Central Auditory Processing Disorder (CAPD) and Tourette Syndrome

Photo by Joel Mwakasege on Unsplash

Tourette Factiod: One of the comorbid conditions that my eldest son was diagnosed with as part of his Tourette Syndrome is Central Auditory Processing Disorder (CAPD).

For us that meant that sometimes, in my son’s case, in order for him to actually, actively hear what was being said he had to move…a lot. He’d pace back and forth in the classroom, fidget with things in his seat. And it worked. Even though it looked like he wasn’t paying attention, if he was quizzed on what was just being said he’d score perfectly!

It also meant that we had to give very, very clear one line directions to him while speaking directly to him. There wasn’t really a lot of ‘go put your shoes on’, more ‘go into your room….okay, now get your shoes…put your socks on…now put your shoes on…’ a little at a time. Patience became key and ensuring that no matter what we were doing as a family we made sure that there was enough time for us to get ready in ways that didn’t stress our son to the max.

According to Mugsy.com “Central Auditory Processing Disorder (CAPD) is a problem with the way incoming sounds are processed by the brain. Sounds are received properly by the ear, but are not processed and interpreted correctly by the brain. This disorder primarily affects language sounds and can cause problems with paying attention to auditory input, descriminating between sounds, remembering and recalling auditory information, and higher level thinking skills involving auditory information. CAPD may lead to language and behaviour problems and often looks like Attention Deficit (Hyperactivity) Disorder(ADHD).”

Like many other children we know with Tourette Syndrome our eldest spend the first few years of life with one ear infection after another, eventually having 7 ENT surgeries before the age 9. The specialists told us that they weren’t certain whether or not this played a part in his developing CAPD, though it seems clear that his medical history certainly didn’t help.

From ChildMind.org:

“What are the signs that a child might have auditory processing challenges? Here are some behaviors you or your child’s teacher might have noticed:
Doesn’t pick up nursery rhymes or song lyrics
Has trouble following directions
Doesn’t remember details of what she’s heard
Appears to be listening but not hearing
Often mistakes two similar-sounding words
Has difficulty understanding speech in noisy environments
Has trouble learning to read and spell
Finds it hard to follow conversations
Finds it hard to express himself clearly
Frequently asks people to repeat what they’ve said

These are all behaviors that can indicate auditory processing problems, but they are also behaviors that can have other causes. Some of them appear in children with ADHD or other language or learning disorders, so determining the cause of the behavior is crucial to diagnosing the child’s challenges correctly.

Because these symptoms overlap with other disorders, auditory processing disorder cannot be diagnosed just from a checklist of symptoms. While a teacher, educational therapist or speech-language pathologist can evaluate how a child is functioning in terms of language and listening tasks, the condition is only diagnosed by audiologists, who use tests that measure specific auditory processing functions. Children can be weak in one or more of them.”

In Tourette Syndrome CAPD isn’t the only thing that can hamper auditory processes.

From the Tourette Association of America:
“OCD can present itself as an auditory processing problem; for example, a student may need to repeat in his/her mind the last sentence said by someone or he/she may need to complete a thought or action before responding.

Because distractions (e.g. what a person is wearing, what is going on behind the person, a noise in the hallway, other activities in the classroom, etc.) can interfere with a child’s auditory processing, some children may require additional time for tasks, or may need to develop strategies for focusing attention on something else to reduce the amount of stimulation while processing information.”

Our son had therapy to help with his CAPD and, in his case, it worked to make things a bit easier on him. At 15 he’s showing almost no signs, though, he still needs to fidget to truly pay attention.

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