Case Study: Team Helps Child with Hearing Loss Develop Language Skills

Work Setting: Schools Work Setting: Health Care

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Background

Two-year-old Danny was recently identified with bilateral, severe-to-profound sensorineural hearing loss as a result of cytomegalovirus (CMV). Records indicate that Danny passed his newborn hearing screening in the left ear but not in the right ear. Danny’s family reported that they were unaware of his hearing loss, so they did not follow up after the newborn hearing screening.

At the time that the IPP team was assembled, Danny communicated his needs and wants by pointing and vocalizing. Family members reported that he was using some single Spanish words to communicate. Danny’s family spoke Spanish at home and used a Spanish language interpreter in educational and health care settings. His parents were concerned about Danny’s ability to eat independently and his aversion to particular textures.

Danny had recently been fit for hearing aids and showed increased awareness to sound. He had an appointment with an otologist to assess candidacy for a cochlear implant (CI).

Meet the Team

Danny’s case involved two speech-language pathologists (SLPs). One is part of a local early intervention program, and the other serves on a CI team. Team members included:

How They Collaborated

Each member of the IPP team met with Danny to assess his hearing and language skills. Afterwards, the team met to share their findings.

The audiologist evaluated Danny’s hearing and reported that his hearing aid check and fit were unremarkable. The ENT/otologist deemed that Danny was a good candidate for a CI and referred the family to a CI center for further evaluation. Danny’s family expressed concern about missing work for frequent appointments as well as travel to and from the appointments.

The SLP conducted a speech, language, and auditory skill assessment, which showed that Danny had severe language delays. Danny’s vocabulary was moderately delayed, but his social communication was normal. During the assessment, via an interpreter, Danny’s parents reported that they were unable to understand most of what Danny said. Most of their communication was through pointing and gestures. They also reported that Danny loved playing with cars and trucks and imitated two- and three-step sequences from home routines.

The OT evaluated Danny’s sensory skills and found that Danny’s aversions to foods and textures were typical for his age. His family was counseled to continue Danny’s exposure to new foods and reevaluate at transition to preschool.

During the CI candidacy timeframe, Danny’s family traveled to the CI center to meet with the hospital-based SLP once a month. Also, the local SLP saw Danny and his family once a week to work on the language and listening goals outlined by the IPP team. In addition, the local SLP connected Danny’s family with other Spanish-speaking families who also have children who are deaf and/or hard of hearing (DHH). The IPP team stressed that Danny needed to use his hearing aids full time and monitor how the hearing technology works in different environments (i.e., home, noisy situations, clinic, car).

After reviewing the evaluation results, the IPP team recommended that Danny receive a CI. After the implant’s activation, Danny continued to receive therapy for language development and listening skills. The team emphasized that Danny’s family needed to expose him to verbal language as he learned to use his CI.

Outcome

The local SLP shared data with the team about Danny’s development after receiving the implant. This data showed Danny’s expressive vocabulary had grown steadily, and he had begun to communicate using two- and three-word utterances.

Ongoing Collaboration

The IPP team planned monthly calls with team members and Danny’s family to coordinate ongoing care. During these calls, the team and the family will continue to share what is working and what needs adjustment with Danny’s CI.

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