Auditory Processing Disorder APD/CAPD

[akafred]

Looks like DD has it. Because of course she does. She saw an audiologist today who stated that she still needs to score the specific tests but expects it will be "at least borderline" (for APD).

Other than a listening program (which I will only pursue if covered via insurance), what treatments are available. Any sort of classroom accommodations?

[waverly]

My child doesn't have it, but reading the information on it- its sounds like some of the things they may suggest is what DS is currently using.

FM system (his connects to his hearing aids, but it could be as simple as the teacher wears a microphone), pull outs for speech and his hearing itinerant teacher. Both the speech and the hearing itinerant teacher work on listening skills and speech reading, and he learns about his condition (for him parts of the ear and the hearing aids how to put them in and out etc.)

The school district also pays for annual audiology testing, and then one additional test for the FM system after he got his hearing aids. He failed the FM system test without hearing aids, but passed it with hearing aids because I think the hearing aids amplified the background noise.

His IEP also specifies using visual materials to supplement the lesson plan and preferential seating near the teacher.

[auntie]

CAPD is one of those dxs that doesn't get a whole lot of "respect".

I think that, in part, this is because the people who diagnose it are the ones who stand to benefit from it financially. This is an area where the adage if you only have a hammer, everything looks like a nail holds especially true.

Auditory processing is a skill that is immature in all children; it will continue to mature as they do right up until the early teen years. While some kids will test lower than same aged peers, they will improve to some degree even if you do nothing.

I have never know of someone to get insurance to pay for any kind of auditory training program. Insurance pays for treatments that are more evidence-based and most of the "listening programs" just don't have the data to support meaningful and long term improvements. 

Many of the programs for CAPD meet my own personal criteria for woo. Clever names for the program? Earobics. FastForWord. Interactive Metronome. Splashy websites with parent testimonials rather than refereed journals? Promises to treat CAPD, autism, dyslexia, ADHD and toe nail fungus? That said, I do know a few- very few- who saw real lasting improvements with Berard AIT. Be careful dedicating time and money to this.

One of DS's classmates, Emma, was a very bright girl with CAPD. TBH, the way you describe Charlotte sounds nothing like this girl. Emma tested well on IQ and on achievement tests. She did well in school when given enough time. She had a lot of problems because of how slowly she processed both verbal and non-verbal social communication- she couldn't keep up with the girls on the playground because how much of their play was word play so she gravitated to the boys who were more physical as a group. She became quite shy by the time she was 5ish. Her processing seems to have impacted her expressive language which was not a reflection of how bright she really was- teachers always treated her as if she was duller than she is. Her vocabulary, especially was blunted- so many people see vocabulary as a test of how smart someone is. I recall this one time when she was in about 4th grade- she was telling me about the food she had in Tuscany and how wonderful it was. I asked her about her favorite dish and she told me about "duck- it's a kind of chicken" because she didn't have the word "poultry". DS would totally have said poultry, of course he wouldn't have eaten it. 

Her mom and I talked about listening programs. They did do a program every summer between 1st and 5th grade- and they did help, but the benefit seemed to wear off by New Years. The programs often have very strict rules about the schedule for therapy sessions and also headphones and listening to music for pleasure. 


Her parents had a relatively difficult time getting her into a private high school- she did well on the entrance exams but the interview portion kept her out of the very selective schools her sister attended. The school that did accept her did so with the proviso that she be enrolled in their learning support program for extra help if needed. It wasn't and she went on to Bryn Mawr. 


One of the most effective strategies for any kid is an FM sound field. These benefit all kids whose auditory processing skills are still emerging. DS's elementary school PTO had them installed in all of the general ed classrooms by the time DS was in 5th. The school did see a slight bump in the performance of the students on standardized testing. It's hard to say whether DS benefited; he did math and RELA in resource which was a class of 4-6 kids. His 5th grade teacher was kind of retired in place and his 6th grade year was a cluster- team taught inclusion with a different teacher for social studies and science- so it's hard to judge. 

If you do a sound field, avoid the headphones which can be stigmatizing and isolating. Written instructions, teacher notes/outlines and rubrics are useful accommodations going forward. 

[akafred]

Yeah, I'm sure the specific write up will provide more specifics. Charlotte has so many issues affecting her. I know many kids here have more severe or more serious problems, so I don't mean that in a woe is me sense, but she literally has several dx at this point plus I suspect SLD, so it can be a bit of a challenge to see how they interplay and determine which is causing or contributing to what behavior. With Char she tends to avoid certain auditory stimuli or in certain auditory environments which just contributes to her hyperactivity. She will literally run away from you (more so when she was little; she is maturing into just seeming like she isn't paying attention).

The wealthy school district supposedly pays for listening programs, a rental anyway. That would have applied when C was in K because her school was in that district. Now her school and our home are in the city district so I doubt there is much there. You would be surprised what C's actual insurance will pay for. Finding a provider who does it is the challenge though. I saw Interactive Metronome recommended online and it looks interesting, but I'm not exactly clear why it is better than, say, drum lessons.

The main benefit from having this dx is knowing so we, and school, and relatives, and future camp counselors, can exhibit more patience with her when she doesn't immediately do your bidding. Maybe she is being a jerk or maybe she didn't get what you asked for. But she would benefit from benefit of the doubt. And we can learn new strategies.

One thing I am picking up from re-reading The psychoeducational eval, plus another conversation with a neuropsych, is that DD's nervous system is pretty "immature." The evaluator called it "neurodevelopmentally immature." I don't know if that is a real term or one she coined. Of course it gives the hope that she will outgrow these issues. But we all know "developmental delay" doesn't mean they somehow catch up necessarily. So trying to temper that hope.

[waverly]

DS had the loud noise issue. He has outgrown most of it but we had to get him noise canceling head phones for a while.

[akafred]

Ok report is already done, which is awesome.

Charlotte was borderline in a couple areas but moderate in "tolerance fading memory." The description of kids with this type describes Charlotte perfectly. Basically in noisy environments (say, a mall) she becomes hyperactive and dysregulated in general big time. If this is a "real thing", it makes sense C has it.

Recommendations include classroom mods (did not mention an FM system, interestingly), direct therapy (by a speech pathologist, specifically to build memory and work on speech amidst background noise), and some at home options (mostly free online games).

[waverly]

Nov 16, 2017 7:15:10 GMT -5 akafred said:

Ok report is already done, which is awesome.

Charlotte was borderline in a couple areas but moderate in "tolerance fading memory." The description of kids with this type describes Charlotte perfectly. Basically in noisy environments (say, a mall) she becomes hyperactive and dysregulated in general big time. If this is a "real thing", it makes sense C has it.

Recommendations include classroom mods (did not mention an FM system, interestingly), direct therapy (by a speech pathologist, specifically to build memory and work on speech amidst background noise), and some at home options (mostly free online games).

Perhaps because she is borderline in the FM system. They are pretty expensive and require additional testing to see if she qualifies, so it could make sense that they aren't going in that direction at this time. I don't know if you could get a private school to purchase one.

[akafred]

Oh I agree it might not work in our situation anyway. I just found it interesting it wasn't recommended specifically. Perhaps you're right that it would benefit a child most in an area DD was borderline.