Several years ago, while working as an educational audiologist in southwest Michigan, I received a list of students from our very own Pat Rivard requesting audiology testing. My position was new and we had just obtained a soundbooth. Pat came to us as a school psychologist, previously employed in Oakland County where he worked closely with a dynamic team of educational audiologists. After some discussion with our speech pathologists (up to this point, all audiology referrals were first screened by an educational speech pathologist), it was decided to move ahead with these referrals and thus began a magnificent partnership.
Six audiograms later and 50% of these referrals were identified with medically correctable hearing losses. The students ranged in ages from 7 to 15. In each case, the hearing loss was mild or minimal, barely noticeable. In at least one instance, the student later underwent middle ear reconstructive surgery for a condition that would have progressed in severity if left unattended. A hearing loss of this degree may be missed on a hearing screening. The students did not receive speech services and were not being considered for speech. What they all shared in common were reading difficulties.
When it comes to hearing loss, labels are arbitrary, as the functional impact of a ‘mild’ hearing loss is anything but mild. Children with mild degrees of hearing loss will have difficulty hearing faint or distant speech, particularly in noise. Speech may sound distorted and words and concepts will be heard inconsistently, placing an extra burden on understanding instruction and learning new vocabulary. The student will miss subtle conversational cues and have difficulty following fast paced peer interactions, resulting in occasional inappropriate or awkward responses and thus impacting self esteem. The additional effort required to understand what others are saying, results in fatigue as the day progresses.
Studies indicate that as many as 30% of children who qualify as learning disabled have a history of middle ear involvement which resulted in some degree of hearing loss. Because of auditory deprivation, many of these children have additional difficulty processing auditory information. In the September 2010 issue of the ASHA Leader, Nina Kraus and Jane Hornickel reported on two studies of poor readers and summarized that both studies “revealed that poor readers had impaired (auditory) brainstem encoding of speech relative to good readers, and that these impairments were correlated with the perception of speech in noise”.
Treatment for Auditory Processing Disorders can help a child re-learn the listening skills they need in quiet and in noise to make listening, language, and reading easier.
We know that reading is an auditory skill. So next time you are interviewing a parent about their concerns, consider asking, “Do you think she can hear?”
Marcie V. Brown
Educational Audiologist/TCHI
