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Don't think my daughter is processing what she is hearing

(31 Posts)
bishybashyboshy Mon 04-Feb-13 12:53:04

Right my daughter is currently at MS nursery and is having weekly meetings with a speech therapist due to delayed expressive language, she is on a program for this which both the school and I are working on with her. the thing is I am pretty sure she isn't processing everything she hears, Most of the time I can put her not hearing down to not wanting to hear smile, a lot going on at the time, coming down with or getting over a cold and ear infections. Then there are the times I can not put it down to anything eg. walking upstairs either next to me or behind me, if she isn't actually watching my mouth (She tends to really concentrate on my mouth when I am talking to her), if she is across the room she constantly mis-hears what I say. I have mentioned this to her therapist who said there was no evidence of it during her time with her but in all honesty my daughter is sat in a quiet room, face to face across a small table and if the therapist doesn't catch what she says she always looks to me for clarification. Well at our last session I made a point of not hearing what my daughter was saying so when the therapist looked towards me for guidance I just said I'm sorry I didn't get what she said blush felt like quite a fraud tbh, anyways there it was plain as day my daughter was just repeating the last few words that the therapist had said but wasn't realizing whether she was asking a question or giving a command. She has had her hearing checked and all is fine. Has anyone else experienced this with their child?

SallyBear Thu 07-Feb-13 18:20:15

KeepingOn. ToD is Teacher of the Deaf. I don't know the answer to your other question. DS4 is deaf and is non verbal Autistic. He is nearly 6 and has been in LA Special School since Summer term last year. We were in MS but we had a very good SALT who gave him a communication age of a 5-8mos old baby. This was all the evidence we needed to facilitate a transfer from MS to a Special School. We were able to name the one we wanted too, so we've been very lucky.
Have you spoken to the NDCS and the NAS about his problems. The NDCS have been particularly helpful to me in the past.

SallyBear Thu 07-Feb-13 18:11:40

Keepingon. ToD is a teacher

KeepOnKeepingOn1 Thu 07-Feb-13 08:44:41

Sally - forgive my ignorance, but was is ToD? DS1 was seen at GOSH in August last year but we have had no feedback or any support from his comm paed. He is currently out of school (since September) and we are going to tribunal in may and have named an indi SS (he also has SpLD and ASD). The LA have named mainstream but have made no provision in his statement relating to APD. Is there any other organisation that APDUK that could offer advice?

SallyBear Wed 06-Feb-13 18:36:10

KeepOn. Your poor DS. That made such depressing reading. Has the ToD come in and given training to all staff about Deaf Awareness and APD? I got mine to do that for my DD about her Conductive Hearing Loss and BAHA.

KeepOnKeepingOn1 Wed 06-Feb-13 17:04:29

DS1 has been to the APD clinic at GOSH. Reports are rather difficult to understand. eg DS1 is on the 5th percentile for understanding speech when there is background noise but this is actually more severe than you would think (given the 1-2% rule). Visit the APD website and phone the helpline. In the classroom this actually meant that DS1 only understood 5 words out of every 100 if he was really concentrating (which he quickly gave up on) and meant that he couldn't access the curriculum - he was relying on watching the other DC and trying to guess what he was supposed to be doing. Don't expect much in terms of intervention other than sitting at the front of the class. The clinic send out questionnaires to the school prior to the appointment - these indicated no problems whatsoever. Most teachers are unable to interpret the manifestions of APD.

moajab Wed 06-Feb-13 16:26:10

My DS has been at pre-school for nearly a year now and hasn't improved much. He does show better understanding and has increased his vocabulary. But still struggles with expressive language. He can't answer questions about, for example what he did at school that day or if he does he just answers with one of his 'stock' answers. He can say sentences but they tend to be sentences he's learnt parrot fashion.

As far as I know it is just an expressive language delay/disorder. His pre-school teacher thinks, and I agree, that his recpetive language is fine. And he is very able in terms of phonics and numbers. I'm pretty certain he doesn't have ASD or dyslexia. He has always enjoyed pre-school, but the pre-school takes children from age 2 1/2 so there are other children there at a similar stage of communication.

bishybashyboshy Wed 06-Feb-13 11:13:25

moajab my daughter is almost 4, I think she struggled a little to begin with, she really didn't want to go to nursery we had many a morning drama (although I'm not sure if this is because she has always been by my side since she was born or if it was because she was struggling with communication???)the school contacted her therapist when her teacher said she could not understand her most of the time and they have since been working with her which seems to be around the same time that she started to enjoy nursery more so like I say I'm not too sure if its just coincidence. When my daughter first began therapy she hadn't started nursery and I was reassured by the therapist and teacher that once she was amongst the other children she would pick everything up much quicker, she has now been there for 4 months (not very long I know) and I can't actually see much of a difference which is what is making me wonder if there is a little more to it than just being delayed in her expressive language.

moajab Tue 05-Feb-13 23:09:13

Thankyou Handywoman My DS sounds similar. He likes looking at books, but tends to be only interested in the letters or counting the number of birds in the picture. It's hard to say at the moment, but I think he will struggle with comprehension.

Bishybashyboshy How old is your DD? You say she's at nursery so I'm guessing she's a similar age to y DS (just turned 4) The more I read the more I think he has an expressive language delay/disorder. My main worry is how he's going to cope when he starts school in September.

bdaonion Tue 05-Feb-13 20:48:14

Bishybashyboshy - I'm not sure if what you wrote is indicative of the pure tone test only, what I think of as the standard test which my DD has passed with flying colours ( everytime they insist on freakin' testing it!!). You can always asked to be referred back for further testing if you suspect there may still be a 'hearing' issue.

Mummytomog - I suspect ADP can be hereditary as both my partner and his mum are very similar to DD too and the consultant was very interested in his history. There is a Mumsnetter called Dolfrog who is very knowledgeable about the condition if you search on his posts.

MummytoMog Tue 05-Feb-13 20:03:19

Are auditory processing disorders hereditary? Just that OH and I were talking about DD's latest delightful habit of screaming every time we talk loudly or over her head, and I said I wondered if her glue ear was clear at the moment so loud sounds were hurting her ears, and he said that he thought it was like that thing that he and his mum where they couldn't bear too many different sounds or conversations going on in the same space shock. This thing you've never mentioned? Even though we have a severely speech delayed child?

So I can happily listen to music while working or reading, or have the tv on while I read or have a conversation with someone. I did sort of know that OH was easily distracted, but I never noticed that he doesn't listen to music while he reads on the tube, or that he can't have the tv on while he reads. Huh. Anyway, is it worth mentioning this at DD's next audiology appointment? She's only three, and can't really participate very well during the hearing test, so not sure we could do anything to test it? Could I just have OH tested instead...

Handywoman Tue 05-Feb-13 17:19:39

moajab my dd2 (7yrs11months) is a great decoder (fabulous skills for reading and spelling words and is a quick reader) but has really quite poor reading comprehension. She had 'severe language difficulty' (ie not distinguished between delay/disorder.... there is still no consensus on definitions and distinctions as far as I know, someone correct me if I'm wrong) by aged 4.

Different sorts of language problems will impact on different literacy skills. Your first port of call will be to understand the profile of your ds language skills ie verbal and non verbal understanding and expression.

moajab Tue 05-Feb-13 16:58:54

Sorry, don't want to hijack this thread, but I have never heard of recpetive language disorder. But reading about it now (and also expressive language disorder) is ticking alot of boxes about my DS (aged 4). We are currently waiting for speech and language therapy, so no diagnosis yet. But when I mentioned it to his pre-school teacher she said that this is what she suspects. Can anyone tell me about their childrens phonic knowledge? Because my DS is very advanced for his age in phonics (knew all letter sounds from age 3 1/2 and can blend them together to read and spell simple words) Is this typical for receptive and expressive language disorders - that they can do the mechanics of language, but not the art IYSWIM!?

Anyway, sorry for the hijack and thank you for starting this thread - it's been a real lightbulb monent for my DS grin And sorry the therapist is being a twat! My DS watches TV, but also we spend loads of time chatting, playing and looking at books.

SallyBear Tue 05-Feb-13 16:08:21

Therapist is indeed a twat. Probably says more about her home life situation than she would like to admit Bishy.

Handywoman Tue 05-Feb-13 15:58:05

no it's not, the therapist is being a twat. there is more than one research study showing that normally hearing children born to 2 totally non hearing/non speaking parents are capable of developing normal language.

so the therapist is out of order in my opinion.

BeeMom Tue 05-Feb-13 15:18:04

No, I think it is the therapist being a twit... but that is just me.

bishybashyboshy Tue 05-Feb-13 14:47:27

BeeMom grin Will try this I just can not abide people making assumptions about our home life in fact there have been many times that I have wanted certain people to knip in for a brew so they can see what family life is actually like. It just really got my back up when she wrote on my daughters program that the TV MUST be turned off and had also made references towards us always watching tv at various times, and when I first mentioned that I don't think Tinybishy is taking in everything she hears she said make a note of when you think it happens especially when she goes to bed really late, which also hit a nerve as she is in bed between 6.30-7.00 most evenings unless she is really tired and then she asks me to take her to bed. Oh well maybe its just me being touchy. grin

BeeMom Tue 05-Feb-13 14:12:36

Bishy, chances are that the therapist is lazy assuming things about BittyBishy. Sadly, being sat in front of a TV all day CAN lead to an expressive language delay, as the interactive give and take of conversation is absent and the children don't have ample opportunity to practice these skills.

With that in mind, expressive delays are not always caused by this, and to have painted BittyBishy with this brush does her a massive disservice. Tell the therapist to sod off that you have eliminated all TV save for whatever educational show the therapist likes but don't make any changes at all and then see what she says.

bishybashyboshy Tue 05-Feb-13 12:35:38

Hello bdaonion my daughter was discharged from the audiologist after the initial appointment. I have just dug out her report (after A LOT of digging indeed, I am the queen of organized kaos grin) and this is what it says if it helps;

Tinybishy was assessed using play audiometry in the soundfield with warble tones. Reliable and repeatable responses were obtained at the following frequencies and levels:

Frequency kHz/overall hearing levels dB HL
0.5/20
1/20
2/20
4/20

Speech discrimination was assessed using the Manchester picture test a score of 100% was obtained at a level of 40 dB A

CLINICAL FINDINGS: Otoscopy: Obscured by a small amount of soft wax bilaterally.
Tympanometry(guess this was the print out of the sound waves then?): within normal limits bilaterally

CONCLUSION: Todays assessment indicates good overall hearing down to quiet levels across a range of frequencies and her ears are healthy with no signs of glue ear.

And can I please ask why after it was mentioned that my daughter had an expressive language delay, her therapist suddenley had the opinion that my child spends all of her time sat in front of the TV??? We limit our TV time because we prefer to spend time talking to our children not watching them watch TV, TBH I find it quite insulting when this assumption is made. Sorry just wanted to mention that. blush

bdaonion Tue 05-Feb-13 11:59:21

We have just started the assessment for ADP with GOSH. My DD was diagnsed with a receptive language disorder when she was 3 and always performed better in quieter environments. Same as your son bishybashyboshy, she struggles in a classroom environment, but don't try to have a private conversation with her in the house!! grin

She has always passed her pure tone hearing tests, but during the first appointment at GOSH, the audiologist performed a very simple test of her acoustic reflexes (how her ears react to increasing sound) and they have identified a possible issue with her auditory nerve. We have to go back for further testing in April, but I was quite frustrated that no one had bothered to test this during the last three years.

Might be worth asking the audiologist for an acoustic reflex test too.

bishybashyboshy Tue 05-Feb-13 11:15:29

Thankyou BeeMom, ok so maybe it wasn't an audiogram grin see I am terrible!. My daughter is very similar to my son with this and he has also had his hearing tested (although not with an audiologist) which all came back fine, I also took him to the GP and he said there were no signs of glue ear etc so that was that, when we got his SATS results last year he was average for everything but way below average for speaking/listening. He has always complained that when in the classroom he can't hear what the teacher is saying (although the teacher insists that the noise level is acceptable) yet when he is at home he can hear a very very private quiet discussion which his dad and myself have had in another room hmm. TBH for many years we thought it was very much selective and we also thought the same for our daughter. Sadly my daughter is not as good at telling me things due to her expressive language delay so I will just have to get some evidence together and go from there.

BeeMom Tue 05-Feb-13 00:07:00

I am glad I could contribute. For the longest time, we thought DS had a hearing impairment (he did test with a mild 25 dB one for ages, and had an FM soundfield in his classroom for years). It was not until we went to see a new audiologist after we moved that this was uncovered.

The more she explained it to me, the more I realised I have the same issue... my hearing is fine, in a quiet house I can hear Bee pass wind in her bedroom from downstairs in the lounge, but hearing the kids talk while we are out driving and DH has the radio on - I am hopeless. I can hear their voices, but can't make out what they are saying for love or money.

SallyBear Mon 04-Feb-13 14:05:32

BeeMom, I've not seen that explained that way before. Very helpful. Having two deaf children already, my eldest son has apparently perfect hearing, yet his left ear has always had repeated infections and is "dull and scarred". Audiology test was fine, yet his hearing is very up and down. I think it's more to do with CAP than glue. I will ask again. Thank for that! grin

BeeMom Mon 04-Feb-13 13:41:56

My DS had auditory processing testing done that uncovered a central auditory processing deficit - and it presents exactly as you describe (including the fact that symptoms are lessened or eliminated in a quiet environment. He also had a history of glue ear and infections, but never had grommets. By the time we knew he had an infection, his eardrum had ruptured (and it happened repeatedly).

With that in mind, central auditory processing deficits can be improved or corrected if they are caught early and therapy is started. Unfortunately, his wasn't finally found until he was 12, and what isn't dealt with by 12 or 13 usually won't improve much (the pathways solidify about this age).

If you can get her in for an audiogram, ask specifically about "Central Auditory Processing" problems. The testing is done with background noise coming through one side of a pair of headphones, while the sound they need to attend to comes from the other side... it was very enlightening for us. It will also determine if she has a "better" side (faster processing if the sound comes from one side vs. the other) which has helped DS immensely in the classroom.

SallyBear Mon 04-Feb-13 13:33:24

The test your dd had was tympanometry test. Tympanometry is not a test of hearing; it is used to check how well the moving parts of the middle ear are working. A small earpiece is held gently in the ear canal. A pump causes the pressure of the air in the ear canal to change. The eardrum should move freely in and out with the change in pressure. The earpiece measures this by checking the sound reflected by the eardrum. If the eardrum is not moving freely, there is likely to be some fluid or another problem with the middle ear. This build-up of fluid is usually glue ear (or otitis media). Glue ear can cause temporary conductive deafness.

Can I suggest that you look on the NDCS website, its very helpful and will explain hearing loss etc very clearly. here

bishybashyboshy Mon 04-Feb-13 13:24:42

Thanks salondon that's what it was....an audiogram!! grin I have the worlds worst memory blush. ok thank you again, I would of just had a surf but I would probably end up getting into my stressy pants over nothing smile

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