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Hearing Loss in Children

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About 2 to 3 out of every 1,000 children in the United States are born with a detectable level of hearing loss in one or both ears! Hearing loss can occur gradually over time and parents may not even realize their children have it. Children may simply adjust to the changes in their hearing and not realize they are missing out on important speech sounds and words. 

What is a hearing screening? 

Pediatric Audiology 101: Your Child's Hearing Health

A hearing screening is frequently used to check a person’s ability to detect the loudness and pitch of sounds. You can either “pass” or “fail” the screening. If your child passes and there are no other concerns, then you can continue with your child’s regularly scheduled hearing screenings. If your child “fails”, or if you have other concerns about their hearing, then an appointment for more in-depth testing may be necessary to see if there is a hearing loss and what treatment options are best to help support your child. These hearing screenings can help identify people who may need a more thorough hearing evaluation that can be completed by medical personnel such as ENTs or audiologists. Pediatric hearing screenings may take place in early intervention, school audiology, medical, and/or home settings. 

How can I tell if my child has hearing loss? 

  • Difficulty recognizing familiar voices
  • Delayed or absent speech sounds (not making cooing noises, babbling less, few words, distorted speech sounds, etc.)
  • Not turning head toward interesting or startling sounds
  • Delayed language (difficulty understanding simple words, following directions, etc.)
  • Delayed or absent emergence of first words as by two years old children should start combining words into 2-word phrases)
  • If child is older, they may frequently asks others to repeat themselves for clarification
  • Child is speaking louder than others
  • Lack of attention to others, conversations, environmental surroundings
  • Struggles with academics

 

What causes hearing loss in young children? 

  • Frequent ear infections (otitis media; most common)
  • Measles or meningitis
  • Head injuries
  • Exposure to loud noises 
  • Genetic disorders

Interesting Fact… 5/6 children experience ear infections (otitis media) by the time they are 3 years old!

 

What should I do if I suspect my child has hearing loss? 

If you suspect your child has hearing loss, speak with your healthcare provider and discuss your child’s current hearing abilities and address your concerns if you suspect signs of hearing difficulties at home. Early hearing detection and a formal evaluation completed by an audiologist, ENT and/or other qualified medical professional can help determine specific needs and appropriate treatment goals to further support your child’s success. It is important to regularly check on your child’s hearing health to monitor potential changes in hearing!

 

How can Speech therapy help?

Speech-Language Pathologists can play a role in your child’s hearing health by completing hearing screenings as a part of a formal speech and language assessment. If your child does not pass a hearing screening completed by the Speech-Language Pathologist, then a referral will be made for further evaluation with audiological/medical professionals to provide the best of care to your little one. Language acquisition is an essential component of your child’s overall development. Significant hearing loss, if undetected early, can lead to a speech and language delay, further putting your child at risk of falling behind same-aged peers. Given that our hearing plays a significant role in living our daily lives, it is crucial to have your child’s hearing formally evaluated at key milestones, beginning at birth to help lead them to better speech, language, and educational outcomes in the future!

Schedule a screening at Carolina Therapy Connection today!

 

Blog By: Lindsey Bryant, SLP

What is AAC?

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AAC stands for Augmentative and Alternative Communication. It encompasses all of the ways in which an individual may communicate outside of speaking verbally. Augmentative communication means to add to someone’s existing speech skills, and alternative means to be used in place of verbal speech. There are many different kinds of AAC including, but not limited to: gestures, facial expressions, writing, pictures symbols (e.g., picture exchange communication system/ PECS), drawing, sign language, high-tech speech generating devices, communication boards, etc. Some people may use one of these modalities, and some may use multiple modalities depending on the way in which they can most quickly and clearly communicate the topic.

Who Needs AAC?

Many different people use AAC throughout their lifetime. It can be used across the lifespan by any age, at any time, and for a variety of different reasons. Some people use AAC for their entire life, and some use it for only a short period of time. AAC can help any person who has difficulty fully or partially meeting their daily communication needs such as expressing wants and needs, socializing, asking questions, and a variety of other functions.

 

 

How can AAC help your child?

AAC may be able to help your child if they have difficulty being understood by others, have a limited vocabulary, demonstrate limited spontaneous speech, are non-speaking, and a variety of other different reasons. There are no prerequisite skills to your child beginning to use AAC. One common misconception is that AAC will hinder language development or cause your child to become dependent on it for communication. While some children may have minimal to no verbal speech throughout their lifetime, there is research to show that AAC can actually help children to develop language. Using AAC can also help to reduce frustration surrounding communication attempts, and help your child to communicate their needs more clearly, quickly, and effectively.

 

 

Parent’s Role in AAC

When introducing AAC to your child, it is important for family members/ caregivers to make the commitment to help the child succeed with the chosen AAC device. Your input is crucial in helping to choose and develop an appropriate AAC system, and using the device at home and in the community is a vital step to help both you and the child continue to learn the system. According to Jane Korsten, SLP, the average 18-month-old has been exposed to 4,380 hours of oral language at a rate of 8 hours/ day from birth. A child who has a communication system (AAC) and receives speech/language therapy 2 times/week for 20-30 minutes will reach the same amount of language exposure (in their AAC language) in 84 years. It is our role as professionals and caregivers to help minimize the communication gap between oral language users and AAC users. 

Modeling:  Modeling is an awesome way to both learn your child’s AAC system, and teach them an example of how they can use it. The best way to model is to speak and use the system at the same time, although you do not always have to select an icon for every word you say. For example, you may verbally say “time to go to school” while modeling “go” and “school” on the AAC system. A general rule of thumb is to model the number of icons your child is currently using, plus one. If your child uses 1 icon at a time, you may choose to model 1-2 icons at this time. It is important to model without expectation, meaning that you use the AAC system without expecting or requiring the child to respond, withholding items or activities, or “testing” their skills. The goal is to provide an example to the AAC learner, which they will then learn by watching and listening to what you do/say.

 

How can CTC help you and your child?

Whether your child is already receiving speech/language therapy services at our clinic or not, CTC is ready to help support both parents and children through their own individual journey with Augmentative and Alternative Communication. If you believe that your child may benefit from the use of AAC, talk to one of our many incredible speech-language pathologists to begin the process of figuring out what type of system (no tech, low-tech, mid-tech, high-tech) will work best. This process can take time, but with your support and the support of your SLP, it is possible to find the right system for your child! 

Down Syndrome Awareness Month!

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October is filled with so many exciting things, the start of fall weather and holidays approaching; but did you know that October is also Down Syndrome Awareness Month? Established for over 40 years, it is a time to recognize and celebrate our friends with Down Syndrome and the amazing abilities they have!

 

What is Down Syndrome?

Down Syndrome is often called Trisomy 21, though there are actually three types: trisomy 21 (nondisjunction) which makes up 95% of cases, translocation (4%), and mosaicism (1%). It occurs in approximately 1 out of every 691 births, and more than 400,000 people are living with Down syndrome in the United States. These individuals are born with an extra copy of the 21st chromosome. They are able to work, go to school, develop meaningful relationships, make their own decisions, and participate in society however they wish! According to the National Down Syndrome Society, “Quality educational programs, a stimulating home environment, good health care, and positive support from family, friends, and the community enable people with Down Syndrome to lead fulfilling and productive lives.”

 

You are welcomed here!

Here at Carolina Therapy Connection, we are honored to serve our families who have children with Down Syndrome! One of our special friends, Hannah Hill, has made tremendous progress in her therapy. Her mother stated, “Because Hannah is very verbal, people often ask me if she has a ‘mild’ case of Down Syndrome. It’s not commonly known that there is no ‘spectrum’ of Down Syndrome! You either have it or you don’t! While the extra chromosome does impact their lives, people with Down Syndrome are unique, and have their own strengths and weaknesses. They have physical features, personality traits, abilities, challenges, interests, successes, and failures just like everyone else!”  

Hannah: Age 8

 

How can therapy help?

  • Speech therapy services provided by a speech-language pathologist reap great benefits. Many children with Down syndrome develop language later than same-age peers. Low muscle tone could also impact the ability to produce speech sounds accurately, and therapy is paramount to helping a child develop the ability to confidently and effectively communicate their thoughts, feelings, wants, and needs. SLPs can provide assistance with prelinguistic and oral-motor skills, as well!
  • Physical therapy can help a child with Down Syndrome starting at a young age to increase strength and gross motor development. From rolling and sitting, to developing an efficient walking pattern, and even participating in sports, physical therapy can make a huge difference in a child’s life. In a physical therapy session, our PT’s will focus on things such as: gross and fine motor development, balance, coordination, and age-appropriate daily living skills. 
  • Occupational therapy can assist people with Down Syndrome in learning to complete many everyday tasks. Occupational therapy will provide support specifically in three areas, motor, cognitive, and sensory integration. Specifically, an occupational therapy session may include activities that promote self-care, fine motor, play, and social skills!

 

A Total Communication Approach 

Many parents are excited to begin therapy and learn ways to promote and enhance communication for their children. According to our colleagues at the Boston Children’s Hospital Down Syndrome Program, a Total Communication Approach can be beneficial! The Total Communication Approach means using any functional means of communication; this could include: verbal speech, ASL, gestures, pictures, and/or simple or high-tech communication devices. Many children with Down syndrome are visual processors, and the goal of Total Communication is multi-sensory (i.e., visual, auditory, tactile, etc.) in order to encourage any form of expression. What are some ways to facilitate this approach at home?

  • Visual input: Pointing to objects and pictures that you are naming or describing. 
  • Use sign language for basic words (eat, want, bath, play, etc.). Research shows using signs increases understanding and offers an additional method for communication. 
  • Incorporate music into pretend play.
  • Joint book reading. Follow your child’s lead!

 

How can Carolina Therapy Connection help?

Children with Down Syndrome often benefit from therapy from skilled professionals, including speech-language pathologists, occupational therapists, and physical therapists. At Carolina Therapy Connection, our treatment is highly individualized to your child’s needs. A standardized assessment will be administered to detect any delays, and our therapists will work with you and your child to develop a plan for enhancing skills to  build confidence across all social environments (home, school, social groups, etc). If you have any concerns or questions regarding your child’s development, call our clinic at (252) 341-9944.

By Ashley Holloway, MS, CCC-SLP, CAS

Is My Child Ready For Potty Training?

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Is My Child Ready For Potty Training?

Many parents ask the question, “Is my child ready for potty training?” Making the transition out of diapers is an important developmental milestone but it can also be a topic that causes frustration and anxiety for both children and their caregivers. Questions about when to start and how to promote a child’s success with potty training can feel overwhelming. If you are a caregiver that can relate to any of those feelings, this blog post is for you!

When Should I Start Potty Training?

This is a question that many caregivers ask themselves. A variety of factors must be considered before initiating the toilet training process. A child must be physically, emotionally, cognitively, and physiologically ready prior to  starting the process. Here are some tips to identify whether your child may be ready:

Emotional readiness – Can your child tolerate sitting on the toilet or potty training seat? Are they excited about wearing “big kid” underwear?

Cognitive readiness: Can your child follow 1-2 step directions? Can they communicate their need to use the restroom?

Physiological readiness: Are they able to stay dry up to two hours at a time or wake up from a nap with a clean pull-up?

Physical readiness: Is your child able to sit on a toilet or potty training seat without assistance? Can they get on and off the toilet with little to no assistance? Can they assist with managing their clothing during toileting tasks?

potty training, occupational therapy, tips and tricks of potty training

If you have said yes to the majority of the above questions, then your child may be ready to begin potty training! 

At what age can I expect my child to start potty training?

 The following list includes general guidelines to help establish a baseline of where a child might be on their journey towards potty training. However, each child has a different timeline in which they are emotionally, physically, cognitively, and physiologically ready for potty training. It is vital that you never push a child towards progressing through the developmental sequence. If you see meltdowns or signs of regression, it may be best to take a break and try again at a later time.

 

Developmental Sequence for Toileting:

1 year – Children indicate that they are wet/soiled through non-verbal signs of distress

2 years – Child begins to tolerate sitting on the toilet

30 months – Child communicates that they need to use the bathroom and will likely require assistance with managing their clothing and wiping

3 years – Children will initiate using the toilet independently. They may attempt to wipe but continue to require assistance for thoroughness. 

4-4.5 years – Children may have a few accidents. They are able to manage their clothing independently. 

5 years – Child is able to complete a full toilet routine independently, including washing and drying their hands. 

5-7 years – Children are consistently able to stay dry throughout the night. 

 

Tips to Help Progress Through the Potty Training Process

  • Make potty training FUN!

Whether it is the sound of the toilet flushing or the new environment, some children may have a fear of sitting on the toilet. If a child is anxious, they may be hesitant to sit on the toilet or may not even tolerate sitting on it. One method to help ease this transition is to allow the child to play with their favorite toys while sitting fully clothed on the toilet. Another method to make potty training fun is to invite the child into the process. You can do this by allowing the child to pick out their underwear and ask them to choose their potty seat. This helps address their newfound need for autonomy and allows them to take pride in the potty training process. 

  • Consistency is key. 

Establishing a consistent routine will help minimize a child’s accidents and increase their likelihood of using the toilet successfully. A general guideline is to prompt the child to sit on the toilet as soon as they wake up, after naps, and in two hour intervals throughout the day. Encourage your child to sit on the toilet for a few minutes at a time. It can be helpful to read a story to them while on the toilet or provide them with a preferred toy to make this time fun and engaging.

  • Know the signs. 

If a child is squatting, holding their genital area, or fidgeting, they may need to use the bathroom. Prompt the child to sit on the toilet when these signs occur. This can help the child become familiar with these signals to increase their ability to identify these signs as well. 

  • Celebrate the small victories. 

It is important that parents and caregivers build up a child’s confidence and self-efficacy during the potty training process. Caregivers can do this by providing their child with positive praise and celebrating the small victories! Some examples of this include praising their child for sitting on the toilet, communicating that they need to use the bathroom, successfully using the toilet, and completing all other steps in the toileting sequence (ex. Pulling up their pants, flushing the toilet, washing their hands). Sticker charts can also help motivate children to use the bathroom by providing them with a tangible reward to work towards!

  • Know there will be accidents. 

In combination with Point 4 above, it is important to know that accidents will happen and how to respond when they do. Never punish a child for soiling their clothing. Instead, always be prepared with an extra set of underwear or clothing, especially when going out in the community. 

You can find more tips on the potty training process here!

 

How can Carolina Therapy Connection Help?

If your kiddo struggles with self-regulation, completing their daily activities, or meeting developmental milestones, call our clinic at (252) 341-9944! Your child may benefit from an occupational therapy screening or formal evaluation!

Blog By: Emily Britt, OT