There is no consensus in the literature about the nature of CAPD, and many discussions have taken place in an attempt to clarify the diagnosis. Therefore, a multidisciplinary assessment may be necessary for differential diagnosis, identifying the primary deficit and the presence of comorbidities. Alterations of higher functions, such as language, attention, and memory, are not included in the definition of CAPD, but may coincide. The difficulty in the perception of auditory information along with the central auditory nervous system, evidenced by the poor performance in one or more of the mechanisms mentioned above, characterizes central auditory processing disorder (CAPD). There are no clinically viable measures yet to assess integration and temporal masking. It has four subcategories: temporal ordering and sequence, temporal resolution, temporal integration, and temporal masking. Temporal processing refers to the way nonverbal patterns (rhythm, intonation, emphasis, and intervals) of auditory information are perceived, associated, and interpreted. The monoaural low redundancy mechanism occurs when there is degradation of the acoustic signal reducing extrinsic redundancy (phonemic and contextual speech cues) requiring intrinsic redundancy (repetition of acoustic signal analyses along the auditory pathway) to perform auditory closure of missing information allowing understanding of information. Tests with dichotic listening tasks assess binaural integration skills (ability to hear and understand different stimuli at the same time), binaural separation (when it is possible to ignore one of the stimuli and direct attention to the other simultaneous stimulus), and are sensitive to dysfunctions or injuries of interhemispheric and intrahemispheric connections of the right hemisphere and the left hemisphere. The mechanisms involved in auditory processing are: binaural interaction, dichotic listening, monoaural low redundancy, and temporal processing.īinaural interaction is the way the two ears work together for the purpose of locating and lateralizing auditory stimuli, lowering the threshold by masking, detecting acoustic signals in noisy environments, and binaural fusion.ĭichotic listening consists of the simultaneous presentation of different stimuli in both ears, which causes suppression of ipsilateral auditory pathways and predominance of contralateral auditory pathways.
AUDITORY PROCESSING SKILLS SERIES
Confirmation of the presence or absence of comorbidities between different disorders allows directing the therapeutic behaviors and reducing the impact of possible auditory and/or cognitive deficits in the different daily life situations of children.Ĭentral auditory processing (CAP) refers to a series of processes and mechanisms that occur from sound being picked up by the outer ear to being interpreted in the auditory cortex, and involves the following skills: sound localization and lateralization discrimination and recognition of acoustic stimulus differences temporal processing (resolution, masking, integration, and sequence) and auditory background and perception of the target stimulus in situations with competitive signals. The associations identified reinforce the complexity of the tasks involved in the evaluation of central auditory processing and the need for multidisciplinary evaluation for the differential diagnosis of auditory processing disorder. The statistically significant positive correlation found between the ability of binaural interaction and the components of emotional control and behavior regulation of the behavior rating inventory of executive function was unexpected. Significant correlations were found between the hearing ability of temporal resolution and executive functions, temporal ordering/sequencing, binaural integration and separation, and sustained auditory attention, operational memory, inhibitory control, and cognitive flexibility binaural integration was also associated with intelligence. To investigate possible associations between auditory abilities and cognitive functions in schoolchildren.įifty-eight schoolchildren, aged between 8 years and 0 months old and 11 years and 11 months old, who underwent the following tests: masking level difference, gaps in noise, pitch pattern sequence test, dichotic digits test, sustained auditory attention ability test, Wechsler intelligence scale for children – IV, junior Hayling test, five digits test, and behavior rating inventory of executive function. A better understanding of the association between cognitive functions and central auditory skills may help elucidate this dilemma. Nowadays, there is no consensus on whether central auditory processing disorder is a primary or a secondary deficit to other cognitive deficits.
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