Thursday, March 23, 2017

15 Red Flags that your Student may have an Undiagnosed Hearing Loss

So often I hear people describing their students, and their students'  challenges, and I become concerned that their student may have a possible hearing loss.  For SLPs who do not specialize in children with hearing loss, or who do not see this population on a regular basis, it is so easy to confuse the signs of an undiagnosed hearing loss with that of a language disorder.  Students who have special needs (autism, down syndrome, cerebral palsy, etc) may be at a higher risk for going long periods of time without having their hearing loss identified because a delay in language development can easily be blamed on the diagnosis that they already have.  Hearing loss is time sensitive, and if your student does have a hearing loss, it is imperative that we help identify it as quickly as possible so that the gap between them and their peers in terms of articulation or language does not continue to grow.

Here are 15 red flags that your student MIGHT have an undiagnosed hearing loss.

1. Child is not responding to their name
2. Child does not turn or react to loud noises
3. Child is omitting the /s/
4. Child is omitting /f/
5. Child is omitting morphological markers.  What do I mean? Plural -s, possessive -s, past –ed
6. Child omits function words (remember these are the little words like: and, in, on, the)
7. Sounds robotic- poor intonation/rhythm in their voices
8. Confusing /n/ and /m/ in speech
9. Poor volume modulation
10. Looks like they have poor attention
11. Don’t socialize well in noisy environments
12. Difficulty following directions – be careful, these are the students who may appear good at following routines and will assume the directions you give are part of that routine 
13. Frequent ear infections – Are they frequently rubbing their ears, are their ears red inside (use your iPhone flashlight to look), is their discharge from their ears?
14. Family history? Do you have their sister in speech and she has hearing aids?
15. Do they understand you less when your back is to them?

Bonus red flag to look out for -> Does your student omit the final sound of words?  Often people assume this is the phonological process of final consonant deletion.  Please note, that the final sound of words is often omitted by students with hearing loss because these sounds are less acoustically salient, and thus perceived less often. 

 "Oh no, Lauren! My student meets like ten of these red flags! What do I do now?"

Don't panic!  Here's what to do:

1. Contact the family – see if the child has had a hearing test lately and see if the family has any of the same concerns
2. Speak with their teacher and see if they share any of your concerns. 
3. Speak with the school nurse  - some nurses can give hearing screenings right in their office
4. Lastly, document all of these events.  Keep track of the speech characteristics that you’re noticing so that you can see if they fluctuate or are consistent.