Special Needs

Intro and Question: Speech and Hearing


I have been lurking on this board for a few months and wanted to formally say hello and ask some questions or just get any insight there is out there. I have 22 month old b/g twins. My DS has been behind in speech and we've been doing evaluations and appointments for months. We started when he was 15 months old with EI because he wasn't sticking out his tongue or moving his mouth in a way that would enable him to make sounds outside of grunting and 'ah'. They recommended developmental intervention with an educator and OT. They said he was too young for speech. We did the DI and OT. The OT was private because the wait was long through EI. The DI educator was terrible and showed up 15 mins late, spent 10 mins in the bathroom, and then 20 mins filling out paperwork. He improved with skills like blocks, puzzles, and playing with toys appropriately though OT and was discharged and recommended to speech. We did the speech assessment in which he has definite deficiency and although he recognized objects and follows instruction he cannot communicate outward. She recommended a developmental pediatrician and hearing test. We filled out all of the paperwork for DP and are waiting for an appointment. We did the hearing test today.

I had never been concerned about his hearing because he can follow direction, can hear his songs and music on the television, and dances along when he hears music. Today we found that he has fluid behind his eardrum and neither of them are working properly and it does effect his hearing. They had to turn the noise up quite loud for him to recognize the sound and said that it is correctable but he definitely is having trouble hearing. We are now going to see our pedi and ENT and will have to repeat the test. I guess I am confused since it seemed like he could hear. And also confused because I don't know if it's possible he's had this congestion for all of these months when he's had no ear infections and while he has been sick recently was not in the fall when we started all of this. I guess I am just unsure if the speech could possibly be related to the hearing since it's a deficiency I've noticed for a long time and I don't know if its possible he's been congested all of this time. I guess I am really curious about any insight or experience there might be out there. Thanks in advance for any experience or advice.

Re: Intro and Question: Speech and Hearing

  • Yes, the quality of hearing definitely effects speech.  Its usually the first thing that is checked when a speech delay is suspected.

    Having fluid in the ears was explained to me like trying to hear while you are underwater.  Yes, you'll hear sounds and probably music, but it will not be clear and you will not hear softer sounds at all.

    You can also have fluid in the ears for an extended period without it getting infected.  So its possible he just has some fluid hanging out in there that isn't draining - or when it eventually does drain, it comes back.

    Now, its not to say that this is definitely the cause your sons speech delay but it could be a factor.  And even if its not the cause, its certainly not helping matters.  So the best course of action would be to eliminte this variable and then contune treatment from there.  In this case Ear Tubes is probably your next step.


  • Hi there!  My DS could hear but he still had hearing loss due to fluid in his ears. He had his 1st hearing test at 24 months and I thought the hearing loss was because I had the test too soon after an ear infection. But six months later with a retest, the loss had worsened and he still had fluid. DS got tubes 4 weeks ago and the improvement in his speech since then has been remarkable. He had been making great strides with speech therapy but now his diction is improving and we're better able to work on dropped consonants.

    I would definitely go to the ENT and have another hearing test. Especially if your insurance covers it. Speech problems can definitely be related to hearing loss due to ear infections. And if it's fluid related, the hearing loss is reversible with tubes. (Not saying your LO needs them, but as a FYI.)

    I'm also surprised that they are "too young" for speech therapy. Aaron started with NJ EI at just 24 months and got DI and ST -- OT for sensory issues started in January. But I am aware that we got lucky with our EI team and the amount of services we receive. I hope you are able to press for ST because I think it really helps.


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  • Thanks everyone for sharing your info. We are definitely going to persue the developmental pedi and speech therapy as well. We're just doing it privately versus through EI. We will go to the ENT as well andif he needs tubes we'll do that too. It's so hard to be patient when someone drops a bomb like a hearing deficiency you just want to correct it right then. And I am trying to patient to wait for the appointments.
  • Our DD has hearing loss from meningitis, not fluid, but has had 2 sets of tubes for fluid drainage and let me tell you...they are WONDERFUL!  Sure, you have to use ear plugs in the bath, pool, etc but that is a small price to pay for the ease of that fluid getting out of those ears!  DD now has both her second set of tubes out and already we have been dealing with infections so we might be back to replace again...but that is more for her safety with cochlear implants, where you really don't want infection near her ears. 


    Anyway, good luck on the next steps, but don't be the least bit scared of tubes.  The surgery is super fast, we had no recovery time at all...dd was back to normal within minutes of the surgery...and the benefits are so great!

    Ask if you have other hearing questions...we are in year 3 of speech etc.

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  • EI here doesn't lilke to evaluate for speech until after 18 months, even for a kid with a known developmental delay and brain issue. I didn't bother trying to get an eval until then, and frankly, I had so much other stuff on my plate(therapies) I just didn't have the time.

    Nate can "hear just fine" too an does all of the things your LO does, but he has mild-moderate hearing loss. It is brought into typical hearing range with hearing aids. Without them he can catch alot of sounds, but he also misses alot too. Children, with hearing levels similar to his, will miss a lot of endings on words like "ss" and "sh" because those frequencies are higher. Without hearing aids he does not hear them.

    He also has tubes put in last August because an MRI/CT scan (done for other reasons) showed that he had fluid bilaterally and some "obliteration" of his mastoid cells in the skull due to fluid sitting in there. (I suspect since birth). Before the tubes, he never had an ear infection. We knew there was fluid, but at that age there was no way to know if the fluid was an intermittant thing due to sicknesses or was there all the time.

    We were able to gain about 10 decibles more of hearing after the tubes, so Nate's hearing loss definately was affected by the fluid. He still wears hearing aids because he also has sensoneural hearing loss. I do not reget the tubes one bit and wish I had been more "on top of things" regarding a protential conductive loss.

    Take it one step at a time and know we will be here if you have any more questions.

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  • Wow it's so amazing to me children can 'appear' to hear ok and then to have hearing loss due to the fluid. I only wish I did this sooner. I so want to just start helping him but like you've said we've been doing OT, EI, evluations, speech evaluations...just so many appointments I've been putting this one off and feel this is the one I should've done first.
  • Don't worry about the past. You can only make decisions on the information presented to you by professionals and sometimes their information is lacking. Just think about moving forward and getting all the interventions you can. Good Luck!

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  • DS has moderate to severe hearing loss and if you do not know that he is a child with hearing loss you would never guess. Because he responds when given instructions, he is the first to hear music in the distance, it is a bit early to be sure about his speech but so far most of his words are clear (as clear as it gets for a 2 yr old :-). A lot of people think that hearing is black and white, either you are hearing or not. This was the reason I was stuck in denial for a long time after he was diagnosed. Like a previous poster said he hears a lot but he also misses a lot.
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