Imagine, you are a school kid, sitting in the middle row of a classroom full of 20+ students. Someone is rustling papers to your right. The teacher is lecturing, you’ve got the topic right, something about aviation. But the details aren’t clear... All you hear is the noise. Footsteps in the hallway. The words are jumbled together, but thankfully, you’re teacher has written some keywords on the board, so maybe you can catch up. But after hours of this, you give up. English language as the last subject of the day…no way.

Or perhaps you are sitting in class and can hear and write down verbatim what you hear during the lecture, but it makes no sense, the semantics, the figurative language, idioms. It’s too hard, so you do what would come natural in these difficult situations…zone out, lose interest, and just wait for it to be over.

Or simply, you’re an adult at a work function with several new clients. The background noise is overwhelming when someone is talking, so you are intently watching the client’s body language, attempting to lip read, and hoping your brain can fill in the gaps. You can’t make out where each voice is coming from within the circle of clients, so you are on high alert all night. Although you are quick-witted and funny, hearing in social situations where background noise is present makes it so difficult to participate and follow along with conversation, jokes, and story-lines, that you stay quiet all night.

Step 1: Request Consultation

Fill out our simple intake form online to request a consultation. Following your request, you will receive intake paperwork via email to fill out. You must also have a current hearing test you can upload to the paperwork portal. This can be a picture of the hearing test but the formal report and audiogram from the hearing care professional is recommended.

The intake paperwork may take 20-30 minutes to fill out. The intake questions look at different types of auditory processing that help with differential diagnosis and help classify results to offer individualized treatment programs.

Step 2: Phone consultation

Prior to a phone or video consultation, the audiologist will review the intake paperwork and ask detailed follow-up questions during the consultation. This consultation helps prepare for an individualized test battery.

The online video or telephone consultation is informal and is designed to allow the provider to get a realistic picture of how the client functions in daily life. What struggles occur daily? What emotions are provoked when talking about hearing struggles? How do you perform at work and school?, etc. This consult may last anywhere from 30-45 minutes.

Step 3: Equipment requirements

If the audiologist recommends completing an assessment, you’ll need to make sure you have certain equipment for the appointment.

1. Stereo headphones or stereo earbuds (must have a wire leading from each ear). That means, blue tooth earbuds or similar cannot be used for the assessment.

2. High speed wireless internet. A high speed connect is important so real-time audio is perceived correctly.

3. A quiet space for testing without distractions is required. Testing should be completed in a quiet area. No additional distractions like TV, phones, radios, other children, background chores, etc., should be completed during the evaluation.

Step 4: Evaluation

When it’s time for your evaluation, be sure to already have your stereo earphones and quiet space for testing ready to go! We will begin promptly at the time of your appointment. Prior to your appointment, you will receive a secure link to a video conferencing software.

You will likely need a break or two (or more for children) during testing. It’s always okay to ask for a break if you need it.

Step 5: Results

Typically, results are not reviewed immediately after your testing. Instead, a follow-up appointment is scheduled to discuss formalized intervention and management. This is completed usually about 2 weeks after the evaluation but can be completed sooner if time allows.

The most common issue seen with CAPD is a decoding issue. Decoding issues may present in the listener as hearing but not understanding, trouble hearing in background noise, difficulty following directions, and more. Decoding issues can be remediated with phonemic awareness training through the Buffalo Model Auditory Training. Training is usually completed once a week in 50-minute sessions for rounds of 13 weeks. Most clients need one or two rounds of therapy for decoding remediation. You or your child may also have supplemental computer-based programs to facilitate training. Training is performed in a one-on-one model but may be adapted for therapy groups as needed.

For some, environmental modifications and compensatory management is necessary. Some listeners, for example, may benefit from a notetaker in class or in meetings. Compensatory management teaches foundational skills within higher order cognitive structures to help the listener draw on other areas of strength within the brain and cognitive processes to help fill in gaps in understanding due to auditory processing difficulties. We employ assistance from other professionals as oftentimes, certain types of CAPDs present as issues in receptive or expressive language. A qualified speech pathologist may be needed for additional intervention. Other professionals may include occupational therapy, psychologist, reading interventionist, counselor, etc.

How old does the patient need to be for testing?

Because of the way our brain develops from in utero throughout the lifespan, most Central Auditory Processing Disorder (CAPD) tests give normative responses around 7 years of age to classify a “disorder”; however, we know children with CAPD may present auditory behaviors that may suggest the need for CAPD testing much younger than 7 years of age. We can modify the test battery to suggest weaknesses in certain auditory processes. We can test for deficits in as young as 4 years of age, but an auditory processing disorder would not be defined until around age 7 years.

What is testing like?

Although I’d like to say testing is super exciting (it is for me!), it’s a series of auditory tests designed to determine specific sites within the brain that are in charge of specific auditory processes. For example, certain tests observe the child’s ability to fill in gaps of a message presented verbally without redundant cues, which is called auditory closure. Each test is a puzzle piece that may help paint the picture of the underlying auditory processes that need remediating, including issues in auditory closure for example. The CAPD testing may consist of repeating words, sentences, etc. Most of the testing requires a spoken response from the listener. If your child is non-speaking, there are tests available for CAPD assessment if the child can initiate a physical prompt (like thumb’s up, picture-pointing, etc.). We give routine breaks during testing so we don’t exhaust the listener.

After testing, we follow-up to review an individualized management plan for you or your child’s CAPD, if the test battery supports a CAPD diagnosis or deficit. This follow-up is to help organize a multidisciplinary approach to care if testing reflects the need for a multifaceted intervention. Individualized auditory training may be recommended and usually lasts for 13 weeks per round. Most often, clients with CAPD need one to two rounds of intervention to help remediate the severity of CAPD symptoms. Testing may also show the need for speech pathology or occupational therapy services in addition to auditory training.

Do you take insurance?

No, we are a fee-for-service model clinic and are out-of-network for all private insurances. We accept several forms of payment for your convenience including credit or debit transactions.