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Audiologists are primary providers of hearing healthcare. They hold a Master’s or Doctorate degree in audiology and are regulated by the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO). Audiologists perform hearing evaluations, prescribe hearing aids, and also repair/troubleshoot hearing aids and assistive listening devices. Audiologists provide treatment for other hearing-related issues including tinnitus, vestibular function, and cerumen management (ear wax removal).
Speech-Language Pathologists possess specialized knowledge, skills, and clinical training in the assessment and management of communication and swallowing disorders. They hold a Master’s or Doctorate degree in speech-language pathology and are regulated by the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO). Speech-language pathologists assess and treat a variety of communication difficulties including cognitive communication disorders, voice disorders, stuttering, literacy, articulation and language delays. Speech-Language Pathologists also provide consultation to other professionals (e.g. teachers, occupational therapists), and provide counselling/coaching to caregivers of those with communication delays.
A Communicative Disorders Assistant (CDA) is support personnel who works under the supervision of a Speech-Language Pathologist and/or Audiologist. CDAs possess a graduate certificate in combination with various undergraduate degrees or diplomas in areas such as Linguistics, Early Childhood Education, Social Work and Educational Assistants. CDAs provide treatment for communication disorders in adults, children, and infants. They may also perform speech, language, and hearing screenings.
Depending on the nature of the problem, a speech and language assessment is completed to determine the nature and extent of the delay or disorder in order to provide appropriate programming, goal selection and planning. Depending on the severity of the problem, the assessment will include a series of formalized tests are administered and the client is then compared to their same age peers to determine the level the child is performing at. Assessment results may serve as baseline information whereby after a series of intervention the results can be revisited to determine areas of improvement, as well as those areas which require further intervention and practice.
A speech and language assessment typically entails that the child be engaged in a variety of picture books and tasks where he/she may be asked to point to various objects and pictures or put together words and sentences to respond to various questions asked by the clinician.
Children of all ages can be tested for language development. Many formalized tests begin from birth. The younger the child, the more critical the parents’ reports and observations are necessary in determining the nature of the speech and language delay.
As a firm believer in prevention and early intervention, it is never too early to start asking questions and seeking advice if you feel there are signs of a speech and/or language delay. The sooner a child is identified as being speech and/or language delayed, the more quickly the delay can be addressed. Parents and caregivers tend to be very accurate in their reports of a child having specific difficulties, and if you feel there is some area where your child may not be developing it is a good idea to look into it at an earlier age.
The form of intervention may vary depending on individual circumstances. It can consist of tracking progress, parent training and modeling, an enriched early childhood education experience, group therapy and/or individual therapy.
No. Augmentative communication systems can enhance the development of verbal language.
Auditory processing disorder is defined as difficulty in the way auditory information is processed. This is not to be confused with a hearing loss since the actual hearing acuity is normal, rather the problem lies beyond the auditory pathway at the level of the brain where information is processed. Once again, hearing thresholds and hearing sensitivity are normal, it is a problem with the processing of information that is problematic. If a child is identified with auditory processing disorder the child will likely experience difficulty attending to the teacher’s voice in the classroom, will struggle with listening in the presence of background noise, and overall may be struggling in school. Appropriate accommodations can be made so that the child can excel in the classroom.
Auditory processing skills are assessed through a battery of tests where the child listens to words and sentences through headphones while in the sound proof booth. A standard hearing test is conducted prior to the actual auditory processing skills testing. Various tasks are completed and a series of 4 tests are administered in order to determine how well the child would do when placed in various challenging listening environments. The norms for these tests are based on children of at least 5 years of age or older, and of children with normal hearing thresholds.
It is very important to note that despite a determination of an auditory processing disorder there may be other underlying causes for the child’s difficulties in the classroom. Auditory processing may only be a small ‘piece of the puzzle’ and other testing is critical in order to truly determine whether the child has an auditory processing disorder verses a language disorder, learning disability, etc. In order to validate the auditory processing results, it is very important to pursue further testing (i.e., speech and language testing, and educational assessment). It is only with the combined results of all testing that we can truly determine whether the child’s difficulty stems from auditory processing alone so that we can provide accurate and appropriate recommendations.
This is a very individual question since each client is different, and it is very dependant on the extent of the delay and the nature of its cause. Articulation/speech sound production in children tends to show improvement after a series of weekly sessions. However, it is the carryover of speech sounds into every day conversation that tends to be the most challenging aspect of the therapy process. Generally, the younger a child begins therapy, the more rapidly changes are seen. Research has proven that early intervention results in the greatest overall outcome when it comes to developmental milestones and early speech and language development.
Depending on the nature and severity of the hearing loss, the impact of hearing loss can be quite extensive. There are generally 3 types of hearing loss:
Conductive hearing loss is a hearing loss that is often due to fluid behind the eardrum (i.e., due to an ear infection or what is also known as ‘otitis media’) which is very common in young children. Although fluid behind the ears causes this temporary hearing loss, it certainly does impact speech and language development and children often struggle to hear the teacher’s voice in the classroom, particularly in the presence of background noise. In the case of a conductive loss, it is very important to follow up with your family physician, and hearing should be tested to determine the extent of the hearing loss. If the child is prone to ear infections and has recurrent episodes of otitis further intervention may be warranted by having the child followed by an Ear, Nose and Throat Specialist (ENT) and the possibly of ear tubes may be considered.
Sensorineural hearing loss is a permanent hearing loss which implies that there is damage to the actual hearing nerve which cannot be regenerated. Typically with a sensorineural hearing loss some or all of the tiny hair cells in our ears have broken off causing a permanent hearing loss. It is this type of hearing loss that is usually fit with a hearing aid.
A mixed hearing loss is a combination of both the conductive and sensorineural hearing losses.
The degree of hearing loss also plays a large role on the impact it will have in your life. However, that being said, it can vary greatly from one individual to the next depending on personal lifestyle. For example, a person with a mild hearing loss who sits in large group meetings all day and needs to respond to the comments made in the group may really feel the impact of that hearing loss despite the mild nature of the hearing loss, whereas another individual with a similar hearing loss who works in a one-to-one setting with little background noise may not be as affected by their loss.
Auditory-Verbal therapy is in approach used with hearing impaired clients which maximizes residual hearing. Auditory-verbal practices support clients in developing auditory skills for communication through the use of their hearing aids and/or cochlear implant. Education, guidance, advocacy and family support play a large part in this very specialized therapy, and the cornerstone of auditory-verbal therapy is the partnership between the family and the professionals.
Length of the therapy process varies depending on each client’s progress. Speak to your clinician if you have any questions/concerns regarding your child’s progress.
Yes. Speech and language therapy works to elicit and target new skills; however, additional practice is strongly recommended to consolidate and carry over these new skills to home, school, and other settings.
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