The Importance of Modality Specificity in Diagnosing Central Auditory Processing Disorder

2005 ◽  
Vol 14 (2) ◽  
pp. 112-123 ◽  
Author(s):  
Anthony T. Cacace ◽  
Dennis J. McFarland

Purpose: This article argues for the use of modality specificity as a unifying framework by which to conceptualize and diagnose central auditory processing disorder (CAPD). The intent is to generate dialogue and critical discussion in this area of study. Method: Research in the cognitive, behavioral, and neural sciences that relates to the concept of modality specificity was reviewed and synthesized. Results: Modality specificity has a long history as an organizing construct within a diverse collection of mainstream scientific disciplines. The principle of modality specificity was contrasted with the unimodal inclusive framework, which holds that auditory tests alone are sufficient to make the CAPD diagnosis. Evidence from a large body of data demonstrated that the unimodal framework was unable to delineate modality-specific processes from more generalized dysfunction; it lacked discriminant validity and resulted in an incomplete assessment. Consequently, any hypothetical model resulting from incomplete assessments or potential therapies that are based on indeterminate diagnoses are themselves questionable, and caution should be used in their application. Conclusions: Improving specificity of diagnosis is an imperative core issue to the area of CAPD. Without specificity, the concept has little explanatory power. Because of serious flaws in concept and design, the unimodal inclusive framework should be abandoned in favor of a more valid approach that uses modality specificity.

1995 ◽  
Vol 4 (3) ◽  
pp. 36-48 ◽  
Author(s):  
Dennis J. McFarland ◽  
Anthony T. Cacace

A central "auditory" processing disorder (CAPD) is an auditory perceptual dysfunction that cannot be explained on the basis of peripheral hearing loss. As a concept, CAPD has not been completely validated, and many issues continue to be controversial. A primary issue of concern is whether currently used tests to evaluate CAPD are sensitive to factors that are not of an auditory perceptual nature. In this paper, we consider the case for modality specificity as a criterion for improving the specificity of diagnosing CAPD. Demonstrating the modality-specific nature of sensory processing deficits is one way to rule out nonperceptual factors as explanations for observed dysfunction.


1998 ◽  
Vol 41 (2) ◽  
pp. 355-373 ◽  
Author(s):  
Anthony T. Cacace ◽  
Dennis J. McFarland

The rationale to evaluate for central auditory processing disorder (CAPD) in schoolaged children is based on the assumption that an auditory-specific perceptual deficit underlies many learning problems including specific reading and language disabilities. A fundamental issue in this area is whether convincing empirical evidence exists to validate this proposition. Herein, we consider the issue of modality specificity by examining the extent to which reading, language, and attention disorders in schoolaged children involve perceptual dysfunctions limited to a single sensory modality. Difficulty in validating CAPD as a diagnostic label is due in large part to use of the unimodal inclusive framework, which has biased the diagnosis to favor sensitivity of test results over documenting the specificity of the deficit. Indeed, empirical research documenting modality-specific auditory-perceptual dysfunction in this population is scarce. Therefore, the existing literature on this topic has not clarified the "true" nature of the problem, and has left many questions about this disorder unanswered. It is argued that demonstrating modality specificity is one way to rule out supramodal disorders as explanations for observed dysfunction. Multimodal perceptual testing is one logical approach to help clarify this area of investigation.


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