CAPD AND ANSD: A BASIC OVERVIEW · 2018. 4. 24. · 4/24/18 1 CAPD AND ANSD: A BASIC OVERVIEW IECC...
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4/24/18 1 CAPD AND ANSD: A BASIC OVERVIEW IECC Session B16 May 3, 2018 Presenters: ■ Nancy Hatfield, Ph.D. Early Childhood Consultant, WSDS/Deaf-Blind Project ■ Emma Packard, M.Ed./M.A. TVI, O&M Specialist Consultant, WSDS/Deaf-Blind Project Objectives for Today 1. Define the terms Central Auditory Processing Disorder (CAPD) and Auditory Neuropathy Spectrum Disorder (ANSD) in lay terms. 2. Present a framework for considering a child’s risk factors, behaviors, and audiologic test results for ANSD and CAPD. 3. Describe some “do no harm” strategies to support speech/language acquisition and learning in children at risk for one of these conditions. 3
Transcript of CAPD AND ANSD: A BASIC OVERVIEW · 2018. 4. 24. · 4/24/18 1 CAPD AND ANSD: A BASIC OVERVIEW IECC...
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CAPD AND ANSD:A BASIC OVERVIEW
IECC Session B16 May 3, 2018
Presenters:
■ Nancy Hatfield, Ph.D.Early Childhood Consultant, WSDS/Deaf-Blind Project
■ Emma Packard, M.Ed./M.A.TVI, O&M SpecialistConsultant, WSDS/Deaf-Blind Project
Objectives for Today
1. Define the terms Central Auditory Processing Disorder (CAPD) and Auditory Neuropathy Spectrum Disorder (ANSD) in lay terms.
2. Present a framework for considering a child’s risk factors, behaviors, and audiologic test results for ANSD and CAPD.
3. Describe some “do no harm” strategies to support speech/language acquisition and learning in children at risk for one of these conditions.
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And, why are WE here? (1/2)
#1 – Lily
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And, why are WE here? (2/2)
#2 – Jenny
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1. LAY DEFINITIONS OF CAPD AND ANSD
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Overview of “Hearing”
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Definition of Auditory Neuropathy/Dys-synchrony
“A type of sensorineural hearing loss that hinders clear transmission of sound signals to brain; the signals are often distorted.”
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Where ANSD Occurs. . .
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ANSD: Deeper Dive
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ANSD: Some Factoids■ “ANSD is much more complicated than we
originally thought.”■ _■ _■ _■ _■ _
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Simulation of Auditory Neuropathy/Dyssynchrony
How would this type of hearing loss affect development of spoken language and learning?
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Definition of Central Auditory Processing Disorder (CAPD)
“A problem not with actually hearing sounds, but with processingin the brain the sounds we hear.”
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Where CAPD Occurs. . .
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CAPD: Some Factoids■ Affects approximately 2 – 3% of children.■ _■ _■ _
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Simulation of Central Auditory Processing Disorder (CAPD)
How might this type of disorderaffect a child’s development of spoken language, reading, and academic achievement?
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2. A FRAMEWORK FOR DIFFERENTIATING CAPDAND ANSD:
A. RISK FACTORSB. BEHAVIORSC. AUDIOLOGIC TESTS
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2.a Risk Factors: ANSD and CAPDANSD CAPD
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Syndromes Associated with ANSD
■ Charcot-Marie-Tooth Disease ■ Leber’s Hereditary Optic Neuropathy ■ Fredreich’s Ataxia ■ Refsum’s Disease ■ Mitochondrial Disease
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2.b.1 Behavioral CharacteristicsANSD (1 of 2)
■ Infants often will pass newborn hearing screening, if only OAEs are used.
■ _■ _■ _
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2.b.1 Behavioral CharacteristicsANSD (2 of 2)
■ Hearing may fluctuate. ■ _ ■ _ ■ _■ _
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In Washington’s 62 birthing hospitals, newborn hearing screening looks like this:
■ 35 (56%) use AABR for initial screen■ 18 (29%) use OAE for initial hearing screen■ 9 (14.5%) use OAE and/or AABR*
*Some have NICUs. The OAE is for well-baby nursery; AABR is for NICU.
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2.b.2 Behavioral CharacteristicsCAPD (1 of 2)
■ Difficulty understanding speech in presence of competing background noise*
■ _*■ _*■ _* ■ _■ _■ _
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2.b.2 Behavioral CharacteristicsCAPD (2 of 2)
■ _■ _■ _■ _■ _
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2.c - Audiologic TestsANSD CAPD
Tympanogram Normal (or not) Normal (or not)Middle ear muscle reflexes
Abnormal or absent Present and normal
Otoacoustic emissions (OAE)
Present or absent (vary over time)
Present
Auditory brainstem responses (ABR)
Abnormal or absent Normal
Pure-tone thresholds
Normal to severe/ profound
Normal
Word recognition (quiet)
Excellent to poor Excellent
Word recognition (noise)
Poor Fair to poor
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Test Battery for CAPD■ Includes at least one or two dichotic
listening tests■ SCAN-C Test includes four tests of AP
including filtered words, auditory figure ground, competing words, and competing sentences
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A word about CVI (cortical visual impairment)
“Any child with a diagnosis of CVI and concomitant speech/language delays should be assumed to have cerebral hearing impairment (or) auditory processing disorder. . .”
~ Gordon Dutton
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3. STRATEGIES TO SUPPORT SPEECH/ LANGUAGE ACQUISITION AND LEARNING WHEN YOU SUSPECT CAPD OR ANSD
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3.a Strategies to Support ChildrenANSD (1 of 2)
■ There is great heterogeneity; individualized monitoring and observation required for each child
■ _■ _■ _
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3.a Strategies to Support ChildrenANSD (2 of 2)
■ Hearing aids help about half of children with ANSD, at least in quiet settings
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3.b Strategies to Support ChildrenCAPD (1 of 2)
■ Manage the noise in child’s environment■ _■ _■ _■ _■ _
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3.b Strategies to Support ChildrenCAPD (2 of 2)
■ _■ _■ _
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References/ResourcesSee Attachment for more complete list with hyperlinks.
Central Auditory Processing Disorder■ https://cviscotland.org/mem_portal.php?article=66
■ Bellis, Teri J. (n.d.). Understanding Auditory Processing Disorders in Children. Retrieved from www.asha.org
■ Chermak, G.D., Musiek, F.E., & Weihing, J. (2017, May). Beyond controversies: The science behind central auditory processing disorder. Hearing Review, 24(5):20-24. Retrieved from: www.hearingreview.com
■ Heymann, L. K. (2010). The sound of hope: Recognizing, coping with, and treating your child’s auditory processing disorder. New York, NY: Ballantine Books.
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ReferencesAuditory Neuropathy Spectrum Disorder■ Berlin, C.I. et al. (2010). Multi-site diagnosis and management of 260
patients with Auditory Neuropathy/Dys-synchrony (Auditory Neuropathy Spectrum Disorder). International Journal of Audiology, 49:30-43.
■ Clarin, G.P. (2015). Auditory neuropathy spectrum disorder. In A resource guide for early hearing detection and intervention. The NCHAM eBook (Chapter 8). Retrieved from:http://infanthearing.org/ehdi-ebook/2015_ebook/8-
Chapter8AuditoryNeuropathy2015.pdf■ Teagle, Holly F. B. (2013, January). Cochlear implants for children with
auditory neuropathy spectrum disorder: What are we learning?AudiologyOnline, Article #11483. Retrieved from http://www.audiologyonline.com
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Contact Us!
Emma [email protected](206) 915-2831
Nancy [email protected](800) 572-7000
