Jennifer, 9, seems to pay attention when the teacher works with her one-on-one.
But when there are group discussions, she spends most of her time looking
out the window. The teacher is complaining she doesn't participate in class,
and is giving Jennifer lower grades as a result.
Shawn, 12, was supposed to be home in time for his dentist's appointment
at 3:30. But when he finally walked in the house at five o'clock, he was
surprised to hear about the appointment and that his mother had reminded
him about it that morning.
Normal kids? Or is something else going on?
Paying Attention
Life is complicated these days, for children as much as adults. There is
a lot to remember and a lot to do. But sometimes a child may seem to be
more than simply distracted by a complex life. If you think there may be
a problem with your child, answer these questions:
* Is your child easily distracted or unusually bothered by loud or
sudden noises?
* Are noisy environments upsetting?
* Does behavior and performance improve in quieter settings?
* Does your child have difficulty following directions, whether simple
or complicated ones?
* Does your child have reading, spelling, writing or other speech-language
difficulties?
* Is abstract information difficult to interpret?
* Are verbal (word) math problems difficult?
* Is your child disorganized and forgetful?
* Are conversations hard for your child to follow?
These, as well as other behaviors, may be signs of a central auditory processing
disorder (CAPD), an often misunderstood problem. CAPD is misunderstood because
many of the behaviors noted above may also appear in other conditions such
as learning disability (LD) and attention deficit hyperactivity disorder(ADHD)
and even depression. CAPD can exist by itself or be part of a larger problem
such as a learning disability (LD) or attention deficit - hyperactivity
disorder (ADHD). Symptoms of CAPD can range from mild to severe, and can
take many different forms. Trained professionals, such as speech-language
pathologists and audiologists who specialize in CAPD, can determine if your
child has a central auditory processing
disorder.
What is it?
Central auditory processing disorder occurs when the ear and the brain do
not coordinate fully. Assuming your child's hearing is good (and this should
be verified by an audiologist), auditory information breaks down somewhere
beyond the ear. The causes of CAPD are varied and can include head trauma,
lead poisoning, possibly
chronic ear infections - and unknown reasons. Because there are many different
possibilities - even combinations of causes - each child has to be assessed
on an individual basis.
Problem Areas
Here are the five main problem areas that can affect both home and school
activities in children with CAPD.
1. Auditory Figure-Ground Problems: This is when the child cannot
pay attention when there is noise in the background. Noisy, low-structured
classrooms could be very frustrating to this child.
2. Auditory Memory Problems: This is when the child has difficulty
remembering information such as directions, lists or study materials. It
can exist on an immediate basis ("I can't remember it now") and/or
a deferred basis ("I can't remember it when I need it for later").
3. Auditory Discrimination Problems: This is when the child has difficulty
hearing the difference between sounds or words that are similar (COAT/BOAT
or CH/SH). This problem can affect following directions, reading, spelling,
and writing skills, among others.
4. Auditory Attention Problems: This is when the child cannot maintain
focus for listening long enough to complete a task or requirement (listening
to a lecture in school). Although health, motivation and attitude may also
affect attention,
among other factors, the CAPD child CANNOT (not WILL NOT) maintain attention.
5. Auditory Cohesion Problems: This is when higher level listening
tasks are difficult. Auditory cohesion skills - drawing inferences from
conversations, interpreting abstract information, understanding riddles
or comprehending verbal math problems - require heightened auditory processing
and language levels. They develop best when all the other skills (levels
one through four above) are intact.
Trouble concentrating If your child has CAPD, there are strategies
that can be used at home to alleviate some of the problem behaviors.
Never Follows Directions Difficulty with following directions is
possibly the single most common complaint. Reducing background noise, having
your child look at you when you are speaking and using simple, expressive
sentences usually help significantly. Speaking at a slightly slower rate
and at a mildly increased volume may also help. Ask your child to repeat
the directions back to you aloud and to keep repeating them aloud
(or to himself) until the directions are completed. Make certain the child
understands the directions and isn't just parroting your words. You can
be more certain of this if the child is able to rephrase the directions.
"Take the garbage to the side of the house," may be restated,
"You want me to take the garbage, not to
the front, but to the side of the house."
For directions that are to be completed at a later time, writing notes,
wearing a watch and maintaining a predicable routine in the household also
help. General organization and scheduling appear beneficial to many CAPD
children.
Making your child responsible and actively involved in his or her own success
is important. The child can be encouraged to notice noisy environments,
for example, and move to quieter places when listening is necessary.
The child should realize that she has a responsibility to use the strategies
taught in speech-language therapy, and to do so on a continuing basis. When
she chooses to do so, success at home and in school is more likely.
Other home strategies are helpful. Providing the child with a quiet study
place (not the kitchen table), maintaining a peaceful, organized lifestyle,
encouraging good eating and sleeping habits, assigning regular and realistic
chores including keeping a neat room and desk and building your child's
self-esteem are all very important goals. Your model of these behaviors
goes far toward encouraging them in your child.
As a parent, keep in regular contact with school personnel regarding your
child's progress. Provide your child with whatever aids may help in class,
such as an assignment pad or a tape recorder. Discuss seating plans with
the classroom teacher (the CAPD child should sit toward the front of the
room with his back to the windows), as well as specific plans for problem
academic areas.
One of the most important things that both a parent and teacher should do
is to realize that CAPD is real. Symptoms and behaviors are not within the
child's control. What is within the child's control is the recognition of
these problems and the application of the strategies learned in therapy.
A positive, realistic attitude and healthy self-esteem in the CAPD child
can work wonders.