Warning Signs
CAP Test

CAP Test

Central Auditory Processing Testing

Central auditory processing (CAP) is defined as a person’s ability to attend to, discriminate, recognize, remember and understand auditory information with normal hearing.

Difficulty with following directions is possibly the single most common complaint about children with CAP-D. CAP is often misunderstood and due to similar characteristic symptoms shasred with other conditions, it can also be confused with learning disabilities, attention deficit hyperactivity disorder and depression. 


Signs & Symptoms of CAP-D:

  • child may be easily distracted
  • child may be unusually bothered by loud sounds
  • child’s behaviour improves in quieter environments
  • child has difficulty following directions, simple or complicated
  • child may show difficulty in the following academic areas: reading, spelling, writing or other speech-language challenges, including verbal or problem-based mathematics
  • child seems disorganized and forgetful
  • child has difficulty following conversations, especially when the room is noisy

The symptoms may range from mild to severe and may take various forms. If you’ve answered “yes” to two or more of the above, it is advisable to seek a CAP evaluation for your child.


Problem Areas for Kids with CAP-D:

  1. Auditory Figure-Ground Problems: This is when the child cannot pay attention when there is noise in the background.  Noisy, low-structured classrooms could be very frustrating to this child.
  2. Auditory Memory Problems: This is when the child has difficulty remembering information such as directions, lists or study materials.  It can be immediate (“I can’t remember it now”) and/or delayed (“I can’t remember it when I need it for later”).
  3. Auditory Discrimination Problems: This is when the child has difficulty hearing the difference between sounds or words that are similar (COAT/BOAT or CH/SH).  This problem can affect following directions, reading, spelling, and writing skills, among others.
  4. Auditory Attention Problems: This is when the child can’t maintain focus for listening long enough to complete a task or requirement (such as listening to a lecture in school).  Although health, motivation, and attitude may also affect attention, among other factors, a child with CAP-D cannot (not will not) maintain attention.
  5. Auditory Cohesion Problems:  This is when higher-level listening tasks are difficult.  Auditory cohesions skills – drawing inferences from conversations, understanding riddles, or comprehending verbal math problems – require heightened auditory processing and language levels.  They develop best when all the other skills (levels one through four above) are intact.

Evaluating CAP

A CAP evaluation begins with a hearing test and then a battery of standardized tests for auditory brainstem and cortical function.  The test may take anywhere from one to three hours to complete, depending on the child’s attention and ability to perform.  As such, the appointment may be completed in two different sessions. 

Audiologists are the professionals to seek for CAP evaluations; however, not all audiologists are trained to perform such testing.  Sherina Samuel, Doctor of Audiology at Bovaird Hearing Clinic is qualified in testing and working with children with CAP disorders.  If your child is diagnosed with a CAP disorder, recommendations will be made for both home and school functions in order to improve/manage the child’s auditory processing skills.




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