Sometimes it is difficult to tell whether or not a child with a hearing loss is presenting with a true speech and/or language disorder, or if the problems in their speech and language skills are due to hearing loss alone.  For some children, you think, “Wow.  This child probably would have had speech/language issues even without his hearing loss!”  For example, some speech and language problems, like fluency disorders (i.e. stuttering), have a strong genetic component.  But other times, you think, “Does this child really have speech and language problems, or is she just delayed because of inadequate access to hearing?”  These two theories require very different therapeutic approaches.  For a child with a true speech and language issue, like apraxia, that is unrelated to his or her deafness, a more traditional “speech therapy” approach may be in order.  For the latter group of children (in my opinion, the majority of children with HL), the goal should be to give the child more access to sound, and more listening and spoken language training, to allow them to develop these skills — a developmental, acoustic approach, not a remedial, visual plan.  But where do you draw the line?  How do you decide the “cause” of these invisible, ever-changing delays or disorders, especially when so many children with hearing loss are not “just deaf” and often have a multitude of complicating factors?

Continue reading “Speech/Articulation Issue or a Hearing Problem?”