I was at Walgreen’s the other day when an overhead announcer requested a price check on papaya tablets. When I heard this, I had to pull over with my shopping cart and pause. What did they just say? Popeye’s tablets? Is that a euphemism for canned spinach? Oh, wait a minute… they are saying “papaya” tablets.
This kind of thing happens sometimes when you have a central auditory processing disorder (CAPD). It’s not a bad idea to laugh about it…or at least laugh about it after some time has passed if the distortion caused an embarrassment for you. After all, the distortions CAPD causes CAN be comical.
CAPD is neurological
What happened to me at Walgreen’s is a common occurrence for those of us who, for all the audiologists in the world, hear normally, but our brains distort what we hear. CAPD is actually a neurological condition. You may then ask, “Well, doesn’t everyone sometimes misunderstand what they hear?” Of course they do; the difference is in proportion. How frequently do you misunderstand what you hear? Do you often miss important information that most everyone else seems able to process? Has your processing style significantly impaired you/interfered with your life? Has your processing style adversely affected you socially and occupationally? Are your grades at school slipping because you “miss” important points in lectures?
When sounds hurt
Having CAPD can feel a bit like old age setting in…about 75 years or so ahead of schedule. People tend to think I am hearing impaired when in reality I sometimes can’t accurately process what I’m hearing the first time; subsequently I may “miss” things. Yet and still, I test normally on hearing screens. Airports, shopping malls, the Fourth of July parades and fireworks—these are harmless places for most people; for those of us with CAPD, these places at one point or another in life may have created serious stress since we can hear and experience them so differently from people whose brains normally process what they hear. As a very young child, I could not tolerate the sound of fireworks and would cover my ears and scream. The sounds were painful. Imagine what you hear amplified by a factor of 10.
Processing speeds will vary
As a teen, I forced myself exposure to novel and often noisy situations to desensitize my “quirky” wiring. Still, I used to think I was slow on the uptake and was sometimes labeled “ditsy” because of my differences in auditory processing, which can come across to others as being “slow.” Of course, there is a grain of truth to the “slowness” part, but it does not reflect a person’s intelligence; rather, it reflects a slower auditory processing speed since CAPD brains simply take longer to process what’s heard. I used to often ask people to repeat themselves, of course, and I even had a rule about it: If after asking someone to repeat themselves a third time I still did not understand what they were saying (as I could sense they were getting impatient with me), I would just go ahead and PRETEND to hear them. Now, you can imagine just how distorted stories might get in the retelling in the world of someone with CAPD…kind of like an endless game of “telephone.” It’s no surprise that I disliked and avoided that game as a young child. Just use your ears and stop being so dopey, they would say. As if being dopey were a choice, I thought at the time. More important– I knew that I wasn’t “dim”–something else was going on. Little did I know at the time that my brain just worked differently in processing what I heard compared with other kids.
Closed captioning: Not just for the hearing impaired and the elderly
For a while, before I knew I had CAPD, I rationalized that all people just mumbled and talked too fast. To this day, I rarely ever understand the lyrics to songs on the first listening, much less the third. If I’m curious about song lyrics, I can usually find them if I search Google. I find places like bars or other places with lots of stimulation going on stressful and even confusing when I am expected to process conversations with others in those settings. I rely on closed captioning when I take in programs on television or the computer (I am so grateful for transcriptions-and I have to say You Tube is in dire need of better closed-captioned transcriptions). I find I must ask people with unfamiliar accents and those who speak quickly to repeat themselves; and I’m no longer afraid to ask people to repeat themselves more than three times. If there is background noise, the problem is compounded, and I must ask for patience and help and to perhaps relocate to a quieter spot.
An irony, or at least a “perceived” irony, in all of this is that I have been successfully employed in medical editing and transcription for many years. This type of work requires listening to medical providers dictate audio on patients and then editing what is heard. How is it I’m so proficient in this work living with CAPD? It’s essential to understand that the work itself takes place in a highly-controlled setting, wherein I can listen and relisten as many times as I need if I don’t understand what is said the first time. Because the voices are prerecorded and not live, it is not embarrassing to go back and listen again. There is no one there to ask, “Please say that again.” Plus, with repetition, I have become so familiar with providers’ voices (including accents, quirks, and nuances from all over the globe) that it is like a second language in which I have achieved fluency.
As for my teaching, all in-person tutoring sessions happen one to one in settings that tend to be quieter and more controlled, which is essential for students and tutors to succeed regardless of sensory processing differences that may exist.
Compensatory strategies
Figure out your strengths and find a way to pursue them. A central auditory processing disorder undiagnosed might feel limiting, but do not allow it to limit you. Easy to say, I know. You need to find ways to create a life that is less overwhelming. Learning compensatory strategies will allow you to thrive (and in places like noisy bars—survive) in a world where the majority processes information differently than you. You are in the minority, which is maybe not where you’d prefer to be if given a choice. However, as in other things you might encounter in life, here again you must accommodate to the majority way of doing things. Know that you CAN adapt to the culture with practice and patience. Most important–don’t ever allow anyone to put you down for it. It would be like putting someone down for having diabetes or cerebral palsy. Of course, there are settings that are obviously a setup for you to do worse and even fail (you might reconsider your idea of supplementing your income by becoming a bartender– unless you want to say you’ve REALLY overcome an obstacle; I cannot fathom a more disastrous career choice for someone with CAPD). You need to also learn about where you perform your best and work to your strengths. It’s not unlike the experience you may have had in high school where you tried to change your personality to fit into a group when really you needed to find the group that fit you.
Explain to people how you process information. There is nothing wrong with disclosing your CAPD; the condition is more common than you might think. The other thing is people need to learn about it. And the average person does not know what CAPD is. I tell most people about it in some way. I may simply tell them I process things a bit differently through hearing and leave it at that. I do this straight away if we’re working closely together. In my experience, people are usually respectful about it. There will always be those rare few who may dismiss your condition as a “café syndrome” and who might be mean or impatient about it. I say, do you really want such people in your life anyway? If these are chosen relationships (e.g. they are NOT your bosses, co-workers, clients), stay away from them if you can.
Pursue work in settings that aren’t overstimulating to you or at least in settings that you can tolerate. Most people who know me well put information in writing for me. Our virtual society in which emails and texts are the new norm is a godsend and an empowerment to people with CAPD–or really to anyone who communicates better in writing than speaking. I gravitate toward quieter, structured, more predictable and controlled settings, which helps me better process what I hear. That might be a good workaround for you, too. I take solace in written communication and have always preferred it, although I have learned to become proficient in auditory processing on the phone and in face-to-face interactions. I do very well one on one in live tutoring sessions. Add two or three people to the situation, and it becomes more complicated to auditorily process all that is going on, although I have worked long and hard to adapt to it and can do it well.
Ask people for what you need. What’s the worst that can happen? It is important that you learn compensatory tricks, just as people with hearing impairments adapt to the world around them; otherwise you’ll end up shortchanging yourself and the world around you. It is tempting to want to become a hermit when you’re met with misunderstandings and impatient reactions all of the time, but try not to isolate yourself. Remember–this is not your fault. It is your neurology. Do not blame yourself for it. You will find that processing the world around you does get easier with practice and exposure.
Do ask people to please slow down their pace of speech. Do ask them to repeat themselves or to speak louder (especially when there is background noise). Don’t pretend to understand what you can’t process (even if you feel stupid asking, ask–and you might even educate people about your condition if it’s fitting). Do limit your time in places where you feel overloaded (if you are like me, you’ll avoid or limit your time in noisy places like bars). If you feel that you don’t want to disclose your CAPD, you don’t need to. You can always just tell people that you have trouble hearing. Who isn’t empathic about that?
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Do you lack the motivation and energy to complete tasks (especially “boring” ones)? This can be a frustrating no-end battle for people with ADHD and other self-regulation spectrum conditions (autism is a condition that can impair your ability to get things done, too; sometimes 
If you live with a condition like ADHD, you know that you’re not dumb, lazy, or unwilling, even if other people might label you in this way. It might not take much physical/mental activity to exhaust you. ADHD is neurobiological, so you’re NOT imagining things. You feel lousy and have trouble keeping up with life’s demands because you have a real condition. Read 
Now July 1 may be have been a washout from every angle—but at least when you look back on it in your diary, you will know why: 
Once you keep a daily record of these variables, you should begin to see some patterns after a few months. Your reward—you should be better able to predict when to “schedule” more cognitively demanding activities like writing papers. 
If under scheduling is just too unrealistic, make it a priority to at least eat properly (please see below), sleep sufficiently, exercise as much as you can stand, follow a structured routine, and if you know toxic people/situations/places that trigger stress for you, avoid or minimize exposure if possible. 
Regular sleep patterns with relatively little deviation over weekends are essential in managing your condition. You know what happens when you stay up until 3 a.m. on a weekend when you are accustomed to an 11 p.m. bedtime during the work/school week. Monday morning will be even more of an ordeal, and you’ll likely feel irritable and exhausted. You will then be tempted to turn to heavily caffeinated and/or sugared fixes for a temporary boost and subsequent crash.
With ADHD and similar conditions, if you underestimate what you can do in a period of time, you will probably get it just right. Imagine that a task will take 3 times as long to finish, and you may be pleasantly surprised to find you have finished it sooner. 
This strategy has been legendary for keeping people (especially easily distracted people) on task. Why do bosses exist in most workplaces? In large part, bosses babysit. When you go home, you sometimes need a sitter there, too.
If you have ADHD or a similar condition, you may be familiar with having multiple sensitivities, and gluten intolerances are not uncommon to people who complain about an inability to focus and complete tasks. A high complex carbohydrate, moderate protein, low simple carbohydrate, sugar free diet may be helpful. 
This is also known as the “caveman diet.” Ask yourself if our ancient ancestors suffered with ADHD, chronic fatigue syndrome, autoimmune diseases, joint pains, arthritis, rashes, and other “modern” diseases. 
