Grommets, hearing loss and speech problems

[adoptmama]

DD2 is almost 3 and her speech is awful. I am waiting for an assessment from a speech therapist re delay versus speech disorder (such as verbal dsypraxia). In the meantime the hearing test has come back with hearing loss caused by fluid build up in both ears and she is due to have surgery to fit grommets. From what I have read it is very possible that full hearing will be restored after this, so I am very positive about this. I'm also aware that it is possible that, given the potential long standing nature of her difficulties, there could be a degree of permanent damage. However I am optimistic regarding the outcome for her.

I am wondering if there is any point going forward with speech therapy before she has the surgery of if I should just wait and see if her speech improves as her hearing does. Is there any point in having ST if she cannot hear clearly what the therapist is doing, or is any early intervention going to be positive regardless? Should I focus on adding to her sign language vocabulary? Mix the approach? Presumably her hearing loss is not that severe - hospital have not really given me any info on the degree of loss but she can mimic some sounds, hears if I whisper in her ear etc, so would speech therapy help her in the meantime (3 months till surgery)? I'm not in the UK so I don't have to worry about waiting lists etc: I can access the speech therapy immediately if I wish.

Does anyone have any experience of similar situations, advice etc? Thanks in advance

Hello, yes! we've been, and kind of still are, in a similar situation.

All 3 ds's have had glue ear, ds1's picked up late once in School (although no speech delay has just been referred to SALT at 6 yrs) Its lead to no end of difficulty so its great you are picking this up before School!

Our experience was first 2 ds's had grommets within 4 months of each other - once one was picked up we saw the 'issue' if you have 3 non hearing children you don't really get its not 'normal'! ds3's 2yr check with HV was just after ds2 (3) had his grommets, HV flagged up his unclear speech and wanted to refer to SALT we held off because we felt we needed to check his hearing first. Had a hearing test 2 months later and was bad (40db - normal hearing 0-20db) and he was referred to ENT consultant (we've been very lucky to have the same consultant for all 3 boys) and put on waiting list for grommets - it was 6 weeks from seeing consultant to having grommets as day op. Why do you have to wait 3 months for your dd?

I would recommend understanding the degree of your dd's hearing loss/impairment Understanding Hearing tests - some people have also used hearing aids rather than surgery so thats always an option to explore if you do have a long wait (3 months sounds long to me, ds1 and ds3 was 6 weeks after seeing consultant, ds2 was private and done the next week).

The difference in hearing was profound for all of them once they had grommets - ds3's speech has improved immeasurably. He has been seen a couple of times last year for drop in SALT clinic so 'they can keep an eye on him' but not received therapy as he was making good progress and well supported at nursery.
I've just today asked for him to be seen again as I feel his speech has stalled and as he starts School in September I would like him to be on the waiting list for therapy now if he needs it.

If you get in the SALT system now they may well monitor as they have my ds and you get a 'direct line' back into the system (like I have today!) if she needs therapy at any point - I can't see any harm in doing both together. I know you said you are not in the UK so I'm thinking more it would be good to make contact now and get advice.

This link for NICE guidelines explain what to expect if you decide to go for grommets in the UK - where are you?

The NCDS is a great source of information and they take glue ear seriously.

Does dd go to nursery? they need to know of her difficulty and understand how to support her (this was really inportant to us as ds is in childcare 4 days a week) I give this leaflet on Guidance for teachers to EVERYONE even my parents and in-laws have a copy

We also did babysigning (not realising that they would all have glue ear!) but I truely believe it was a blessing, ds has unclear speech but he can communicate very well and it relieves his frustration. I believe signing supports language development - its important to understand speech and language are different.

Wow incywiny you really do know your stuff. i didnt realise (until i reasearched) how much of an affect glue ear has on childrens developmemt. Not one of the doctors ever explained to me what it does. I joined the ndcs website and it was really useful. Big I definitely think there should be more open information and awareness of glue ear for everyone including teachers. You have the right idea with the leaflet.
My daughter had glue ear from 18months old. She had grommets in February (she was 4 in may) she had mild hearing loss, and also had an aid in her right ear before I made them do the grommets. (Had to push a great deal to get it done as they like to do "watchful waiting" to see if they outgrow it.
Anyway speech is still unclear, before grommets she could have only been hearing the middle of words, now her speech had come on a great deal, although still not up to 4 yr level. Paid for private therapy in march 6 x 1 hour weekly sessions, and was shocked at the improvement. She came to do a review and said now. At 3-3.5 yr level.
Would definitely get as much done before starting nursery if possible. My daughter used to watch mr tumble ad a baby and when she started nursery teacher was surprised when my daughter naturally did some if the signs, think it helped a little in understanding bits, but that was just from watching t v, if you are already doing sign, I would still keep doing it, and also go for the speech therapy now, even though there is a heating loss it is not a complete loss and I going that mg daughter could actually hear the all the sounds when being tested but they just needed to be louder.,

Thanks so much for the links to both sites and your advice. Very helpful indeed and I have given a copy to the nursery teachers too.

My dd2 had grommets last year at just over 3 yo - the change in her hearing and speech was just miraculous. She had actually been referred to have her adenoids and tonsils out and they did a hearing test and discovered that she had considerably reduced hearing in both ears, so they put the grommets in as part of the same op. We really hadn't noticed that the problem was so pronounced, even though our DD1 has normal hearing - we just put it down to one child developing differently from the other.

The very next morning she spoke to me on the phone - something which she had never done before! We had always assumed that she just wasn't interested in phone calls in the way that small children aren't, but it turned out she had never realised there was someone on the other end of the call.

I am still considering asking for a speech therapy referral as she still has a very pronounced lisp and can't form some sounds at all, which is fine now (and in fact very cute!) but I can see it becoming a problem when she starts school in September. But really her vocabularly is just unrecognisable, as is her ability to form long sentences. It is a bit like she has woken up from a long dream!

I hope it all works out well for your DD2 - if you are positive that you want the grommets then push to have them done asap, the sooner the better.

I'd def go for the salt now, so that you are in the system. Are you encouraging her to look at you when you speak, too? That is the main thing that I would advise.

Fingers crossed for her that the op restores full hearing for her!

I'm hearing impaired, had gromits too, but my hearing is a nerve issue, so can't be 'fixed'. That link is brilliant that incywincy shared! I'm keeping that to explain to dh when he gets ratty on the rare occassion he has to repeat something 5 times

My loss varies between 40-60 decibles depending on pitch. I should wear hearing aids but don't, and I lipread. My speech was also awful, though I never did have salt input and by the time I got to 10-12 years, it was normal.