The classic, direct symptoms of CAPD involve difficulty recognizing speech in the presence of background noise or other competing signals, and difficulty recognizing rapidly presented speech. Current research has been directed at determining the likely, abnormal neural activity that may underlie deviations in auditory perception, as well as methods and strategies for remediation of these conditions.ĬAPD is a condition found in children and adults that typically presents with normal hearing. There are a number of relay points along the pathway that contribute to the complex neural activities of decoding, analysis along frequency, intensity and time domains, distribution, and interpretation of the incoming auditory signal. After sound is decoded in the cochlea or inner ear, it travels via the VIIIth cranial nerve to the brainstem and ultimately to higher areas of the brain.
CAPD is an umbrella term that covers a variety of difficulties in processing auditory input due to the interactions of the auditory periphery and the CANS.
We discuss how this can be incorporated into a pragmatic approach to hearing aid fitting that does not require increased loading on audiology services.Central Auditory Processing Disorder (CAPD)ĬAPD, a distinct and defined diagnosis (ICD-10CM Code: H93.25), refers to deficits in the processing of information in the central auditory nervous system (CANS). We argue that slow-acting compression should be considered as a default for some users and that other advanced features should be reconsidered as they may also introduce distortion that some users may not be able to tolerate. The primary cause of distortion is the speed and range of change to hearing aid amplification (i.e. We argue that a primary concern should be to avoid hearing aid settings that introduce distortion to speech envelope cues, which is not a new concept. We believe that it is important to recognise that the combination of peripheral and central, auditory and cognitive decline make older adults some of the most complex patients seen in audiology services, so they should not be treated as “standard” despite the high prevalence of age-related hearing loss. We focus on patients with age-related hearing loss because they represent the vast majority of the population attending audiology clinics. This review paper highlights the need to consider the distortion introduced by hearing aids, specifically when considering normally-ageing older adults. However, they cannot directly enhance central processes and may introduce distortion to sound that might act to undermine listening ability. Hearing aids can address some aspects of peripheral hearing impairment and improve signal-to-noise ratios. Audiometry provides no information about the status of auditory processing and cognition, and older adults often struggle with complex listening situations, such as speech in noise perception, even if their peripheral hearing appears normal.
Throughout our adult lives there is a decline in peripheral hearing, auditory processing and elements of cognition that support listening ability. You just subscribed to receive the final version of the article
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