newbie to board: EI related

RickeyandDani

 DS will be 2 1/2 in a few weeks. He suffered ear infections from age 4 mo., consistently, until he had ear tubes put in at 10 mo's old. His pediatrician and the daycare both recommended DS be examined by  EI. They felt he was delayed in receptive language, just slightly. He was reevaluated this past week and they are recommending he be seen by a speech pathologist and get a hearing test. Based on his current language skills its seems to be the agreeance of everyone, we all feel he legitimately is not ignoring, but really not focused or hearing. I am starting to get worried now. interested in hearing any feedback. I'm hanging on to positive thinking that this is just a minor setback. 

MummyGruetzie

DD is bilaterally profoundly deaf (complete loss in both ears). Getting your son into the audiologist ASAP for hearing tests and aided as soon after that if there is a loss is going to be invaluable for his speech and language development if that is the root of his delay. Literally, if you haven't already--I would contact an ENT (otolaryngologist) and audiologist tomorrow to make these appointments. The ENT is the medical doctor who will examine your son. The audiologist is the Au.D/Ph.D who will test his hearing and be able to direct you if he has a hearing loss. If the appointment will require a wait, go ahead and take it, but continue to call around to see if you can find a sooner one elsewhere or ask your pediatrician if they can do a baseline hearing test. Ultimately he will likely need both a booth test as well and possibly an ABR where they'll test his brain's response to sound while he's sleeping.  

Listening to audio samples of what different losses sound like is a very eye-opening experience. Even "mild" losses, which don't look super significant on paper can make learning language very confusing. Especially for kids who won't automatically fill in the gaps between the sounds they aren't hearing like adults who already know our language will. If there is a hearing loss, you should also be offered a Teacher of the Deaf through EI. Through our EI, the wait for a TOD was very long. Make sure you advocate for this right away. She'll be able to teach him coping mechanisms for any hearing loss he might have. Some EIs also have audiologists on staff. If yours does this may be another way to get his hearing tested sooner than waiting for an appointment at a clinic. Though typically the wait for an audiologist isn't as bad as other specialists, like say a developmental pediatrician (who may also be a good idea to go ahead and make an appt with since their wait is usually 6 months. It'll be WAY easier to cancel the appt if you decide that you don't need it than it will be to schedule it later on). 

Something else to keep in mind. Early Intervention typically ends at age 3 (every state and in some cases county operates EI differently). Some states offer it through age four. In any case, at age three services are available free of charge to those who qualify for them through the public school system. In my state these services are offered beginning at age 2. Between evaluations and goal setting, signing up for special education services through the public school is a lengthy process, so you may want to go ahead and contact someone from the school. If you were eligible to age into the school in September, for example, in order to actually send your son to school in September, you would have needed to already start the process a little while back to actually have your ducks in a row for then. Some school systems are a little more organized and can expedite this faster than others. But with summer time you're running up against more scheduling hurdles than in the school year. You can get in contact with "Child Find" (the public school program) by contacting your local school. You do not have to wait for school to start back to contact them. EI therapists sometimes have a wait-list. Once the need has been established, if this is the case, and he's ending at age 3, you may want to consider just going straight to the school system so that you don't have too many transitions with who your son will work with in a short period. Or EI may be a really great jumping point to help you get your ducks in a row for after he turns 3. In any case, if you find yourself in a gap of time between early intervention and the public school, there are also private speech services available, (both covered by insurance and private-pay options). You can also find speech therapists through the American Speech-Language Hearing Association website: www.asha.org. The other place you will want to contact if you find out your son does indeed have a hearing loss is your state's school for the Deaf. They often have an Early Intervention program of their own specifically for children with a hearing loss which spans a bit larger of an age range than those offered by the county. In most cases you can be enrolled in both the county program and the program through the school for the Deaf. The school for the Deaf also typically offers programs like play groups, etc. This is especially great for children who use sign language.  

One last thought: You said, "Based on his current language skills its seems to be the agreeance of everyone, we all feel he legitimately is not ignoring, but really not focused or hearing."  There is also a condition called auditory neuropathy in which you can physically take in sound, but it doesn't get processed in your brain in the typical way. Some people describe this as "not being able to focus on the sounds you are hearing". If you find that his hearing tests come back normal, this may be something to look into. The treatment for this is different than that of a physiological hearing loss so it would be very important to distinguish which is the true diagnosis. I know this is a lot of information. Hopefully I didn't completely overwhelm you. There are several Moms of children with hearing loss on this board. Feel free to ask more questions as you learn more about what's going on. 

Assembly_Reqd

Hearing loss/ear tube Mommy chiming in Nate has mild-moderate hearing loss that is brought up to typical levels with hearing aids.

Another thing you need to take into consideration is your child's "listening age" If up until 10 months of age you son did not have complete access to sound then you need to adjust his actual age by 10 months when having expectations for speech & listening. So a 2 1/2 year old would be around a 20 month age range for speech & receptive expectations....If his hearing was greatly impacted by fluid he would have spent the first ten months of life listening to sounds as if he was underwater.

You got great info from MG.

I agree that you should just go ahead and get his hearing evaluated by a pediatric audiologist or pedi ENT. Nate's ENT, who practices in a large research/univeristy hospital, has an audiologist right down the hall. So we usually get a hearing test (we monitor Nate's hearing loss every 6 months) and then move on to our appointment.

How do you know the tubes are working? They could be clogged and fluid could have built up again behind them. Just because your child doesn't have an ear infection doesn't mean there isn't fluid build up. An audiologist will do a tympanogram (sp) to test that the ear canals are completely open and the ear drums are able to move.

Did the ENT who did the tubes do any followup with you?  Maybe you could start by calling them and they could point you in the right direction for further testing.

 

Assembly_Reqd

Here is our FAQ post about EI that may answer some of your questions too.....

https://community.thebump.com/cs/ks/forums/thread/66185155.aspx

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