What Is Central Auditory Processing Disorder (CAPD?)

In simple terms, Central Auditory Processing is where you struggle to process what you hear as your ears and brain do not fully coordinate.

It affects people of all ages, but commonly starts in childhood with around 5% of school-aged children experiencing Central Auditory Processing Disorder (CAPD).

If you believe that yourself or a loved one may be experiencing any signs of CAPD, you’re encouraged to visit your audiologist as soon as possible.

Clarity Hearing are CAPD specialists across Houston, providing specialist assessments, treatment and expertise – you can schedule your appointment online or call your local office by clicking here.

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What Are The Signs/Symptoms?

CAPD affects different people in different ways.

Some of the most common signs include:

  • Difficulty localizing sound
  • 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 problems
  • Difficulty learning a new language

Balance Assessments

What to Expect At Your Auditory Processing Test

#1 - Review Your Case History

Case history information will obtained by our specialist, this may include the following:

  • Age, including chronological and mental age in early childhood and age-related decline in older adults
  • Auditory/behavioral complaints (e.g., difficulty understanding speech in noisy or reverberant environments, difficulty localizing sound, difficulty hearing on the phone, difficulty following rapid speech, difficulty following directions, inability to detect humor or sarcasm [prosody], distractibility, inattention)
  • Cognitive status and psychological factors (e.g., attention, memory, motivation)
  • Cultural and linguistic background (e.g., native language)
  • Educational achievement (e.g., academic, learning, reading difficulties)
  • Family/genetic history
  • Health status (e.g., medical history and medications, previous illness or injury)
  • Hearing status (e.g., peripheral auditory system)
  • Pre-, peri-, and postnatal course (e.g., congenital and early infancy events)
  • Prior and current related therapies
  • Risk factors and comorbidities (e.g., learning disabilities, traumatic brain injury [TBI], epilepsy)
  • Social development
  • Speech, language, and literacy concerns

#2 - Audiologic Evaluation of Peripheral Auditory System

This is your standard hearing test where the patient listens for sounds and responds when they are heard.

Peripheral auditory disorders include conductive, sensorineural, and mixed hearing loss, as well as auditory neuropathy.   These disorders can affect an individual’s ability to hear and understand speech in background noise to varying degrees.

#3 - Audiologic Evaluation of Central Auditory System

The audiologist selects the appropriate CAP test battery, on the basis of findings from the case history, interdisciplinary assessment (e.g., results of language and cognitive assessments), and peripheral audiologic evaluation.

There are two types of audiologic evaluation measures that can be used to assess auditory processing skills.

Behavioral assesses the functional capabilities of the auditory system

  • Auditory discrimination tests to assess the ability to differentiate similar acoustic stimuli that differ in frequency, intensity, and/or temporal parameters.
  • Auditory temporal processing and patterning tests to assess the ability to analyze acoustic events over time.
  • Dichotic speech tests to assess the ability to separate (i.e., binaural separation) or integrate (i.e., binaural integration) disparate auditory stimuli presented to each ear simultaneously.
  • Monaural low-redundancy speech tests to assess the recognition of degraded speech stimuli presented to one ear at a time, including speech-in-noise, speech-in-competition, low-pass filtered speech, or compressed (rapid) speech.
  • Binaural interaction tests to assess the ability to combine complementary inputs distributed between the ears, synthesizing intensity, time, or spectral differences of otherwise identical stimuli presented simultaneously or sequentially.


This assesses neural processes in the central auditory pathway and provides information about the integrity of the CANS from the vestibulocochlear nerve (also known as the “auditory vestibular nerve” or “eighth cranial nerve”) to the auditory cortex. These measures include auditory brainstem response (ABR), middle latency response (MLR), late cortical response, P300, and mismatch negativity.

Schedule Your Appointment Today 

It’s our duty to care for the hearing health of our local residents, if you’re experiencing balance concerns, we would be delighted to help. Schedule your appointment and allow our highly experienced and friendly team to assess your hearing and identify the reason for your imbalance.

Frequently Asked Questions

Q: What is The Treatment if CAPD is Discovered?

In many cases, the treatment is performed by speech-language pathologists.

They use a multi-step approach which includes Auditory Training where they use listening exercise to strengthen the brain’s ability to process, they use Learning Compensating strategies that help the brain to compensate for weaker areas and they modify the environment by reducing background noise, using FM systems in schools, etc.

Q: Which of Your Locations Offers These Services?

Currently, our Tomball office – click here for contact information

Q: What Age Can Be Tested for CAPD?

The minimum age for testing is 7 years.

Q: What Audiologist Will I See at My Appointment?

You will be cared for by Dr. Katie Miller