At what age can APD/CAP disorders first be diagnosed? (Note: We use the terms APD -Auditory Processing Disorder and , CAPD- Central auditory processing Disorder interchangably)
Auditory processing abilities develop at different rates in different children. I tell parents to think of emerging auditory processing skills in the same way they think of other aspects of a child's development: some toddlers have greater verbal skills at an early age and others better motor coordination. However, by age six or seven years, these abilities have more or less ''equalized'' among typically-developing children. Even so, there will be kids with strengths and weaknesses in various areas, and parents should be aware of milestones against which to gauge individual progress.
With this in mind, I generally recommend CAPD testing for children aged 7 and older. I am hesitant to evaluate children younger than 6 years of age for auditory processing disorders. Even at 6, I strongly caution parents about being careful not to ''overinterpret'' the results. If a very young child 's score on a given test was ''normal'', I could reasonably say the auditory processing abilities assessed by that test were age-appropriate. If the score fell outside normal range for the child's age, I would be hesitant to diagnose an auditory processing disorder. The skills might ''catch up'' to age level, given another year's development.
Another concern in testing very young children is the large range of values for normative performance. Bellis (1996) reported on norms developed on 150 individuals from ages 7 through adult for the compact disc version of Musiek's Frequency Patterns Test. For children 8 years, to 8 years 11 months, normative values ranged from 42 to 100 percent correct. With such a large range of scores constituting normal performance, with what degree of confidence can we tell a parent whose child scores 43 percent correct that their child is truly ''normal?''
Additionally, very young children often have limited ability to attend to the tasks required for the APD battery. Many tests of APD are repetitive, and keeping strict attention throughout the entire test battery can be exhausting. Screening tests can be used, but if their purpose is to decide who needs further evaluation, the APD battery may need to be administered .
Further, it is my clinical experience that referral for APD testing is a sufficient ''screening'' tool. That is, if a parent, educator, speech-language pathologist, pediatrician or other adult involved in the child's care is sufficiently concerned about the child's APD abilities to refer for testing, the index of suspicion is usually high enough to warrant administration of the APD battery.
In conclusion, I am very comfortable testing 7 year olds for auditory processing disorders. I will test a 6-year-old after cautioning the parents about the potential limitations in diagnostic and prognostic information that can be inferred form the results. For children 5 years and younger, I refer to other professionals based on the parent or referral source's predominant concerns.
Barbara Roe Beck M.A., CCC-A initially became interested in central auditory processing as a master's student (1983) at State University of New York-Buffalo. Ms. Beck has taught multiple Instructional Courses on CAP remediation at AAA conventions. She has published an article on CAP in the August, 2000 Hearing Review, and co-authored an article on the same topic for Audiology Online (see Article Archives). Ms. Beck is completing the Au.D. program at Arizona School of Health Sciences.