Clinical Focus ■ Consult

A lthough the etiology and nature of central auditory processing disorders (CAPD) remain unresolved (ASHA, 1992; Musiek, Gollegly, & Ross, 1985), performance deficits associated with this complex group of disorders are well documented. Children with CAPD present deficits in auditory perception and auditory-language processing (Katz, 1992; Keith, 1983; Willeford & Burleigh, 1985). In addition to deficits in dichotic listening, selective attention, and temporal processing, children with CAPD often demonstrate reduced auditory memory and sound-blending skills (Butler, 1983; Ferre & Wilber, 1986; Jerger, Johnson, & Loiselle, 1988; Jerger, Martin, & Jerger, 1987; Katz, 1983, 1992; Lasky & Tobin, 1973; Musiek, Geurkink, & Keitel, 1982; Pinheiro, 1977; Sloan, 1986; Wepman & Morency, 1973; Willeford & Burleigh, 1985). These functional deficits underlie the commonly cited difficulties observed among children with CAPD, including difficulty comprehending speech in backgrounds of noise or competing speech, distractibility, inattentiveness, difficulty understanding verbal directions, and associated reading difficulties due to auditory-phonetic confusion (ASHA, 1992; Chermak & Musiek, 1992; Musiek & Guerkink, 1980; Willeford, 1985; Willeford & Burleigh, 1985). Similarly, theoretical differences exist about whether auditory processing deficits either underlie or reflect language disorders (Bannatyne, 1971; Keith, 1981a, 1981b; Rees, 1973, 1981; Sloan, 1980, 1986). New assessment strategies, however, may clarify the relationships among auditory processing, cognitive, and linguistic deficits, and may offer greater direction for management (Chermak, Vonhof, & Bendel, 1989; Jerger, Johnson, & Loiselle, 1988; Jerger et al., 1991; Jerger, Martin, & Jerger, 1987). Although further research is needed to establish the efficacy of both assessment and treatment approaches, aggressive rehabilitative efforts must incorporate strategies and techniques most likely to reduce the communication and learning disabilities associated with CAPD (Chermak & Musiek, 1992). In this paper, we address three questions about the management of CAPD in children that are frequently posed at national meetings and in our practices. By publishing these questions and answers in this forum, we hope to reach a large number of clinicians who struggle with the issues raised in these questions.