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ADHD vs. Central Auditory Processing Disorder

by Michelle Rexach

In recent years, researchers have suggested an overlap between ADHD and central auditory processing disorder (CAPD). In fact, some have questioned whether CAPD and ADHD are actually distinct disorders, and have even suggested that children diagnosed with ADHD often have CAPD instead. A study published in the Journal of Learning Disabilities takes a careful look at this issue (Vol. 32, 1999).

Since many people are unfamiliar with CAPD, I'll begin with a brief overview of the condition. CAPD is defined as a deficiency in one or more of the following processes:
sound localization (ability to determine where sounds are coming from), auditory discrimination (ability to detect differences between sounds), auditory pattern recognition (ability to correctly identify patterns of sounds), temporal aspects of audition (ability to identify the ordering of different sounds), and auditory performance decrements in the presence of competing sounds (ability to screen out extraneous auditory stimuli to correctly identify important sounds).

Deficits in one or more of these areas are believed to adversely affect an individual's speech and language functioning. Thus, someone with CAPD may have unusual difficulties in accurately processing spoken language, particularly in the presence of background noise, and thus have a difficult time comprehending what is being said. One can certainly see how such a problem would make it difficult for a child sitting in a crowded and noisy classroom, and how this child might display symptoms of inattention and hyperactivity as a result. This is why some professional speech and language specialists, among others, suggest that CAPD may often be misdiagnosed as ADHD. (Note that speech and language problems are more common in children with ADHD.) Prior studies have shown that children with ADHD tend to perform poorly on central auditory processing tasks and that as many as 50% of children diagnosed with CAPD also have ADHD.

It is important to realize that in order to better serve children, proper diagnosis is critical. Although ADHD and CAPD are distinct conditions, it is still possible that some children with CAPD are misdiagnosed as having ADHD. If this were to occur, it seems unlikely that proper treatment would be instituted, although there is some data to indicate that stimulant medication is helpful to children with CAPD. These results also suggest that children with ADHD who are also learning disabled in reading may be especially likely to have CAPD. For such children, a careful evaluation of this possibility may prove to be quite helpful in developing the most effective treatment plan.

If you suspect your child may have any symptoms similar to ADHD or CAPD or even both, have him or her tested as soon as possible. A good age for psychoeducational testing that would rule out these issues is around 7 and 8 years old or 2nd grade. Don’t wait; remember early detection is essential for your child’s success!
Michelle Rexach, Licensed School Psychologist and founder of Psychoeducational Solutions of Tampa Bay, visit www.Child-Testing.com or call (813) 468-6528, 7 days a week.