Friday, April 22, 2011

Ear Infections' Impact on Reading

Two of my family members have children that recently had tubes placed in their ears due to recurring ear infections.  Because of my 25 years in the field of special education, with 7 years in private practice, I spoke to both of them about watching the potential of reading difficulties further down the road.  There are many easy to find sources of information connecting ear infections and language delay, but the sources that connect ear infections and reading delays aren't in the mainstream, yet.

A majority of students that I have worked with who had reading difficulties also had recurring ear infections in their early years.  When fluid builds up in the ears, sounds are muffled like listening to the sounds under water.  Most children will have at least one middle ear infection in the first year of life; it is the recurring ear infections that can have the most impact.  It is said that 10-20 percent of children will have ear infections three or more times, with the fluid lasting an average of one month each time, while the persistent ear fluid is more common in children under two years old.  The middle ear contains air which causes the vibration of the bones to produce sound.  When there is fluid in the space instead, the bones do not vibrate which may cause a mild, temporary hearing loss, or inefficient sound processing.

So, during the first three years of life when the child is tuning into the sounds of their language, the fluid in the ears are giving inconsistent and inefficient speech sounds which are difficult to process.  Speech sounds are called phonemes, blended phonemes make up words, like /c/ /a/ /t/ says cat.  If you hear /c/ /a/ /t/, then you can later match up those sounds with the letters to spell or read cat.  If you are getting inconsistent feedback from your ears, cat can sound like cap, tat, etc.  Phonological awareness, understanding how speech sounds are used in words, is the basis for reading success.  The lack of auditory discrimination, difficulty differentiating the difference in similar sounds, especially in the first three years of life may impact the child's future reading skills. 

In private practice, I saw students in all age groups have dificulty with phonological awareness.  Three keys to the success of the students were receiving occupational therapy with a sensory integration approach, therapeutic listening to help retrain the brain to process sensory information more efficiently, and direct instruction in phonological awareness.  This approach was very successful, and I would encourage any parent to seek out an occupationl therapist that has a sensory integration focus who is also trained in therapeutic listening. 

There are a couple of different ways to find an occupational therapist with knowledge of therapeutic listening.  One way is to go to Sensory Processing Disorder Foundation (SPD) and look through their directory of service providers. 

Click on the link to go to that site.
While you're there, look into their site, it's an excellent resource for research and current trends.

Another site that you can access is Vital Links, founded by Sheila M. Frick, OTR.  This link sends you right to their provider list which you can search by email.  Most of the providers are occupational therapists, others are people providing academic therapy.
If you are interested in reading more about therapeutic listening's role in improving processing, I suggest you read Listening With the Whole Body by Sheila M. Frick.  Clicking on the link will send to to purchase a copy of the book.    Listening with the whole body

When looking for academic intervention to improve phonological awareness, there are several curriculums that will have proven successful.  Interview people to find out if they have been trained in any or all of the following interventions:
Linda Mood Bell:

 The Lindamood - Phoneme Sequencing Program for Reading, Spelling, and SpeechThe Lindamood - Phoneme Sequencing Program for Reading, Spelling, and Speech 

Susan Barton:

Barton Reading & Spelling System (Phonemic Awareness, Level 1)Barton Reading & Spelling System (Phonemic Awareness, Level 1)

Barton Reading and Spelling System Level 2

The Barton reading and spelling system: An Orton-Gillingham influenced simultaneously multisensory explicit and systematic phonics program

Phonics revealed: Lesson by lesson

SIPPS: Challenge level teacher's guide : systematic instruction in phoneme awareness, phonics, and sight words : a polysyllabic decoding unit (Reading for real)SIPPS: Challenge level teacher's guide : systematic instruction in phoneme awareness, phonics, and sight words : a polysyllabic decoding unit (Reading for real)

Orton Gillingham:

The Orton-Gillingham approach (Reprint series)

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