By Grade 3, school was a nightmare for Edward Rick. Reading and writing were next to impossible. His schoolmates near North Bay called him dumb and bullied him.
Diagnosed with attention deficit hyperactivity disorder, Edward briefly tried Ritalin. But nothing helped, and he became more withdrawn and unhappy.
Then he gave his mother an ultimatum: home-school him or he'd die, he said. "I didn't want to live," he recalls.
An educational psychologist finally uncovered the real problem when he was 9: Edward, now 11, had central auditory processing disorder, known as CAPD.
The disorder is used to describe problems that occur when the brain processes heard information incorrectly. Experts say the little-known CAPD has been falling through the cracks between tests for bona fide hearing problems and tests for learning disabilities and mood disorders - because the symptoms look similar.
Many children diagnosed with ADHD or with dyslexia in fact have an auditory processing problem - sometimes as a stand-alone disorder. Without specific treatment for CAPD, the symptoms will continue.
In school-aged children, symptoms can include problems following spoken instructions, being distracted or off-topic during group discussion, and difficulty taking notes. They may have trouble filtering out background noise and holding multiple pieces of information, such as directions, in short-term memory.
But as researchers refine their understanding of how children's brains develop and learn, they are zeroing in on what each of these symptoms signal and how best to treat them - and urging increased awareness among parents and medical practitioners.
"CAPD is not a hearing problem," says educational psychology professor Alan Edmunds of the University of Western Ontario. "It's an information-processing-once-it's-been-heard problem."
Although their hearing may be perfectly normal, kids with the disorder can't process spoken information in the same way as others because their ears and brain aren't co-ordinating their efforts. Some research suggests childhood trauma such as severe ear infections may be the cause. Edward's CAPD, for instance, may be related to severe and critical lung problems he suffered.
Isolating CAPD can be difficult, though. Central processing issues are often left out of ADHD assessments, says Dr. Edmunds, who most recently has studied discrepancies in cases across Canada. Many of those children are diagnosed and treated by doctors who have never heard of CAPD.
"You have to know what the whole enchilada looks like in ADHD to make sure you get at all these things," Dr. Edmunds says. "You want to establish whether they have a CAPD problem or an I'm-not-listening problem."
Undiagnosed, children often adopt strategies to cover up their difficulties, which then also look like bad behaviour: The dog ate my homework; I left it on the bus.
"As these children get older, it starts to sound like a litany of excuses to teachers and parents," Dr. Edmunds says. "At the same time, there are strokes of brilliance these kids are capable of at school. But we start to think of them as bad students."
Identifying CAPD can take many hours and includes a battery of learning tests and other screening tools. But diagnosis can have immediate benefits, even before treatment is under way, experts say.
"It causes parents and educators to think differently about what a child is doing; they're not purposely, selectively forgetting what you want them to do," Dr. Edmunds says.
Edward undertook about six months of intense remedial work with Toronto educational psychologist Deborah Chesnie Cooper. Using computer software and a series of books that she sells, Edward worked on learning the sounds of individual letters until hearing and understanding words and sentences became second nature.
Dr. Chesnie Cooper sells the program, called Decode, which is not covered by the public health system.
Edward's mother, Christine Rick, says she was so impressed by Dr. Chesnie Cooper's program that she is now working with the psychologist to make it available for use by families in Powassan, near North Bay, who can't afford to buy it.
While private treatment ran into the thousands of dollars for the Rick family and took months of intensive work, Edward reports that he's now reading and doing math at his Grade 6 level, pulling in "B+ in my worst subjects and A or A+ in my best subjects."