100% correct answers 2025/2026
Peripheral auditory system - ANS ✔✔The ears
Central auditory system - ANS ✔✔From the cochlear nucleus up to the primary auditory cortex
(i.e., from the brainstem up to the cortical areas of the brain)
The peripheral auditory system is fully developed by ____. - ANS ✔✔birth
The central auditory system is still developing at age ____. - ANS ✔✔20
How does the central auditory system develop? - ANS ✔✔Develops from bottom up - from the
brainstem to the cortical areas of the brain.
Develops from lower level functions to higher level functions (bottom up) -
May start with responses by sucking / crying, then moves to receptive language, then to
expressive language
Maturation of the central auditory system - ANS ✔✔Neurons myelinize and form neural sheaths
(myelination). This increases the neural processing speed.
Plasticity of the central auditory system - ANS ✔✔Ability to adapt to changing external and
internal events - we learn to respond in multiple ways to the same thing.
Can compensate for damage - If there is stroke, may find other neural pathways to compensate.
,Greater plasticity when younger. Decreases with aging, but still maintains some ability to adapt.
History of (C)APD testing - 1950s and 1960s - ANS ✔✔Prior to imaging technology, the testing
was used to diagnosis tumors and site of lesion.
No CT scans or MRIs, only X-rays existed at the time.
Understood pretty early that tone testing would test peripheral system, but not tax central
system. So testing hearing with tones was not enough. Almost exclusively used speech testing
for the task. Used degraded speech to reduce redundancy: filtering (some sounds missed),
compression (faster), competition (other signals presented at same time)
With imaging advances, no longer used for site of legion testing
Per ASHA, what should (C)APD testing tell us? - ANS ✔✔- Patient's ability to localize sound
- Patient's ability in auditory discrimination (/ba/ vs /da/)
- Patient's auditory pattern recognition ability (ability to analyze acoustic events over time)
- Patient's auditory performance with competing signals (different stimuli in each ear)
- Patient's auditory performance with degraded signals (in noise, poor quality)
Patients with Central Auditory Processing Disorder appear to have significant difficulty in
performing one or more of the above tests
Concerns with (C)APD Testing - ANS ✔✔- Complexity of the central nervous system (peripheral
auditory system, central auditory system, language, cognition, motivation, attention) - all of
these factors are tested during (C)APD testing
, - Reliability of testing - Need to be old enough, have mature CNS (younger will mean slower
processing), and have variable attention
- There may be other processing difficulties that influence the results
Prior to (C)APD testing, first we must exclude undiagnosed.... - ANS ✔✔Temporary hearing loss
(otitis media or cerumen impaction)
Permanent hearing loss - child with permanent HL has auditory processing differences!! They do
not process sound the same way we do. May not even need to assess for CAPD and treat HL
instead.
Language deficits - Spanish speaking child who recently came to English may have difficulty
following directions
Learning disabilities
Cognitive delays / deficits - may be cognitive delay instead of discrete CAPD
Attention disorder - may not attend to directions and need treatment for attention disorder
Lack of motivation
Children's Auditory Performance Scale (CHAPS) - ANS ✔✔Screening for (C)APD in School Age
Children
Questionnaire given to teacher, parents, etc. to evaluate performance in different listening
conditions. Can help determine whether more testing needed for auditory problem or if the
child's behavior is indicating something else.