Carol Venice, speech coordinator for New Orleans Public Schools Exceptional Children's Services (3500 Gen. DeGaulle Drive, 304-4950, 304-4951 or 304-4952), discusses hearing and speech problems in children and what speech pathologists and audiologists can do to help.
Q: What do speech pathologists and audiologists do?
A: They assess, diagnose and treat individuals with communication disorders.
Q: What are some of the disorders they encounter?
A: Language disorders, expressive language problems, and receptive language problems. Then there are articulation disorders, voice disorders and fluency, or stuttering.
Q: What causes them?
A: Just like any other developmental norms, it could be anything, either genetic disorder, language based, or hearing problems. There are several theories of what causes stuttering or fluency disorder. It's more prevalent in boys than girls, and it may not necessarily be inherited. But they have known histories that if you stutter there probably would be others that stuttered in the family. Voice disorders could be either neurological from birth ... trauma from accidents, or vocal abuse -- when you have people who holler and scream and abuse their voice that way.
Q: When are swallowing problems a concern?
A: Swallowing problems are a concern when there's something going on. It could happen with a trauma or a neurologic impairment that goes on with the mechanism (of) swallowing or someone who's had a [tracheostomy], so the traits of textures that go into the mouth (affect) the ability to process them. Usually if you have children with cerebral palsy, some stroke patients, (or) patients with dyspraxia. They can be organic or inorganic. We do have some students who have trachs and we have therapists who are trained to work with those students and also the physical therapist would work with them to make sure they're in the right position to process anything that comes into the mouth for swallowing purposes.
Q: Aren't some speech problems caused by such common things as frequent ear infections or other recurring infections?
A: Hearing losses can result (in) children who have frequent ear infections, who have problems with the inner ear. ... Any child who would have at least six ear infections prior to being a year old would probably encounter speech and hearing problems. Or things that happen to the outer ear, like wax buildup, something going into the ear, conductive loss or sensory loss (dealing with the nerves). When you have children with hearing problems, they tend to have speech problems because they can't hear things to mimic. What they're doing by law now is audiological exams on babies when they're born. They find they can have early detection ... and get to the intervention earlier.
Q: How do those problems affect children's ability to learn?
A: Children acquire language just as everything is developing -- emotional, skeletal and language, too. If you have hearing problems, your language is going to be delayed, and they may have problems articulating. In all of those cases, a voice problem, fluency problem, language problem or articulation problem, it affects how a child acquires and processes language. In a school system, it has to affect them educationally before we intervene. If a child has a fluency problem and is being mimicked or teased at school, he's going to be reluctant to speak. If it's affecting the child emotionally or physically, we need to treat the disorder.
Q: Who usually makes that observation?
A: Usually parents are the first ones to notice that their children are having difficulties. Inquiries come that way, and they may ask their pediatrician, who says they need to look into getting some help. Children ages 0-to-3 get screened through our network. Three years up to 5 years can come through Child Search if they're not in school. If they're already in school, it can be the parent making the teacher aware there is a problem, or the teacher can detect it. The speech pathologist can then do the screening. Any time it comes down to making a diagnosis, it is the speech pathologist within the school or in private (practice who does that).
Q: Are speech therapy services available in all of the parish's public schools?
A: In every school -- every public school and non-public schools in Orleans Parish -- children are able to receive speech therapy.
Q: In addition to working with the students, do you also work with the parents to help them understand and help their kids with the problem?
A: Most definitely. It's hand-in-hand with the student and parent, and also the teacher ... and anyone else who comes in contact with that student. Otherwise you've got a one-way street. In your initial screening, not as much, and after the evaluation the parent is given the diagnosis of what the findings are, and then once a year an evaluation report is made, and we sit down to develop an individual education plan in which the child and the parents are involved.