Frequently Asked Questions

Frequently Asked Questions

1. When should I be concerned about my child’s language development?

Parents often are given advice by friends, family, or professionals to ‘wait and see’ regarding their toddler’s language development. At Speech and Hearing Associates, we recommend a full speech-language evaluation if you are concerned with your child’s development.

Your child may fall within the typical range for their age even if their language skills appear low when compared to siblings or classmates. In this case, an evaluation would provide peace of mind and explanation by a certified speech-language pathologist regarding their strengths and needs.

If your child does, however, require services, then early intervention has been proven to lead to better outcomes – ‘the earlier, the better!’

A typical evaluation at Speech and Hearing Associates takes approximately an hour and a half to complete. Initial evaluations are commonly covered by insurance. If you have concerns regarding the number of words in your toddler’s vocabulary, their ability to use words to communicate their wants/needs, or their ability to combine words, it is worth it to come in and see if your child could benefit from services. Parents and families know their child best – if you have concerns, please trust your instincts and contact our offices to set up an evaluation.

2. If my child had his hearing tested at our pediatrician’s office, why does he need to have his hearing tested by an audiologist?

Best practices require that each child seen for a speech language evaluation or for speech therapy must have a recent comprehensive audiological evaluation in his/her chart.

We are often told by parents that their child was recently “tested” by the pediatrician and that his/her hearing is fine. However, the fact is that “testing” at a pediatrician’s office often includes otoacoustic emissions (OAEs), a pure tone hearing screening, and/or tympanometry. Neither of these, alone or in combination, constitutes a comprehensive audiological evaluation.

Many pediatricians use OAEs only. However OAEs do not test hearing. Rather, they assess the integrity of the cochlear outer hair cells. A child can have up to a 35-40 dB hearing loss and still pass an OAE. OAEs are used in newborn nurseries to rule out significant cochlear pathology, not to “test hearing.”

Tympanometry, likewise, does not test hearing. Tympanometry assesses the integrity of the middle ear system. Our audiologists frequently see normal tympanograms even when children have conductive hearing loss or sensorineural hearing loss.

Pure tone screening done in a pediatrician’s offices is often done using a combination otoscope/puretone screener. The screener typically has two presentation levels: 25 and 40 dB. We have heard GOOD pediatricians say that they screen at 40dB because their office is too loud to screen at 25! This procedure nullifies the validity of the screening altogether. Keep in mind that normal hearing for a child is 15 dB or better! Patients with a 40 dB hearing loss need hearing aids!

Pediatricians do not measure hearing sensitivity for speech or other measures that constitute a comprehensive audiological evaluation.

In order to make an appropriate speech and language diagnosis and to plan treatment (if indicated), our speech language pathologists MUST know how your child hears. The only way to obtain this information is with a comprehensive audiological evaluation administered by an audiologist. We can easily schedule your child for this evaluation with one of our audiologists. However, if you choose to have the comprehensive audiological evaluation completed elsewhere, or have had it done within the past year, we must have a copy of the report and will ask you to complete a records release form so we can obtain the report.

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