Skip to main content
Instagram Facebook LinkedIn YouTube Patient Reviews
646-436-7590 · Midtown Manhattan
Now Available CAPD testing is now available for adults 18+ at our Herald Square office in Midtown Manhattan. The evaluating clinician and test battery are matched to each patient's history and referral question. This service is for adults ages 18 and older only.
Adult CAPD Testing · Midtown Manhattan, NYC

Auditory Processing Evaluations for Adults 18+.

When hearing appears normal but listening remains difficult, the problem may involve how the brain organizes and interprets sound. Pinnacle Audiology now provides detailed central auditory processing disorder (CAPD) evaluations for adults ages 18 and older in Midtown Manhattan.

Schedule an Auditory Processing Consultation Call 646-436-7590
A calm, one-on-one listening evaluation at the Pinnacle Audiology office in Midtown Manhattan
Auditory Processing Evaluation

Adults 18+ only · Midtown Manhattan

  • An individualized battery, never a fixed checklist
  • Always begins with a complete hearing evaluation
  • Selected and interpreted by a doctor of audiology

Led by clinical director Dr. Eric G. Nelson, Au.D., CCC-A, a former audiology supervisor at Weill Cornell Medicine, with coordinated support from Pinnacle's doctoral audiology team.

The core idea

Hearing sound is not the same as understanding it.

A standard hearing test measures whether a person can detect sound. Auditory processing testing looks at something different: how effectively the central auditory system organizes and interprets it. Someone can have completely normal pure-tone hearing and still find listening genuinely hard.

Normal test, real difficulty

Normal pure-tone hearing does not rule out trouble understanding speech in noise, following spoken directions, telling similar-sounding words apart, or keeping up with rapid verbal information.

Why we start with the ears

Auditory processing difficulty can coexist with peripheral hearing loss, so every evaluation begins with a complete assessment of the ears and hearing system.

Who may benefit

When listening is harder than it should be.

These are listening concerns adults describe at home, in college, and at work. Our CAPD evaluation service is available to patients ages 18 and older.

Everyday listening

In conversation

  • Says “what?” often, even though hearing tests look normal
  • Struggles to understand a speaker from across the room
  • Loses the thread when other conversations or background noise compete
  • Misses parts of multi-step spoken directions
  • Needs frequent repetition during conversation
  • Confuses similar-sounding words
  • Seems distracted specifically during spoken instruction
  • Does better when information is written or shown visually
College students 18+

As demands grow

  • Finds it hard to take notes while listening
  • Cannot keep up with fast speech or dense lectures
  • Is worn out by listening after a full day of classes
  • Struggles to follow group discussions and seminars
  • Has trouble understanding unfamiliar speakers or accents
  • Reports reading, spelling, or phonological-awareness concerns
Adults & professionals

At work and at home

  • Feels drained after meetings or calls in noisy settings
  • Finds it hard to tell where a voice or sound is coming from
  • Cannot easily separate one speaker from many
  • Asks for repetition despite a clear hearing test
  • Prefers written follow-up to verbal instructions
An important caution

These signs are not specific to auditory processing disorder. Similar concerns can relate to hearing loss, fluctuating middle-ear problems, ADHD, language disorders, learning differences, autism, anxiety, sleep difficulties, or other factors. That is exactly why a careful, individualized evaluation matters more than any checklist.

Age & readiness

Adult evaluations, individualized to you.

Pinnacle Audiology offers CAPD testing for adults ages 18 and older only. We do not offer this service for children or teens under 18.

Adults ages 18 and older

Why an individual plan matters

Behavioral auditory processing tests involve listening carefully, following specific instructions, and responding consistently. Hearing, language, attention, and fatigue can affect performance. We review your history and listening concerns before selecting an appropriate battery, and interpret the findings as a whole rather than relying on one score.

Testing may ask you to

  • Understand the task instructions
  • Give consistent behavioral responses
  • Wear headphones for an extended appointment
  • Repeat words, numbers, or sentences on request
  • Sustain enough attention for valid testing
  • Use English well enough for English-based test materials

Inside the audiometric suite

Pinnacle Audiology’s audiometric suite with an open testing-booth door and audiologist’s workstation
Our audiometric suiteMidtown Manhattan office · photo lightly retouched
The black patient chair, headphones and observation window inside Pinnacle Audiology’s audiometric booth
Inside the testing boothMidtown Manhattan office · photo lightly retouched
Before testing

What happens before auditory processing testing.

A meaningful evaluation is built on careful groundwork. A hearing evaluation comes first because hearing loss and middle-ear dysfunction can change auditory processing test results.

  1. Detailed history

    Developmental, medical, educational, and listening history, in the patient’s own words and the family’s.

  2. Review of concerns

    What you are noticing at home, at work, or in college, and where listening breaks down.

  3. Comprehensive hearing evaluation

    A complete peripheral hearing test, because hearing status shapes how every later result is read.

  4. Otoscopy & middle-ear assessment

    A look at the ear canal and eardrum and a check of middle-ear function.

  5. Speech testing

    How clearly speech is understood, in quiet and in more demanding conditions.

  6. Review of outside evaluations

    Relevant reports from speech-language pathology, psychology, neuropsychology, occupational therapy, education, or medicine.

  7. An individualized battery

    Selection of auditory processing tests chosen for this patient’s age, symptoms, language, and attention.

  8. Pattern interpretation

    Reading the pattern across tests, not leaning on any single score.

  9. Written recommendations

    Clear, individualized recommendations for home, college, or work.

The test battery

How we examine different listening skills.

The measures below are among the most useful in auditory processing assessment. The exact battery is always individualized: not every patient receives every test, and results are interpreted together, never in isolation.

01
Speech in background noise

QuickSIN · Quick Speech-in-Noise Test

What the patient does

The patient listens to recorded sentences presented with competing four-talker babble. Each sentence contains five key words, and the background noise grows more challenging as the signal-to-noise ratio decreases. The listener repeats back as much of each sentence as possible.

How it works

  • Six sentences per standard list
  • Five scored key words in each sentence
  • Speech presented with four-talker babble
  • Signal-to-noise ratio drops in 5 dB steps
  • Yields a signal-to-noise ratio loss, or SNR loss
  • Run through headphones or in a calibrated sound field, depending on the clinical purpose

What it evaluates

  • Functional speech understanding in background noise
  • How much acoustic advantage a listener needs versus an average normal-hearing adult reference
  • Difficulty separating a target speaker from competing voices
  • Real-world limits that may not appear during speech testing in quiet

Why it matters day to day

It connects to understanding conversation in restaurants, following group discussions, and hearing in meetings or lectures, especially from the back or side of a room. Poor speech-in-noise performance can happen for several reasons and is not, by itself, proof of CAPD.

Clinical note: QuickSIN results are interpreted alongside hearing, language, attention, and the whole test battery. One speech-in-noise score does not establish a CAPD diagnosis.
02
Standardized listening tasks

SCAN-3 · Co-normed Auditory Processing Battery

What it is

SCAN-3 is a standardized, co-normed battery designed to identify patterns of auditory processing difficulty. The audiologist selects measures suited to the patient and interprets them within the instrument’s published norms. Pinnacle Audiology’s CAPD service is for adults ages 18 and older only.

Examples of listening tasks

  • Gap Detection: hearing pairs of tones and judging one sound or two, testing temporal resolution
  • Auditory Figure-Ground: repeating words in competing noise, testing recognition and auditory closure
  • Competing Words: different words to each ear at once, testing dichotic listening and binaural integration and separation
  • Competing Sentences: different sentences to each ear, testing binaural separation and selective attention
  • Filtered Words: identifying acoustically reduced words, testing auditory closure
  • Time-Compressed Sentences: repeating electronically accelerated speech, testing processing of rapid, degraded speech

What it evaluates

  • Temporal resolution and auditory closure
  • Dichotic listening, binaural integration and separation
  • Selective and divided auditory attention
  • Recognition of degraded or rapid speech

Why it matters day to day

Its subtests relate to following a speaker while others talk, shifting attention between speakers, and making sense of speech that is fast, filtered by distance or masks, or partly obscured by poor room acoustics.

Clinical note: SCAN-3 does not, on its own, establish a CAPD diagnosis. It is one source of standardized information within the complete evaluation.
03
Listening with both ears

Dichotic Digits Test

What the patient does

Different numbers are presented to the right and left ears at the same time. In common double-digit conditions, two numbers arrive at each ear during one presentation, and the patient repeats all of the numbers heard, in any order unless specific instructions are used.

How it works

  • Different auditory information enters each ear simultaneously
  • Single-, double-, or other digit conditions, depending on the version
  • Scores are calculated separately for each ear
  • The clinician weighs overall accuracy, ear differences, and error patterns
  • Directed-listening conditions may be added for clinical purposes

What it evaluates

  • Dichotic listening and binaural integration
  • How well the two ears and cerebral hemispheres work together
  • Interhemispheric transfer of auditory information
  • Dividing attention across simultaneous inputs
  • Ear asymmetry, read in the context of age and the full battery

Why it matters day to day

It relates to listening when several people speak, joining group discussions, following a speaker while another conversation happens nearby, and holding on to the whole verbal message when sound competes.

Clinical note: attention influences dichotic performance. An abnormal score does not, on its own, separate an auditory disorder from an attention disorder.
04
Sound patterns and sequencing

Frequency Pattern Test

What the patient does

The patient hears sequences of three tones. Each tone is either high or low in pitch, and the patient identifies or imitates the sequence, for example high-low-high.

How it works

  • Three-tone sequences
  • Two distinguishable frequencies
  • Monaural presentation, typically testing each ear
  • Verbal labeling, humming, or both, depending on the clinical question
  • Accuracy compared across ears and response conditions

What it evaluates

  • Temporal ordering and auditory pattern recognition
  • Sequencing of acoustic information
  • Pitch discrimination within a pattern
  • Integration of right- and left-hemisphere auditory function
  • Interhemispheric transfer when a verbal label is required

Why it matters day to day

Temporal pattern perception underlies rhythm, stress, and intonation: hearing whether a speaker is asking a question or making a statement, catching emotional tone and emphasis, and following the order of rapid information.

Clinical note: a poor Frequency Pattern score does not, by itself, cause or diagnose a reading disorder. It is one piece of a broader picture.
05
Timing cues in sound

GIN · Gaps-In-Noise Test

What the patient does

The patient listens to segments of broadband noise that contain zero, one, or several very brief silent gaps, and responds whenever a gap is detected.

How it works

  • Broadband noise segments
  • Silent gaps of different durations
  • Some trials contain no gap
  • Multiple gap opportunities within a segment
  • Threshold is based on the shortest gap detected consistently
  • A percent-correct score may also be considered, and each ear may be assessed separately

What it evaluates

  • Temporal resolution
  • Detection of extremely rapid changes in sound
  • Recognizing that one continuous sound has been interrupted
  • Processing of timing cues important to speech perception

Why it matters day to day

Speech is full of rapid transitions and brief timing cues. Reduced temporal resolution may make fast or acoustically similar speech harder to tell apart, especially when a speaker is rapid or distant, or when noise competes.

Clinical note: GIN is not a test of intelligence, sustained attention, or language comprehension. Attention is needed to complete it, but the target skill is temporal resolution.
Reading the results

What the results can tell us.

The audiologist looks at whether the pattern across tests points to difficulty in one or more specific listening skills.

Speech in noiseAuditory closureDichotic listeningBinaural integrationBinaural separationTemporal resolutionTemporal sequencingRapid speech processingEar asymmetry
The most important sentence on this page

CAPD is not diagnosed from one failed test. Results must form a clinically meaningful pattern, read alongside hearing, development, language, attention, and everyday listening.

APD, ADHD & learning differences

Overlapping signs, separate conditions.

Auditory processing disorder and ADHD are distinct. Their day-to-day signs can look alike, which is why a careful differential evaluation, and often a team, matters.

Auditory processing

Difficulty is often most obvious when information is spoken, rapid, degraded, or buried in noise. The struggle tracks the listening conditions.

Where they overlap

Both can bring missed instructions, inconsistent responses, distractibility, and listening fatigue. An adult can have APD, ADHD, both, or neither.

Attention & executive function

ADHD can affect performance across visual and auditory tasks alike, not only listening. It is diagnosed by qualified medical or behavioral-health professionals.

How we work

Audiologists do not diagnose ADHD. When the picture is mixed, collaboration may involve a physician, psychologist, neuropsychologist, speech-language pathologist, educational specialist, or occupational therapist, so each professional contributes what they are qualified to assess.

After the evaluation

Recommendations that fit your life.

When an evaluation points to specific difficulties, recommendations are individualized to that profile. Examples of what may follow include:

Seating matched to your listening profile
Reducing competing noise in the learning space
Gaining the listener’s attention before speaking
Breaking spoken instructions into shorter steps
Written or visual reinforcement of key information
Repetition and rephrasing rather than simply more volume
Pre-teaching vocabulary before new material
Checking comprehension along the way
Additional processing time
Strategic note-taking support
Recorded or written access to important instruction
Remote microphone technology when clinically appropriate
Listening-environment modifications
Speech-language or educational intervention
Auditory training selected for the identified deficit
Follow-up assessment to measure progress
Please note

An evaluation does not guarantee eligibility for accommodations or a particular device. Our role is to provide clear, individualized recommendations based on the findings and your everyday listening needs.

FAQ

Auditory processing questions.

What is auditory processing disorder?+

Auditory processing disorder, also called central auditory processing disorder or CAPD, describes difficulty with how the central auditory system organizes and interprets sound, even when the ears detect sound normally. It is identified through a careful, individualized evaluation, not a single test.

Link to this answer
Is APD the same as hearing loss?+

No. Hearing loss is a reduced ability to detect sound. Auditory processing difficulty is about interpreting sound that is detected. The two can occur together, which is why an auditory processing evaluation always begins with a complete hearing test.

Link to this answer
Who can schedule CAPD testing at Pinnacle Audiology?+

CAPD testing is now available for adults ages 18 and older at our Midtown Manhattan office. Pinnacle Audiology does not offer CAPD testing for children or teens under 18.

Link to this answer
Where can I get adult CAPD testing in NYC?+

Pinnacle Audiology offers CAPD testing for adults 18+ at 421 7th Avenue, Suite 310, New York, NY 10001, in Midtown Manhattan near Penn Station and Herald Square. Use the patient entrance at 159 W 33rd Street, Floor 3. Call 646-436-7590 or schedule an auditory processing consultation online.

Link to this answer
Why do I hear normally but struggle to understand conversation?+

A basic hearing test measures detection. An adult can detect sound well and still find it hard to understand speech in noise, follow multi-step directions, or keep up with rapid speech. An evaluation helps distinguish auditory processing, hearing, attention, language, and environmental factors.

Link to this answer
Can APD look like ADHD?+

The everyday signs can overlap, including missed instructions, inconsistent responses, and distractibility. They are separate conditions that require careful differential evaluation. Auditory difficulty tends to track listening conditions, while ADHD can affect visual and auditory tasks alike.

Link to this answer
Can someone have both ADHD and APD?+

Yes. A person can have APD, ADHD, both, or neither. When both are present, support for each is usually needed, since one does not treat the other. Audiologists do not diagnose ADHD; we collaborate with the professionals who do.

Link to this answer
How long does an auditory processing evaluation take?+

Plan on an unhurried appointment. Time is spent on history, a complete hearing evaluation, and the individualized battery, followed by a clear discussion of findings. We will give you a specific estimate when we schedule, based on the plan for that patient.

Link to this answer
Does every patient receive the same tests?+

No. The battery is individualized and selected by the audiologist based on age, symptoms, hearing status, language, attention, cognitive demands, and case history. Not every patient receives every test, and results are always interpreted together.

Link to this answer
What should I bring to the appointment?+

Bring your concerns in writing, plus any relevant hearing, medical, speech-language, psychological, neuropsychological, or educational reports. Examples of where listening breaks down at work, in college, or at home are especially helpful.

Link to this answer
Can APD affect adults?+

Yes. Adults describe difficulty understanding speech in noise, following fast or complex conversation, and fatigue after listening-heavy days. Pinnacle Audiology offers individualized CAPD evaluations for adults ages 18 and older.

Link to this answer
Can auditory processing skills improve?+

Many people benefit from targeted strategies, environmental changes, and, when appropriate, auditory training or remote microphone technology. The right plan depends on the specific profile, which is why recommendations are individualized rather than a one-size program.

Link to this answer
Will the evaluation include recommendations for everyday listening?+

When findings support them, yes. You receive written, individualized recommendations for home, work, or college. Recommendations depend on your listening profile and do not guarantee eligibility for accommodations or a particular device.

Link to this answer
Is auditory processing testing covered by insurance?+

Coverage varies by plan, and we cannot promise it. Please contact the practice so we can review your benefits and explain expected fees before your visit, with no surprises.

Link to this answer
Does APD testing diagnose dyslexia or a language disorder?+

No. An auditory processing evaluation does not diagnose dyslexia, a language disorder, or ADHD. It clarifies the auditory picture and, when needed, points toward the right professionals for reading, language, learning, or attention concerns.

Link to this answer
18+
CAPD testing is now available for adults only
Individualized
The battery is chosen for the patient, never a fixed checklist
Hearing first
Every evaluation begins with a complete assessment of the ears
5.0 ★
Rated across 300+ reviews on Google and beyond
Your care team

Three doctors of audiology, one standard of care.

Pinnacle's doctoral audiologists share the same individualized, evidence-based approach to evaluation. The evaluating clinician and test battery are matched to the patient's age, history, and referral question.

Dr. Eric G. Nelson, Au.D., CCC-A
Dr. Eric G. Nelson
Au.D., CCC-A
Founder & Clinical Director

Former Audiology Supervisor at Weill Cornell Medicine. Diagnostic evaluation, real-ear verification, and tinnitus.

Dr. Joshua B. Jablonski, Au.D., CCC-A
Dr. Joshua B. Jablonski
Au.D., CCC-A
Senior Clinical Audiologist

More than 14 years of experience in diagnostic audiology, advanced hearing aid care, and vestibular assessment.

Dr. Jasmin Butler, Au.D., CCC-A
Dr. Jasmin Butler
Au.D., CCC-A
Senior Clinical Audiologist

Clinical training across Northwell Health, the Brooklyn VA, and Columbia, with interests in adult and pediatric audiologic testing.

Schedule a consultation →
Questions about your listening?

Listening should not feel this difficult.

A thoughtful evaluation can help distinguish hearing, auditory processing, attention, language, and environmental factors that may be contributing to everyday difficulty. Pinnacle Audiology provides individualized evaluations, never an automated online screening.

Schedule an Auditory Processing Consultation Speak With Pinnacle Audiology
RELATED SERVICES