Central auditory processing disorders: causes, symptoms, and ways to overcome deficits in the learning environments

Central Auditory Processing Disorders (CAPD) are impairments in the ability to recognize sounds, localize their sources, and/or determine their identity and meaning due to functional impairments of the central auditory system. CAPD is observed in individuals with normal hearing levels and is not the result of high-level speech or cognitive impairment. This disorder is not well known to Russian specialists in the field of correctional psychology, while according to foreign sources it is observed in 2—7% of schoolchildren and is often combined with other developmental disorders (dyslexia, speech developmental disorders, ASD, ADHD). Here we provide a brief review of CAPD: its causes, symptoms, and approaches to diagnosis. In particular, we draw the readers' attention to the insufficient development of tools and practices for diagnosing and treating CAPD in Russia. Next, we review current approaches to the correction of CAPD, with special emphasis on assistive technologies that improve the signal-to-noise ratio (FM systems). Evidence in the literature indicates that in addition to the immediate effect (improved speech understanding), prolonged use of FM systems has a positive long-term effect based on mechanisms of neural plasticity.

1. Boboshko M.Yu. Rechevaya audiometriya: uchebnoe posobie [Speech audiometry]. St. Petersburg: Izdatel'stvo SPbGMU, 2012. 64 p. (In Russ.).
2. Lopotko A.I., Berdnikova I.P., Korotkov Yu.V. Audiometricheskii rechevoi ekspress-test [Audiometric speech express test]. Uchenye zapiski SPbGMU im. akademika I.P. Pavlova = The Scientific Notes of the Pavlov University, 2002. Vol. 9, no. 1, pp. 38—42. (In Russ.).
3. Garbaruk E.S., Goykhburg M.V., Warzybok A., Tavartkiladze G.A., Pavlov P.V., Kollmeier B. Primenenie russkoyazychnoi versii matriksnogo frazovogo testa u detei [Application of the matrix sentence test Russian version in children]. Vestnik otorinolaringologii [Bulletin of Otorhinolaryngology], 2020. Vol. 85, no. 1, pp. 34—39. DOI:10.17116/otorino20208501134 (In Russ.).
4. Boboshko M.Yu., Zhilinskaia E.V., Warzybok A., Maltseva N.V., Zokoll M., Kollmeier B. Rechevaya audiometriya s ispol'zovaniem matriksnogo frazovogo testa [The speech audiometry using the matrix sentence test]. Vestnik otorinolaringologii [Bulletin of Otorhinolaryngology], 2016. Vol. 81, no. 5, pp. 40—44. DOI:10.17116/otorino201681540-44 (In Russ.).
5. Goykhburg M.V., Bakhshinyan V.V., Petrova I.P., Wazybok A., Kollmeier B., Tavartkiladze G.A. Russkoyazychnaya versiya matriksnogo frazovogo testa RUMatrix v svobodnom zvukovom pole u patsientov posle kokhlearnoi implantatsii [The Russian-language version of the matrix test (RUMatrix) in free field in patients after cochlear implantation in the long term]. Vestnik otorinolaringologii [Bulletin of Otorhinolaryngology], 2016. Vol. 81, no. 6, pp. 42—46. DOI:10.17116/otorino201681642-46 (In Russ.).
6. Ryndina A.M., Berdnikova I.P., Tsvyleva I.D. Audiometriya chereduyushchimisya rechevymi signalami v diagnostike tsentral'nykh porazhenii slukhovogo analizatora [Alternating signal speech audiometry in diagnosis of central defects of the acoustic analyzer]. Vestnik otorinolaringologii [Bulletin of Otorhinolaryngology], 1998, no. 6, pp. 13—14. (In Russ.).
7. Savenko I.V., Garbaruk E.S., Boboshko M.Yu. Psikhoakusticheskie metody v diagnostike narushenii tsentral'noi slukhovoi obrabotki u detei, rodivshikhsya nedonoshennymi [Psychoacoustic methods in diagnosis of central auditory processing disorders in prematurely born children]. Vestnik otorinolaringologii [Bulletin of Otorhinolaryngology], 2020. Vol. 85, no 3, pp. 11—17. DOI:10.17116/otorino20208503111 (In Russ.).
8. Boboshko M.Yu., Kalmykova I.V., Garbaruk E.S., Kibalova Yu.S., Savenko I.V. Sovremennye aspekty detskoi rechevoi audiometrii [Modern approach in the children speech audiometry]. Sensornye sistemy = Sensory Systems, 2010. Vol. 24, no. 4, pp. 305—313. (In Russ.).
9. Ministerstvo regional'nogo razvitiya RF. SP 51.13330.2011. Zashchita ot shuma: Aktualizirovannaya redaktsiya SNiP 23-03-2003 [SP 51.13330.2011. Noise protection: Updated edition of SNiP 23-03-2003]. Moscow: FTsS, 2011. 46 p. (In Russ.).
10. Boboshko M.Yu., Mal'tseva N.V., Berdnikova I.P., Salakhbekov M.A., Zhilinskaya E.V. Sravnitel'nyi analiz rechevykh testov v diagnostike tsentral'nykh slukhovykh rasstroistv [Comparative analysis of speech tests in the diagnosis of central auditory disorders]. Vestnik otorinolaringologii [Bulletin of Otorhinolaryngology], 2014, no. S5, pp. 43—44. (In Russ.).
11. Fadeev K.A., Goyaeva D.E., Obukhova T.S., Ovsyannikova T.M., Shvedovskiy E.F., Nikolaeva A.Yu., Davydova E.Yu., Stroganova T.A., Orekhova E.V. Trudnosti s vospriyatiem rechi na fone shuma u detei s rasstroistvami autisticheskogo spektra ne svyazany s urovnem ikh intellekta [Difficulty with Speech Perception in the Background of Noise in Children with Autism Spectrum Disorders is Not Related to their Level of Intelligence]. Klinicheskaya i spetsial'naya psikhologiya = Clinical Psychology and Special Education, 2023. Vol. 12, no. 1, pp. 180—212. DOI:10.17759/cpse.2023120108 (In Russ.).
12. Boboshko M.Yu., Garbaruk E.S., Zhilinskaia E.V., Salakhbekov M.A. Tsentral'nye slukhovye rasstroistva (obzor literatury) [Central auditory processing disorders (literature review)]. Rossiiskaya otorinolaringologiya = Russian Otorhinolaryngology, 2014, no. 5(72), pp. 87—96. (In Russ.).
13. Wilson W.J., Harper-Hill K., Armstrong R., Downing C., Perrykkad K., Rafter M., Ashburne J. A preliminary investigation of sound-field amplification as an inclusive classroom adjustment for children with and without Autism Spectrum Disorder. Journal of Communication Disorders, 2021. Vol. 93, article ID 106142. 14 p. DOI:10.1016/j.jcomdis.2021.106142
14. Aristidou I.L., Hohman M.H. Central Auditory Processing Disorder [Elektronnyi resurs] // National Center for Biotechnology Information. Treasure Island: StatPearls, 2022. URL: https://www.ncbi.nlm.nih.gov/books/NBK587357/ (Accessed 04.10.2023).
15. Hornickel J., Zecker S.G., Bradlow A.R., Kraus N. Assistive listening devices drive neuroplasticity in children with dyslexia. Proceedings of the National Academy of Sciences, 2012. Vol. 109, no. 41, pp. 16731—16736. DOI:10.1073/pnas.1206628109
16. Schafer E.C., Wright S., Anderson C. et al. Assistive technology evaluations: Remote-microphone technology for children with Autism Spectrum Disorder. Journal of Communication Disorders, 2016. Vol. 64, pp. 1—17. DOI:10.1016/j.jcomdis.2016.08.003
17. Geffner D.S., Ross-Swain D. (eds.). Auditory Processing Disorders: Assessment, Management, and Treatment. 3rd ed. San Diego: Plural Publishing, 2018. 606 p.
18. Bamiou D.-E., Musiek F.E., Luxon L.M. Aetiology and clinical presentations of auditory processing disorders — a review. Archives of Disease in Childhood, 2001. Vol. 85, no. 5, pp. 361—365. DOI:10.1136/adc.85.5.361
19. Bellis T.J. Assessment and Management of Central Auditory Processing Disorders in the Educational Setting: From Science to Practice. 2nd ed. San Diego: Plural Publishing, 2011. 553 p.
20. Russo N., Nicol T., Trommer B., Zecker S., Kraus N. Brainstem transcription of speech is disrupted in children with autism spectrum disorders. Developmental Science, 2009. Vol. 12, no. 4, pp. 557—567. DOI:10.1111/j.1467-7687.2008.00790.x
21. Castro A.C., Monteiro P. Auditory Dysfunction in Animal Models of Autism Spectrum Disorder. Frontiers in Molecular Neuroscience, 2022. Vol. 15, article ID 845155. 11 p. DOI:10.3389/fnmol.2022.845155
22. (Central) Auditory Processing Disorders — The Role of the Audiologist: Position Statement [Elektronnyi resurs]. American Speech-Language-Hearing Association (ASHA), 2005. URL: https://www.asha.org/policy/ps2005-00114/ (Accessed 04.10.2023).
23. de Wit E., Bochane M.V., Steenbergen B., van Dijk P., van der Schans C.P., Luinge M.R. Characteristics of Auditory Processing Disorders: A Systematic review. Journal of Speech, Language, and Hearing Research, 2016. Vol. 59, no. 2, pp. 384—413. DOI:10.1044/2015_jslhr-h-15-0118
24. Chermak G.D., Musiek F.E. Central Auditory Processing Disorders: New Perspectives. San Diego: Singular Publishing Group, 1997. 374 p.
25. Chermak G.D., Musiek F.E. Managing Central Auditory Processing Disorders in Children and Youth. American Journal of Audiology, 1992. Vol. 1, no. 3, pp. 61—65. DOI:10.1044/1059-0889.0103.61
26. American Academy of Audiology. Clinical Practice Guidelines: Diagnosis, Treatment and Management of Children and Adults with Central Auditory Processing Disorder [Elektronnyi resurs]. Reston: AAA, 2010. 51 p. URL: https://www.audiology.org/practice-guideline/clinical-practice-guidelines-diagnosis-treatment-and-management-of-children-and-adults-with-central-auditory-processing-disorder/ (Accessed 04.10.2023).
27. Dawes P., Bishop D. Auditory processing disorder in relation to developmental disorders of language, communication and attention: a review and critique. International Journal of Language & Communication Disorders, 2009. Vol. 44, no. 4, pp. 440—465. DOI:10.1080/13682820902929073
28. Dockrell J.E., Shield B. The Impact of Sound-Field Systems on Learning and Attention in Elementary School Classrooms. Journal of Speech, Language, and Hearing Research, 2012. Vol. 55, no. 4, pp. 1163—1176. DOI:10.1044/1092-4388(2011/11-0026)
29. U.S. Department of Education. Earobics. WWC Intervention Report. Washington: Institute of Education Sciences, 2009. 23 p.
30. Engineer N.D., Percaccio C.R., Pandya P.K., Moucha R., Rathbun D.L., Kilgard M.P. Environmental Enrichment Improves Response Strength, Threshold, Selectivity, and Latency of Auditory Cortex Neurons. Journal of Neurophysiology, 2004. Vol. 92, no. 1, pp. 73—82. DOI:10.1152/jn.00059.2004
31. Fast ForWord [Elektronnyi resurs]. Fast forHome, 2023. URL: https://www.fastfword.com/ (Accessed 04.10.2023).
32. Folsom R.C., Weber B.A., Thompson G. Auditory Brainstem Responses in Children with Early Recurrent Middle Ear Disease. Annals of Otology, Rhinology, and Laryngology, 1983. Vol. 92, no. 3, pp. 249—253. DOI:10.1177/000348948309200307
33. Friederichs E., Friederichs P. Electrophysiologic and Psycho-Acoustic Findings Following One-Year Application of a Personal Ear-Level FM Device in Children with Attention Deficit and Suspected Central Auditory Processing Disorder. Journal of Educational Audiology, 2005. Vol. 12, pp. 31—36.
34. Musiek F.E., Shinn J.B., Jirsa R., Bamiou D.-E., Baran J.A., Zaida E. GIN (Gaps-In-Noise) Test Performance in Subjects with Confirmed Central Auditory Nervous System Involvement. EAR and Hearing, 2005. Vol. 26, no. 6, pp. 608—618. DOI:10.1097/01.aud.0000188069.80699.41
35. Musiek F.E., Chermak G.D. (eds.). Handbook of Central Auditory Processing Disorder. Volume II: Comprehensive Intervention. 2nd ed. San Diego: Plural Publishing, 2014. 792 p.
36. Xu S., Fan J., Zhang H., Zhao H., Jiang X., Ding H., Zhang Y. Hearing Assistive Technology Facilitates Sentence-in-Noise Recognition in Chinese Children With Autism Spectrum Disorder. Journal of Speech, Language, and Hearing Research, 2023. Vol. 66, no. 8, pp. 2967—2987. DOI:10.1044/2023_JSLHR-22-00589
37. Hornickel J., Kraus N. Objective Biological Measures for the Assessment and Management of Auditory Processing Disorder. Current Pediatric Reviews, 2011. Vol. 7, no. 3, pp. 252—261. DOI:10.2174/157339611796548438
38. James P., Schafer E.C., Wolfe J., Matthews L., Browning S., Oleson J., Sorensen E., Rance G., Shiels L., Dunn A. Increased rate of listening difficulties in autistic children. Journal of Communication Disorders, 2022. Vol. 99, article ID 106252. 11 p. DOI:10.1016/j.jcomdis.2022.106252
39. Groen W.B., van Orsouw L., ter Huurne N., Swinkels S., van der Gaag R.-J., Buitelaar J.K., Zwiers M.P. Intact Spectral but Abnormal Temporal Processing of Auditory Stimuli in Autism. Journal of Autism and Developmental Disorders, 2009. Vol. 39, pp. 742—750. DOI:10.1007/s10803-008-0682-3
40. Ismen K., Emanuel D.C. Auditory Processing Disorder: Protocols and controversy. American Journal of Audiology, 2023. Vol. 32, no. 3, pp. 614—639. DOI:10.1044/2023_aja-23-00035
41. Keith W.J., Purdy S.C. Assistive and Therapeutic Effects of Amplification for Auditory Processing Disorder. Seminars in Hearing, 2014. Vol. 35, no. 01, pp. 027—038. DOI:10.1055/s-0033-1363522
42. Kulesza R.J., Lukose R., Stevens L.V. Malformation of the human superior olive in autistic spectrum disorders. Brain Research, 2011. Vol. 1367, pp. 360—371. DOI:10.1016/j.brainres.2010.10.015
43. Johnston K.N., John A.B., Kreisman N.V., Hall III J.W., Crandell C.C. Multiple benefits of personal FM system use by children with auditory processing disorder (APD). International Journal of Audiology, 2009. Vol. 48, no. 6, pp. 371—383. DOI:10.1080/14992020802687516
44. Murphy C.F.B., Moore D.R., Schochat E. Generalization of Auditory Sensory and Cognitive Learning in Typically Developing Children. PLOS ONE, 2015. Vol. 10, no. 8, article ID e0135422. 17 p. DOI:10.1371/journal.pone.0135422
45. Musiek F.E. Assessment of Central Auditory Dysfunction: the Dichotic Digit Test Revisited. EAR and Hearing, 1983. Vol. 4, no. 2, pp. 79—83. DOI:10.1097/00003446-198303000-00002
46. Noreña A.J., Eggermont J.J. Enriched Acoustic Environment after Noise Trauma Reduces Hearing Loss and Prevents Cortical Map Reorganization. The Journal of Neuroscience, 2005. Vol. 25, no. 3, pp. 699—705. DOI:10.1523/jneurosci.2226-04.2005
47. Adams D.J., Susi A., Erdie-Lalena C.R., Gorman G., Hisle-Gorman E., Rajnik M., Elrod M., Nylund C.M. Otitis Media and Related Complications Among Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 2016. Vol. 46, pp. 1636—1642. DOI:10.1007/s10803-015-2689-x
48. Patel A.D. Why would musical training benefit the neural encoding of speech? The OPERA hypothesis. Frontiers in Psychology, 2011. Vol. 2, article ID 142. 14 p. DOI:10.3389/fpsyg.2011.00142
49. Schafer E.C., Mathews L., Mehta S., Hill M., Munoz A., Bishop R., Moloney M. Personal FM systems for children with autism spectrum disorders (ASD) and/or attention-deficit hyperactivity disorder (ADHD): An initial investigation. Journal of Communication Disorders, 2013. Vol. 46, no. 1, pp. 30—52. DOI:10.1016/j.jcomdis.2012.09.002
50. Pinheiro M.L., Musiek F.E. Screening and temporal ordering in the auditory system. In Pinheiro M.L., Musiek F.E. (eds.), Assessment of Central Auditory Dysfunction: Foundations and Clinical Correlates. Baltimore: Williams and Wilkins, 1985, pp. 291—338.
51. Pinheiro M.L., Ptacek P.H. Reversals in the Perception of Noise and Tone Patterns. Journal of the Acoustical Society of America, 1971. Vol. 49, no. 6B, pp. 1778—1782. DOI:10.1121/1.1912581
52. Chermak G.D., Bamiou D.-E., Iliadou V., Musiek F.E. Practical guidelines to minimise language and cognitive confounds in the diagnosis of CAPD: a brief tutorial. International Journal of Audiology, 2017. Vol. 56, no. 7, pp. 499—506. DOI:10.1080/14992027.2017.1284351
53. Rance G., Chisari D., Saunders K., Rault J.-L. Reducing Listening-Related Stress in School-Aged Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 2017. Vol. 47, pp. 2010—2022. DOI:10.1007/s10803-017-3114-4
54. Feldman J.I., Thompson E., Davis H., Keceli-Kaysili B., Dunham K., Woynaroski T., Tharpe A.M., Picou E.M. Remote Microphone Systems Can Improve Listening-in-Noise Accuracy and Listening Effort for Youth With Autism. EAR and Hearing, 2022. Vol. 43, no. 2, pp. 436—447. DOI:10.1097/aud.0000000000001058
55. de Wit E., van Dijk P., Hanekamp S., Visser-Bochane M.I., Steenbergen B., van der Schans C.P., Luinge M.R. Same or Different: The Overlap Between Children With Auditory Processing Disorders and Children With Other Developmental Disorders: A Systematic Review. EAR and Hearing, 2018. Vol. 39, no. 1, pp. 1—19. DOI:10.1097/AUD.0000000000000479
56. Schelinski S., Tabas A., von Kriegstein K. Altered processing of communication signals in the subcortical auditory sensory pathway in autism. Human Brain Mapping, 2022. Vol. 43, no. 6, pp. 1955—1972. DOI:10.1002/hbm.25766
57. Sharma M., Purdy S.C., Kelly A.S. A randomized control trial of interventions in school-aged children with auditory processing disorders. International Journal of Audiology, 2012. Vol. 51, no. 7, pp. 506—518. DOI:10.3109/14992027.2012.670272
58. Sharma M., Purdy S.C., Kelly A.S. Comorbidity of Auditory Processing, Language, and Reading Disorders. Journal of Speech, Language, and Hearing Research, 2009. Vol. 52, no. 3, pp. 706—722. DOI:10.1044/1092-4388(2008/07-0226)
59. Shriberg L.D., Smith A.J. Phonological Correlates of Middle-Ear Involvement in Speech-Delayed Children: A Methodological Note. Journal of Speech, Language, and Hearing Research, 1983. Vol. 26, no. 2, pp. 293—297. DOI:10.1044/jshr.2602.293
60. Centanni T.M., Chen F., Booker A.M., Engineer C.T., Sloan A.M., Rennaker R.L., LoTurco J.J., Kilgard M.P. Speech Sound Processing Deficits and Training-Induced Neural Plasticity in Rats with Dyslexia Gene Knockdown. PLOS ONE, 2014. Vol. 9, no. 5, article ID e98439. 14 p. DOI:10.1371/journal.pone.0098439
61. Stefanatos G.A., DeMarco A.T. Central Auditory Processing Disorders. In Ramachandran V.S. (ed.), Encyclopedia of Human Behavior. 2nd ed. New York: Academic Press, 2012, pp. 441—453. DOI:10.1016/B978-0-12-375000-6.00083-5
62. Bao S., Chang E.F., Woods J., Merzenich M.M. Temporal plasticity in the primary auditory cortex induced by operant perceptual learning. Nature Neuroscience, 2004. Vol. 7, no. 2, pp. 974—981. DOI:10.1038/nn1293
63. Bajo V.M., Nodal F.R., Moore D.R., King A.J. The descending corticocollicular pathway mediates learning-induced auditory plasticity. Nature Neuroscience, 2009. Vol. 13, no. 2, pp. 253—260. DOI:10.1038/nn.2466
64. Rance G., Saunders K., Carew P., Johansson M., Tan J. The Use of Listening Devices to Ameliorate Auditory Deficit in Children with Autism. The Journal of Pediatrics, 2014. Vol. 164, no. 2, pp. 352—357. DOI:10.1016/j.jpeds.2013.09.041
65. Whitton J.P., Polley D.B. Evaluating the Perceptual and Pathophysiological Consequences of Auditory Deprivation in Early Postnatal Life: A Comparison of Basic and Clinical Studies. Journal of the Association for Research in Otolaryngology, 2011. Vol. 12, pp. 535—547. DOI:10.1007/s10162-011-0271-6
66. Willeford J.A. Assessing central auditory behavior in children: A test battery approach In Keith R.W. (ed.), Central auditory dysfunction. New York: Grune and Stratton, 1977, pp. 43—72.
67. Willeford J.A., Burleigh J.M. Sentence procedures in central testing. In Katz J. (ed.), Handbook of clinical audiology. 4th ed. Baltimore: Williams & Wilkins, 1994, pp. 256—268.