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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Auditory Processing DifficultyForum: Neurology Forum
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Re: Auditory Processing DifficultyPosted by CCF Neuro MD *!* on November 30, 1997 at 15:02:33: In Reply to: Auditory Processing Difficulty posted by JudyR on November 30, 1997 at 11:51:25: : My daughter is 15. She has never been very successful in school and in junior high started really falling down, not completing work and not turning in work that was completed. We have had many evaluations including psychological evaluations, psychiatric evaluations and auditory evaluations. From early on we felt that she acted like she could not hear well. She seemed kind of spacey and it took a couple of tries to get her to respond to our verbal signals. The popular theory was always ADD even though we didn't feel it otherwise fit her symptoms. Numerous evaluations ruled it out, plus evaluations ruled out learning disabilities and audiologic evaluations ruled out a hearing problem. Finally, recently by looking at a forum for parents with kids with learning disabilities, I came across something called Central Auditory Processing Disorder. Supposedly it was frequently mistaken for ADD, but would not respond to ADD medications and would not be detected by the ordinary audiology testing. I took my daughter, Katie, to the local university for specific testing for CAPD. Their tests indicated that she did indeed have auditory processing difficulties but that they were not consistent with those of CAPD. They are filling out a report that they said we would get in two weeks (2 1/2 weeks ago) and that we should arrange to see a neurologist to rule out a medical disorder that could be treated. Meanwhile, I have to wait for this report to show either my family physician or the eye, ear nose specialist that we previously consulted with to get a referral to a neurologist because the local neurology clinic will only take patients referred from another physician. Then they say we will have to wait a couple months to get in. It seems like as long as we've waited 15 years to find out something that waiting a few more months should be easy--not!!! Katie is struggling with depression which we are reluctant to treat with medication because of possible inaccurate results on future tests with the dyslexia association, etc. This entire situation has been extremely stressful over the years and it has been a great strain on the family. When I think of the abuse Katie has suffered in the school system because of her undiagnosed problem, I cringe. It has taken its toll in withdrawal, anger, frustration, etc. She has always seemed extremely bright to us and now it is possible that her giftedness has been masked by this problem all along. Katie experienced extreme relief that finally someone was able to tell her that something was going on and that she wasn't just lazy, not trying hard enough, etc. However, after that brief honeymoon, we are all worried about the future. Is it possible that a hearing aid might help her? She says that she has trouble hearing consonants, understanding rapid speech and singling out specific voices in a room with any kind of distracting noise. The newer digital hearing aids can slow down speech, emphasize the consonants and filter out background noise. They are tiny computers in the ear. What could these auditory processing difficulties be caused by? I know that no one can make any kind of diagnosis in a forum but if I had some suggestions at least I could research the possibilities and be informed before we actually got to see a real neurologist. Needless to say, after many years of no results or misdiagnoses with numerous professionals, I'm a little gun shy. It's hard to know who to trust. After our disasterous trials on Ritalin and Dexedrine for ADD, I'm also afraid of medications. The Dexedrine intensified her rage and irritability to the point that she mouthed off to a teacher and got suspended from school for three days. This is totally out of character for Katie. Does anyone think we're going to get that ADD runaround again? Any suggestions or just thoughts would be really appreciated. Sitting around waiting while your child is having a miserable time is not easy. By now Katie has a deep seated fear and distrust of teachers for which I cannot blame her. I have done a lot of reading about gifted people who suffer from undiagnosed learning diabilities and it isn't pretty. Dear Judy It would appear that you already have a diagnosis in the form of CAPD, as regards the background to the disorder it probably best understood as being analogous to dyslexia. In dyslexia the child has perfectly normal vision and intelligence but has problems processing language centrally at the level of the cortex of the brain where information from the senses is interpreted and processed. In CAPD by analogy there is perfectly a normal hearing mechanism and normal intelligence but the part of the brain which interprets and processes the information cannot do so. While CAPD is quite a new disorder and information on the background causes is limited, in dyslexia underlying causes have been identified and it is reasonable to suppose that CAPD and dyslexia have some of these in common. A number of underling problems have been noted in dyslexia and similar central processing disorders, they include subtle developmental abnormalities of the cortical layers of the brain in the areas devoted to specific processing tasks , these range from an abnormal number and shape of folds on the surface of the brain, asymmetrical development of the right versus left hemispheres to abnormal distribution of cell types within the cell layers of the cerebral cortex. These abnormalities go under the general heading of CORTICAL DYSPLASIAS and are responsible for a range of problems from subtle learning problems to epilepsy. As regards the use of a hearing aid the decision will probably require a more in depth characterization of your daughters problems and I would be reluctant to comment at his stage This information is provided for general medical education purposes only. Thanks, Judy
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