My middle child fought his way to a political science degree with a learning disorder that crippled his self esteem as a young child and alienated him from social gatherings, from even making close friends.
He had a difficult time with memory and retention of information as well as achieving multitasking as he could process only one thing at at time. His social skills seemed restricted as observance of his interactions with other children revealed his tendency to, well, just observe.
His Pre-K teacher disconcertingly and cruelly told me in front of him that he wasn’t capable of the Pre-K curriculum standards (what?) and would never graduate high school and theoretically placed a dunce cap on his head right then and there.
Her reasoning? He couldn’t properly handle a pair of scissors to cut paper in a straight line at the age of 3.
I wanted to find her and inform her of each of the times he was chosen as an intern for the 3 state Representatives he has worked for and question her, “Hey psycho, as an Educator, haven’t you ever heard the term ‘Don’t judge a book by it’s cover?’ ”
I wanted to find her and teach her a lesson.
American Speech Language Association (ASHA) uses the term Central Auditory Processing Disorder (CAPD) to refer to deficits in the neural processing of auditory information in the CANS (central auditory nervous system) not due to higher order language or cognition…(ASHA, 2005). It is diagnosed by the presence of some of the following symptoms:
- Difficulty understanding spoken language in competing messages, in noisy backgrounds, in reverberant environments, or when presented rapidly
- Taking longer to respond in oral communication situations
- Frequent requests for repetitions, saying “what” and “huh” frequently
- Inconsistent or inappropriate responding
- Difficulty comprehending and following rapid speech
- Difficulty following complex auditory directions or commands
- Difficulty learning songs or nursery rhymes
- Misunderstanding messages, such as detecting prosody changes that help to interpret sarcasm or jokes
- Poor musical and singing skills
- Difficulty paying attention
- Being easily distracted
- Poor performance on speech and language or psychoeducational tests in the areas of auditory-related skills
- Associated reading, spelling and learning problem
Jacob was and is an observer of his surroundings. I have pictures of him and his brother who is 2 and a 1/2 years older, in their Nana’s playroom. My oldest was in mid air in one particular picture, feet off the ground with a crazed look in his eye as he was caught mid snap running to get a toy. (He is exactly the same today.)
Jacob was sitting looking into the distance in the center of the room, with the proverbial slight drop of drool in the corner of his mouth. He was about 6 months. He just looked pensive.
He was 5 years old when diagnosed with Central Auditory Processing Disorder, which at that point, I had never heard of. Attempts to get the public school system to understand this uncommon diagnosis and to provide appropriate accommodations for learning just landed him in the Special Education classes, which was not the correct fit at all.
CAPD in its moderate to severe form renders the individual hostage to rereading paragraph after reread paragraph to attempt to grasp the concept of information provided.
Memory and concept retention is a primary symptom, but frustratingly enough, so is the process of understanding spoken words as they are intended to be heard and understanding and following more than one or two step instructions.
These problems vexed Jacob especially in the classroom. Everything about the experience of education includes understanding and comprehending the spoken word and conceptualizing that information and following instructions.
His critical thinking skills are excellent which frustrated him immensely at that time as he could not grasp concepts, but could remember dates and very particular details of events in history and Social Studies. Math and Science threw him completely.
Later in college, after more remedial classes than the average young adult could stand, Jacob quietly sorted out his own way of thinking, remembering and learning. He took lots and lots of notes and took to being a researcher, so that he could find diverse ways to utilize the information he needed to learn, re-presented in a way he could retain it.
His system is still working, as a grown man of 27, and still in force as he pursues more education currently.
ASHA suggests that the following areas are addressed in treatment and management of CAPD. Although Jacob refused formal therapy throughout his life to this point, these strategies are actually the ones he and I discussed at home that he addressed and remedied on his own terms himself:
- Direct Skills Remediation
- Compensatory Strategies
- Environmental Modifications
- Assessing Treatment Progress
Assessing the progress was something I had to do as a mother quietly as he was not open to discussing progress often.
He then and now saw any discussion on his “condition” as a negative or a put down and just shut down mentally and emotionally. I had to be a sideline observer whose suggestions and perceptions had to be kept to herself. I was not insulted.
I really understood that that was how Jacob responded in conjunction with the reality of the disorder and his self perception secondary to the social stigma he believed he saw signs of at school or work.
Another aspect of the effects of CAPD that he has not yet dealt with is the complexity of being involved in and navigating intimate relationships. He has always had a shy nature, but the processing disorder perpetuated this immensely.
An outward observance into the few relationships he has had, appeared to reveal that he saw no need for patience in the courting part of the relationship. He allowed his feelings to be magnified quickly and did not seem to notice how that affected the relationship.
I believe his Type A no-frills-all-business nature was actually acquired from the anxiousness he felt always as a child to fit in and understand “the group” and in attempting this, he resolved that “the group” was not open to him or even comfortable for him.
When his relationships did not turn out as he had hoped, he viewed them as failures on his part which, to him, maintained his inner belief that he could not and should not be close to others. Now he seems to be ingrained with the belief that he doesn’t need anyone either.
I believe that Jacob can gain an understanding of and succeed better in relationships, both romantic and platonic, by implementing the techniques he used academically to succeed in school. This would irrevocably change the loneliness his isolation has caused for him personally and of his view of the universe.
Strikingly though, especially due to the absence of his own father throughout his life, Jacob has had close relationships with father figures in authority, sharing in that authority, in church environments and work.
In an environment where he is expected to perform as a leader, he has fit in most successfully, probably because of the distancing that is required in leadership.
Jacob has been a successful youth leader and is a Club Director for 2 schools for The Boys and Girls Club, a position requiring much strategic and critical thinking and autonomy. He is comfortable in a position of autonomy as it limits the consistent one on one relationships on a daily basis that many other jobs require.
Interaction is intermittent and short lived with his clients. Interactions with the at risk and high maintenance children he tends to each afternoon are where his skills really shine. He has retained an innocent, childlike wonder and approach to life which transfers to the methods in which he handles children’s activities, behaviors and planning for their individual and group needs in the classroom.
Conversely, in environments where there is an openness of self vs professional skill expected, such as in dating and romantic relationships or in friend relationships, Jacob feels very vulnerable, almost to the point of incapacitation and exhibits an awkwardness that even he is acutely aware of.
There are social cues and norms that he misreads or either under or over accentuates or altogether misses. He seems to misread tone of voice and facial gestures at times as well.
Although these issues have been drawbacks to his acquiring healthy close relationships, he has one to two people he is close to. The majority of Jacob’s “self” is hidden under lock and key, safe from a judgemental eye should he not fit in somewhere or not know how to respond in conversation.
As his mother, I still pick up on how the processing disorder affects his understanding of speech, usually when an argument occurs between us due to misinterpretation on his part of information provided to him or expectations not met as he or I planned.
The moderate lack of appropriate social encounters and associated common life experiences in his life, has had an affect on some of his decisions and perceptions. I forget this often because he is well-spoken and educated.
Most things are just black and white to him as he sees no grey area in many instances. An example is his absence of empathy in many situations in which one would consider the source of others’ behaviors and decisions in life.
He operates under the belief that adversity, trauma and other factors that affect people’s present and future are not to be considered, but rather, that the person just “get on with it.”
If to this point in his life he had had many more diverse interactions with people, places and things, he may have more empathy for the average person and be able to see past the current presentation of a person and see the real person behind their past experiences.
Jacob does not like to be looked at or touched, especially by strangers or acquaintances and barely touched by family members. This equates in my mind, and nursing experience as a sensory issue that also can be seen in CAPD.
A most interesting piece to this diagnosis is that CAPD is sometimes referred to as “the silent deafness” as moderate to severe cases can exhibit themselves as what appears to BE deafness in conversation and social relations. As explained above, CAPD is a processing disorder…what is read or spoken is not understood immediately or in full and so the response of the party with the diagnosis is not many times appropriate to the conversation or social expectation.
Still more interesting is that Jacob’s biological father, whom he did not live with past 6 months of age and had no connection with in his life whatsoever, WAS born deaf. Jacob himself had problems with his eustachian tubes all of his childhood, requiring several surgeries to place and replace tubes in both of his ears to prevent the multiple ear infections he faced at the time.
He also has an extremely narrow eustachian tube of the left ear, which caused the tubes placed in that ear to be pushed out years prior to expectation. A diagnosis of CAPD most certainly can be sourced from frequent ear infections.
As I write this piece today, Jacob is financially supporting both me and the special needs grandson I am raising (and has been for 2 and 1/2 years) as I cannot work FT outside of the home currently with these obligations.
I manage the money as this is a very overwhelming point for him, but he is learning bit by bit to incorporate that task independently into his responsibilities. I also handle all homemaking tasks as he is easily frustrated at having more responsibilities than the very stressful and demanding position he holds with his employer.
The struggles Jacob has battled with CAPD are not independent ones as he has had to face a single parent upbringing and fatherlessness, and some health issues, but I have to say he is a champion in life.
When a mother bears a child, she hopes that a son will have the courage to face challenges and come out on top. And that is what Jacob has done.
Despite grappling with CAPD, he has accurately and effectively processed the idea that you do not give up in the face of adversity.