ĬAPD tends to affect males more than females, with a male: female ratio of 2 to 1. A 2013 study demonstrated that using nine different sets of diagnostic criteria on a population of children that completed CAPD assessment ranged from a prevalence of 7.3% with the strictest criteria to 96.0% with the most lenient. Using different diagnostic criteria causes significant variability in the estimated prevalence of CAPD within the same population group. This extreme range of estimates in prevalence is also reflected in the pediatric population. In patients over the age of 55 years, the prevalence of CAPD has been estimated to be between 27% and 75% however, it is as high as 95% in the population over 80. However, some studies have given estimates on prevalence. Unfortunately, it is difficult to calculate the incidence and prevalence of CAPD due to the lack of standardized diagnostic criteria and guidance from different academic organizations varies. Intensive interventions and auditory training that exploits this plasticity are most likely to produce successful outcomes. Intervention should be undertaken immediately once evidence from behavioral and/or electrophysiological tests demonstrate deficits in the CANS sufficient to diagnose CAPD. When CAPD is identified early, there is an opportunity to utilize the brain's plasticity to induce cortical and brainstem reorganization. The information must be collected from a thorough review of the patient's medical, educational, and developmental background, as behavioral and electrophysiological tests in conjunction with relevant imaging and assessment of speech, language, and cognition. Therefore, to diagnose CAPD effectively, a multidisciplinary team approach that considers other parameters such as cognition, memory, and linguistics should be employed. Problems with the CANS may be isolated or associated with conditions that interact with other sensorimotor modalities and/or higher-level cognitive functions. To diagnose CAPD, a battery of auditory diagnostic tests examines the integrity of the CANS. This list is not exhaustive, and there is significant symptomatic overlap with the aforementioned learning disorders, e.g., ADHD. Inability to follow complex commands or directions Clinically, CAPD presents in young children as behavioral characteristics. However, CAPD can affect adults of all ages, as there are multiple etiologies, including cerebrovascular disease, malignancy, and neurotoxicity. ĬAPD is primarily a condition that affects children and is highly prevalent in patients with diagnoses of learning difficulties such as dyslexia, attention deficit disorder (ADHD), and autism spectrum disorder (ASD). The auditory system is highly interconnected with ascending, descending, and crossing fibers that enable higher-order functions from the prefrontal cortex, hippocampus, limbic circuits, etc., to connect directly or indirectly with the auditory system, giving rise to our perception and understanding of auditory information. There is also a series of descending neuronal circuits within the auditory system, which allows for the modulation of auditory processing at multiple levels. There are several levels of crossing fibers throughout the brainstem, allowing both ipsilateral and contralateral signals to contribute to the many aspects of auditory processing. Auditory information reaches the cochlear nucleus from the peripheral auditory system via the auditory nerve. A series of nuclei transmit the information to the cortex for the perception of sound to occur: the cochlear nucleus, the superior olivary nuclei, the lateral meniscus, the inferior colliculus, and the medial geniculate nuclei. The CANS extends from the cochlear nucleus in the brainstem to the auditory cortex. Patients with CAPD tend to have normal outer, middle, and inner ear anatomy with preserved function however, they have deficits in the neural processing of auditory stimuli that are not due to cognitive or higher-order language pathology. Ĭentral auditory processing disorder (CAPD) is a condition that primarily affects the CANS. Disruption of this process will result in deficits in speech perception, sound localization, auditory discrimination, and temporal characterization of sounds. Central auditory processing (CAP) is the ability to perceptually receive stimuli within the central auditory nervous system (CANS) and conduct the subsequent neurobiological activities that give rise to the electrophysiological auditory action potentials.
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