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Central Auditory Processing Tests

Does your child seem to have a problem hearing in the classroom? Children may pass a standard hearing test but still have trouble hearing in the classroom because they have central auditory processing disorder (CAPD).

CAPD exists in children who have otherwise normal hearing tests (i.e., hear the beep at a specific pitch and raise their hand), but continue to have difficulties in the classroom due to their inability to perform in background noise or in situations with multiple speakers.

These are not children with general hearing loss, but they do require professional evaluation and treatment.

Tiffany N. Colon, AuD, audiologist at Summit Medical, is here to discuss the latest developments in Central Auditory Processing.
Central Auditory Processing Tests
Featured Speaker:
Tiffany N. Colon, AuD
Tiffany N. Colon, AuD/CCC-A, specializes in audiology, with an emphasis on pediatric audiology and early identification of hearing impairment. She has a special interest in treating patients who suffer from tinnitus and assessing auditory processing skills in children. She also provides central auditory processing testing.

Prior to joining Summit Medical Group, Dr. Colon practiced at Robert Wood Johnson University Hospital in New Brunswick, New Jersey, where she provided comprehensive pediatric and adult audiological evaluations and treatment, including hearing aid evaluations and fittings.

Learn more about Tiffany N. Colon, AuD

Melanie Cole(Host): Does your child seem to have problem hearing in the classroom? Children may pass a standard hearing test but still have trouble hearing in the classroom because they have central auditory processing disorder. My guest today is Tiffany Colon and she’s an audiologist with Summit Medical Group. Welcome to the show, Tiffany. What are you seeing with CAPD with children that differs from the standard hearing test that they get at the doctor or at school?
Tiffany Colon (Guest): Hi. Thank you for having me. Kids with auditory processing disorder may very well present as a child with hearing loss although results of the hearing test are extremely normal. These children have normal hearing yet present with difficulty listening and background noise. They might be asking for repetition a lot or saying “what” very frequently, trouble following directions in class especially when there are multiple step directions or difficulty localizing where a sound is coming from.
Melanie: What might a parent notice from some of those thing as far as behavior, performance in different settings? If they’re in a school, or in a quieter setting, or a party or something, will we know something?
Dr. Colon: Absolutely. These kids appear more disorganized. They typically do better in classes that are not so heavily lecture based or heavily listening based. They typically have a lot of difficulty when everything is presented in a verbal manner.
Melanie: If we notice this, who do we take our children to? Is it right away something you take your children to the pediatrician? Do we go see an audiologist? Who do we go to?
Dr. Colon: We have many different referral sources. We work with a lot of professionals. One of them is speech language pathologists are usually first to notice these difficulties, pediatrician as well, as well as educators, teachers and school psychologists may also note some red markers that might be indicative of audio processing disorder.
Melanie: At what age is this most noticeable?
Dr. Colon: You could notice it as early as school age – so around 5 or 6. Our tests are done between the ages of 7-12 years old. Testing below age 7 is very difficult because the auditory pathways are not mature until age 12. Testing younger than 7 is difficult but we can always refer to a speech pathologist that might be able to do a couple screening methods that we don’t have to indicate if there might be a red flag there.
Melanie: How is it diagnosed? What are they looking for?
Dr. Colon: The audiologist does a comprehensive test battery of four different tests. We do a filtered speech test where the child is hearing speech that is not presented very clear and has to tell me what the word is. Children who have normal auditory processing skills can do this very well. They might be hearing a couple sentences presented to each ear and I direct them, “Only tell me the sentence in the right ear” or “Only tell me the sentence in the left”. In another one they’re hearing several numbers and they repeat them all back. Or a pitch pattern test where they hear a pattern of three beeps and tell me whether the pattern was – high-low-low; low-high-low. Kids who have normal processing skills do very well on these type of tests.
Melanie: If you’ve determined that they do have an auditory processing disorder, what do you do for them? Is this something that can be treated successfully?
Dr. Colon: Absolutely. Although many kids to grow out of these types of disorders, as I said, the auditory pathways are constantly developing until at least age 12. We can change the classroom environment so that the child has clearer access to speech such as reducing background noise, closing fans, open doorways, or even providing an FM system which is a device that the teacher wears, like a microphone and the child has something on their ears that looks like hearing aids but it filters out background noise and puts the teachers voice almost directly in front of the child.
Melanie: Wow. That’s pretty cool. What do you want parents to know, Tiffany, about things that they can help their children up until – if it goes away by age 15, or as you say 12 somewhere around there? What do you want parents to be able to do at home?
Dr. Colon: At home, they are going to work closely with whoever provides the remediation, whether it’s a speech language pathologist or they receive treatment in clinic. There are computer based therapies that can be done at home. A couple of them are Fast Forward or Ear Aerobics. There’s definitely a great way to supplement what the child is getting in the clinic in the home environment.
Melanie: Also, what can parents do as far as helping their child? Should they be speaking slower? Should they not keep music on in the background or the TV on all the time? We all have so many noises going on in our houses all the time. What do you want to tell parents about some of those?
Dr. Colon: Exactly. Homework time, situations where we’re trying to have actual family conversation we’re going to want to reduce the noise in the room, turn off the television. Sometimes family members are speaking from the kitchen while listening to people in the dining room. That’s really not ideal, especially for these kids who really struggle with background noise and a lot of competing voices.
Melanie: I think that that’s important. What about as they start to be teenagers? Do you see a difference in the way that this works for them? Is music a problem? Is any of that going on?
Dr. Colon: Music is tricky for kids who have auditory processing disorder but there have been studies that show that music therapy or [inaudible 6:11] training can be helpful in these kids. As I said they typically do mature. We test them frequently to see what the maturation is, whether they are progressing, if their therapy is helping them to meet their targets. We track them very closely.
Melanie: What do you want the parents to tell their children about this disorder so that they can go off and do things that they want to do? What if they’re a teenager and they’ve still got it and they want to start driving? Does this become an issue?
Dr. Colon: We focus a lot of self-motivation and awareness. Educating the child or the teenager about their disorder, what it is, how to overcome it. They might know that one of their teachers speaks very softly. They might anticipate difficulties, so they need to be strategic about their seating in the classroom. They’ll want to sit closest to the teacher. There is a lot that they can do to compensate for the deficits that they have.
Melanie: Give you best advice, Tiffany, in just the last few minutes here about central auditory processing disorder – CAPD – what you really want parents to know and why they should come to Summit Medical Group for their care.
Dr. Colon: We do a very comprehensive test battery which isn’t done in many other facilities. I had the great experience of working on my thesis project with auditory processing disorder. We are at this facility very comfortable with diagnosing, treating, providing recommendations. Any child who is struggling in the classroom should, between the ages of 7-12, absolutely consider getting an auditory processing evaluation minimally just to rule out that this is not an underlying issue.
Melanie: Thank you so much for being with us. What important information. You’re listening to SMG Radio and for more information you can go to That’s This is Melanie Cole. Thanks so much for listening.