(a)

1. (1) Management of CAPD should involve a team of professionals that can include:

   1. (A) Speech-language pathologists;
   2. (B) Psychologists;
   3. (C) Learning disabilities specialists;
   4. (D) Audiologists;
   5. (E) Neurologists; and
   6. (F) Physicians.

2. (2) The amount of each member’s involvement depends on:

   1. (A) What the specific disorder is;
   2. (B) Its practical effects on the child’s daily life; and
   3. (C) How necessary medical treatment is.

(b) Management can be divided into three (3) main categories:

1. (1) Environmental modifications.

   1. (A) Adjusting the environment to minimize noise and improve the child’s ability to process auditory information.
   2. (B) Examples of environmental modifications are:

(i) Preferential classroom seating;

1. (ii) Reduction of extraneous noise; and

   1. (iii) Repeating or rephrasing information;

2. (2) Direct intervention.

   1. (A) Techniques used to improve auditory discrimination, integration skills, and associative skills, as well as teaching specific language or academic skills.

   2. (B) Examples of direct intervention are:

      1. (i) Training the child to hear differences in sounds or words;
      2. (ii) Teaching the child to pick out sounds or words when there is background noise; and
      3. (iii) Teaching the child to use rhythm and tempo cues in speech; and

3. (3) Compensatory strategies.

   1. (A) Allowing the child to use or teaching the child strategies to compensate for the auditory deficit and strategies for coping in daily life.
   2. (B) Examples of compensatory strategies are:
4. (1) Allowing a child to tape record class lectures;
5. (2) Teaching the child how to ask for repetition; and

6. (3) Encouraging the child to use visual cues to enhance the auditory signal.

   1. (c)
7. (1) Regardless of the specific type of CAPD, every child should have a management plan that includes intervention techniques from each of these categories.

8. (2) However, programming must be individualized based on the specific type of CAPD and the specific education, communicative, and social-emotional problems being experienced by the child.

   1. (d) Environmental modifications, direct interventions, and compensatory strategies, consistent with subprofile characteristics, may include:

9. (1) Auditory decoding deficits:

   1. (A) Consonant and vowel training, as well as specific training of speech-to-print skills;
   2. (B) Vocabulary building and other auditory closure activities designed to teach the child to use contextual cues;
   3. (C) Therapy to improve auditory discrimination, listening, and noise tolerance skills;
   4. (D) Preferential seating with line of vision to primary speaker emphasized over distance;
   5. (E) Improve signal-to-noise ratio through acoustic modifications and/or use of assistive listening devices;
   6. (F) Minimize noise in classroom;
   7. (G) Use clear, concise, and explicit language;
   8. (H) Repeat if you can say the message acoustically clearer;
   9. (I) Rephrase information only if sufficient information is added to clarify the original message;
   10. (J) Use an attention getting device, such as calling the child’s name or using tag words to mark key points (first, last, before, after, this, that, etc.);
   11. (K) Give instruction, information, and assignments in writing;
   12. (L) Preteach new and/or unfamiliar vocabulary;
   13. (M) Use visual and contextual cues;
   14. (N) Avoid or modify oral tests;
   15. (O) Give spelling words in sentences;
   16. (P) Tape record class lectures;

   17. (Q) Consider use of:

       1. (i) A computer;
       2. (ii) Books on tape; or
       3. (iii) A note taker/classroom “buddy”;
   18. (R) Improve lip reading skills; and
   19. (S) Allow use of sign language as foreign language requirement;

10. (2) Auditory integration deficits:

    1. (A) Preferential seating with line of vision to primary speaker emphasized over distance;
    2. (B) Because the quality of sound is not the issue, the use of assistive listening devices is not recommended;
    3. (C) Management approaches designed to improve interhemispheric transfer of information;
    4. (D) Linguistic labeling of tactile stimuli, music, singing, and dance activities, and following verbal instructions to complete art projects;
    5. (E) Training in the use of prosodic aspects of speech, including key word extraction reading aloud daily while emphasizing rhythm, stress, and intonational patterns is a good home-based activity;
    6. (F) Playing “Simon Says”, identifying the who, what, when, and where from a story, newspaper, or magazine article, playing with a Simonâ toy, cooking with a recipe, doing household chores that have a specific order/pattern, working jigsaw puzzles, or building models;

    7. (G) Placement in a well-structured, “hands-on” learning environment with a teacher who is animated rather than:

       1. (i) Quiet;
       2. (ii) Reserved; or
       3. (iii) Monotonous;

    8. (H)

       1. (i) Use of multi-modality cues, such as visual and tactile aids, may result in confusion rather than clarification.
       2. (ii) Effective only if concrete examples and repeated modeling of the desired outcome are provided;

    9. (I)

       1. (i) Repeat information with:

(b) (b) Demonstration; or

1. (c) (c) Emphasis on key points.

   1. (ii)

(b) (b) This confuses the child, who may think it is a new message;

1. (J) Provide extra time and practice to complete tasks;

   1. (K) Give tests that are not timed, including standardized tests;
   2. (L) Provide an alternative way to complete tasks;
   3. (M) Provide regular review of learned material;

   4. (N) Consider use of:

      1. (i) Tape recorders;
      2. (ii) Note takers; or
      3. (iii) Books on tape; and
   5. (O) Use of behavioral contracts that define the task and the time or number of items necessary for completion;

2. (3) Auditory association deficits:

   1. (A)

      1. (i) Language intervention and speech-language services are often a key component metacognitive techniques designed to strengthen the memory and aid in item recall.
      2. (ii) Training the child to utilize:

(b) (b) Chunking;

1. (c) (c) Tag words;

   1. (d) (d) Paraphrasing;

(f) (f) Other organizational aids.

1. (iii) Therapy to improve:

(b) (b) Decision making; and

1. (c) (c) Semantic mapping.

   1. (iv) Teach:

(b) (b) Multiple-meaning words;

1. (c) (c) Negative questions;

   1. (d) (d) Antonyms;

(f) (f) Homonyms.

1. (v) Teach use of linguistic rules to the sounds a child hears;

   1. (B) Preferential seating with line of vision to primary speaker emphasized over distance;
   2. (C) Because the quality of sound is not the issue, the use of assistive listening devices is not recommended;
   3. (D) Adjust environment to minimize noise;

   4. (E)

      1. (i) Placement in an educational environment that uses a systematic, logical, multisensory, rule-based approach to language and learning.
      2. (ii) A whole language classroom is not appropriate;
   5. (F) Provide frequent opportunities to learn and practice language rules;

   6. (G)

      1. (i) Use multiple choice or closed set fill-in-the-blank tests.
      2. (ii) Avoid open-ended test questions;

   7. (H) Encourage child to:

      1. (i) Draw diagrams;
      2. (ii) Highlight; and
      3. (iii) Make notes in the margin;
   8. (I) Teach use of a dictionary and/or thesaurus;
   9. (J) Waive foreign language requirement;
   10. (K) Use clear, concise, and explicit language;
   11. (L) Preteach new or unfamiliar vocabulary;

   12. (M)

       1. (i) Rephrasing information using simpler language rather than repeating.
       2. (ii) Comprehension should be checked by asking the child to paraphrase or demonstrate what is expected; and
   13. (N) Impose external organization within the classroom to guide independent work and self-monitoring; and

2. (4) Output-organization deficits:

   1. (A) Language intervention and speech-language services are often a key component;
   2. (B) Management strategies designed to improve organization;

   3. (C)

      1. (i) Improve signal-to-noise ratio through acoustic modifications.
      2. (ii) Use of assistive listening devices may be useful.
      3. (iii) Audiologist should confirm true noise intolerance;
   4. (D) Preferential seating with line of vision to primary speaker emphasized over distance;
   5. (E) Impose external organization within the classroom;
   6. (F) Emphasize metacognitive techniques;
   7. (G) Use both repetition and rephrasing of critical messages and instructions, but only if the message and required response is broken down into smaller linguistic units of no more than two (2) critical elements;

   8. (H) Teach use of:

      1. (i) Outlines;
      2. (ii) Checklists; and
      3. (iii) Assignment notebooks;
   9. (I) If demonstrating poor written expression, allow dictation of child’s answers by a parent or use of a tape recorder when completing assignments;
   10. (J) Allow use of a computer in the classroom;

   11. (K) Teach the use of:

       1. (i) Specific order or sequence, verbal rehearsal, and mnemonic devices; and
       2. (ii) Story retelling, picture sequencing, and describing the action in cartoon strips box by box; and
   12. (L) Teach the use of visualization and visual imagery.