Glue ear and SALT questions

[used2bthin]

Sorry I have had threads which are similar to this but am aware that I need to push for things with DD (she already has medical issues so I am very used to that).

DD has glue ear and possible underlying deafness in one ear. We've got an appointment this week to discuss options (probably grommets and hearing aid). She's been having SALT for almost a year but not very often. The SALT has said leave it till her hearing problems are sorted. I can see her point but feel this is unfair as DD still needs help (especially as the SALT also felt she could have weak muscles in her jaw which mean she can't make sounds properly)and the heaing issues may not be sorted for months if they are at all!

We have got the nurse coming out this week too to talk about DDs over all development so I will bring it up with her but I just wondered how reasonable it was to stop SALT for the time being? I rang the SALT again to say I was worried it could be a long wait and all she said was call after thr appointment when there was a plan-I got the impression she wasn't about to change her mind though.

So my questions about that were-is it normal practice not to have SALT if there is a hearing problem? Would it really be pointless? Also how likely is it that DDs hearing problems could be affecting the way she says words-train is said as bain for instance.

Finally, DD has pulled at her ears so much at the weekend that they are bleeding inside (but not FROM inside iykwim), she seems to have a lot of wax and has shouted about her ear a lot whilst grabbing them. Glue ear related? She could be hearing funny noises due to glue ear? Infection?

I know there are a lot of questions there but answers or suggestions for any of them would be greatly appreciated, I am a bit anxious about it all and over whelmed as I feel I have just got to grips with her genetic condition and now having to learn about something new.

Used3bthin my youngest had johansen sound therapy. Although she passed the NHS hearing test in the lowest and higher frequencies her hearing was reduced more around 30 decibels rather than the 10 you would expect for a young child.

She talked like a hearing impaired child only saying the middle part of the words when she spoke - it was very difficult to understand her. Although the johansen sound therapy wasn't cheap the results have been quick and fantastic

here is some more info www.soundlearningsystems.co.uk/id13.html so much of hearing (and therefore speech) is to do with auditory processing is this is what it helps improve.

At the 2 highest frequencies they measure dds hearing in one ear has gone from 40 & 45 decibels (ie hearing impaired) to exactly where it should be in less than 6 months. As a result her speech is rapidly improving too after just one lot of speech therapy (6 sessions)

Was that for ENT? We didn't even get as far as being referred. The audiology one was urgent, sent through by the community paeds and that came through within three weeks so not too bad. I'm just not sure what the point was as all theydid weas a repeat hearing test and glue ear tests, same as the community ones. They said thier waiting lists are never more than a month. I was under te impression that we were going to discuss grommets but no!

My older dd who had repeated glue ear only got referred to ENT when she massively failed 2 community hearing tests in a row. At the ENT appt she was immediately put forward for grommits. She had 18 months of mixed result hearing tests before the 2 she failed though.

My youngest dd passed the community one, not even recalled as they don't consider it a problem unless the hearing is at 40 decibels or higher. For learning to talk though it was seem that having "poor" hearing like my dd has so 50% of the frequencies being unheard until over 20 decibels was enough to cause her massive speech problems.

u2bt yes, we were referred by local GP to ENT. Urgent Schmurgent

Lucky you chased it up then busybutterfly, often the way I find, scary to think that its so necessary though isn't it.

Cargirl did your youngest Dd have speech problems too? My dd was found yto be hearing only 40decebels and more the second test, then only above 50 the third. But this last one they just said her hearing is fine and didnt elaborate(different department for some reason). It is all very confusing and her speech has ebeen badly affected.

Sorry I hope this makes sense, am on all sorts of painkillers for a bad back and in fact should come off here now as it makes it worse.

Hearing in a young child should be around 10 decibels so more than 10 is not good.

40 decibels is considered to be hearing impaired.

The pitch of the sounds is the frequency so my dd had good hearing in the middle 25% of frequencies, not so good at the lower frequencies and very poor hearing (but not bad enough to be considered hearing impaired by NHS and get follow up) at the highest 50% of frequencies.

Yes she had very poor speech.

At 2.10 her SALT assessment was advanced language skills (she was chatting away in long complicated sentences with amazing imaginative play etc) but moderate speech delay - it was a struggle to understand individual words and even harder when put into sentences.

8.5 months later there had been no improvement in her speech and she was then considered old enough to have the kind of speech therapy she needed.

That is interesting to hear cargirl, how is she getting on now? My DD had a developmental check on thus and was found to be playing apprpriately for her age , her language is behind but speech very much affected, what she does say is very hard to understand.

I have definately noticed with DD that she can hear some seemingly quite quiet nises but then not understand someone talking even when she is concentrating, must be the pitch. Her concentration is also poor though, understandably if she can't hear clearly.

Just realised what I meant to say masoniccpixi earlier is that I have given up taking dd swimming for now but wonder if the ear protectors ould stop water getting in her ears and causing problems?Or similar, ear plugs? maybe she's too young?

She is getting on really well.

All the new words she learns are very clear but it's a long hard slog relearning all the old words.

Her speech therapy (6 sessions) were for her to learn 'S' & 'F' which she used to substitute with "d". We still need to learn "Z" "V" "Y" and a few others I guess! It was all the high frequency sounds that she couldn't pronounce at all.

The brain is like a sponge and if you look at the link on johansen it can help with understanding as well speech issues.

Ive seen all of dds hearing results from the johansen therapist. At first her "curve" was pretty much a horizontal line and it's is now aligned to where it would be in a child/person with "perfect" hearing. Johansen just makes the brain exercise/expand so much of hearing and language is to do with auditory processing rather than physical problems.

The chronic glue ear causes the brain to "forget" how to hear, the glue ear clears up - the brain learns how to "hear" again and then the child gets glue ear again and the brain stops "hearing" - it's a long cycle because they can have hearing problems even when the glue ear is not there. It's also possible that your dd has auditory processing issues in addition to glue ear.

Is she left or right handed or ambidextrous?

That is brilliant that your DD is doing so well. We were due to start work on speech sounds as her language had progressed enough (when we started SALT she had gone from an early ish talker to only using one sound for everything)but the SALTwanted to waittill the hearing was sorted.

That is funny that you ask about her hand preferance becaus eth enurse asked and seemed surprised that I didnt know. I've been watching her since and she doesn't seem to have a definate preference yet,

cargirl sorry I had x posted with ypu so only just saw your link. Thank you I will read that properly when I am more with it, its not something I have heard of.

Well that could be signifcant as dd only chose to be left handed about the age of 3 and even past that if the colour she wanted to use was on the right hand side she would paint/colour with the right hand.

I was told that until 12 months the brain of a child is predominately using one hemisphere (can't remember which ) which is why they respond to touch, comfort etc etc. Then around 12 months it switches over the other hemisphere. He said that dds had got stuck and not moved over fully which could well be the reason why she is/was ambi for so long. Even now at 4 she will often do things right handed IYSWIM.

Sorry for disappearing. Have been dealing with 'first days at school', etc so only been dipping in and out quickley since last week.

U2bt, I used to work with an OT who did Johansen Sound Therapy, mostly with children on the autistic spectrum. She, obviously, was very pro-it in terms of it's results.

I don't know much about it but if you look here there is a list of practitioners and many of them are slts, so it might be worth thinking about.

From memory of where you live, it looks as though there are a couple of people in your area. Perhaps give them a call and discuss it with them, see if you get a feel about it and, most importantly, how much it costs(!).

Have you had a chance to speak to your slt again since dd's audiology appointment? At least now you can push for some input and mention that you would like to do as much as possible before the winter in case her hearing is affected again by glue ear.

If you really feel that she does not know what direction to go i with dd, it might be worth asking if there would be any benefit from a second/specialist opinion from someone else within the department (when I worked, community therapists could bring in specialists to give another opinion or even just to discuss the case with). How experienced do you think the slt is?

Hope your back is better.

Hi sorry I left the messages unanswered, I was put on valium for my back and the last few days have been a blur!

DHT I hope the back to school stuff went well
I heard back from the SALT and will see her in October, she wanted to do an intense few weeks of work on beginnings of words and sounds last time we saw her but then didn't do it due to the glue ear so I woder if she will pick up where she left off. I do feel that she has offered me lots of different explanations for DDs problems and that she finds DD a bit puzzling but am unsure if thats her or whether it is because DD has in fact got a lot of different issues iyswim.

DD only seems to hear the middle of words , the auditory processing stuff coul be relevant? She used to say hoover perfectly and now says bitver, she uses the same for a friend because her name has a v in it. She seems to hear Laura and Florence as the same word/name and says rora for both so its as if she is just hearing the middle of them. Hmm!