Introduction:

Speech language therapy is care that helps kid’s improve speech, understand and use language, communicate in nonverbal ways (listening, taking turns, etc.) Speech-language pathologists (SLPs) also called speech therapists that treat many types of communication and swallowing problems. They have at least a Bachelor/master’s degree and certification/licensure in the field, and a registration from the Rehabilitation council of India (RCI). Speech-language pathologists help kids with speech disorders (like stuttering), hearing problems, and other medical conditions, including cleft palate.

Role of Speech therapist for CLP (Cleft lip and Palate):

SLPs who work with children with cleft palate have extra training to recognize and treat specific problems caused by a cleft palate. Children born with a cleft palate may need speech-language therapy to help with problems such as: Articulation and Resonance Disorders.

An articulation disorder is when a child has trouble making specific sounds. “Cleft palate speech” refers to speech sound errors that are more common in kids with a cleft palate. These include:

1. Glottal stops: formed by a “pop” of air when the child forces his/her vocal folds (located in the voice box) together. The release of air can make it sound like a child is omitting a consonant (like saying “–all” for “ball”).

2. Nasal fricatives: formed by directing the stream of air through the nasal cavity, instead of the oral cavity, during speech. It sounds like the child is “talking through his/her nose” for particular sounds, like S in the word “sun.”

3. Pharyngeal fricatives: formed by pressing the base of the tongue against the back of the throat and releasing a stream of air for speech. It can sound like the child is using a “raspy H” for particular sounds, like SH in the word “shoe.”

4. Mid-dorsum palatal stops: formed when the middle of the tongue contacts the middle of the roof of the mouth and used as a substitute for these sounds: T, D, K, and G. When the child produces a mid-dorsum palatal stop, it often sounds “in between” a T and a K.

A Resonance disorder refers to an unusual amount of nasal sound energy when the child is talking, which can result in: hypernasality (too much nasal sound energy): This makes a child sound “nasally.” hypo nasality (too little nasal sound energy): This makes a child sound like he/she has a cold, mixed (a bit of both) resonance. Hypernasality may mean that the child’s palate is not working properly, called velopharyngeal dysfunction. This can make it hard for others to understand the child’s speech, and might need further treatment.

Goals of Speech therapy:

Speech therapy works best when a speech-language pathologist works one-on-one with a child. Sometimes, though, therapy is done in small groups. The main goals to help children with “cleft palate speech” are to:

• Establish correct articulation (placement, manner, and voicing) using articulation therapy techniques.
• Ensure there is good oral pressure during sound production.
• Establish new motor speech patterns that replace speech sound errors.

Parental Contribution for Speech-therapy:

Speech therapy should begin as soon as possible. Children who start speech therapy early tend to have greater success. Therapy also can help older kids, but their progress can be slower because their motor patterns are more ingrained. Support from parents is key to the success of a child’s progress in speech therapy. Kids who complete the program quickest and with the longest-lasting results are those whose parents are involved. Therapist should give homework to do after each session. Helping the child complete these activities will ensure continued progress and carryover of new skills. For example, practicing the P sound for 30 minutes a week in therapy is much more effective when it’s also done for 10 minutes a day at home.

The process of overcoming a speech or language disorder can take some time and effort. So it’s important that all family members be patient and understanding.

How Can We Find a Speech Therapist?

The Rehabilitation council of India (RCI) has CRR (Central rehabilitation register) of passing graduate and post graduate students in their website. To be registered by the RCI, each student must have a passing certificate. SLP can recommend other cleft-trained SLPs in concern area if they want to use school-based and/or private services. Local SLPs also will be helpful:

• if they have worked with children with these specific speech sound errors
• how many children with cleft palate they have worked with?

Sometimes, speech assistants (who usually have a 1-year diploma degree) may assist with speech-language services under the supervision of RCI-certified Graduates/post graduates professionals. SLP should be licensed in state level and have experience working with kids and child’s specific disorder.

Conclusion:

Children with a cleft that affects their soft palate (the part towards the back of the throat) may have problems with speech that include sounding nasal. This is caused by the soft palate not being able to properly close off the mouth from the nose while speaking and therefore letting air escape through the nose. A speech pathologist is a critical part child’s cleft palate team. Speech pathologists provide support from the early days by assisting with feeding and into childhood as our child master’s speech with the continuous changes they will undergo the first few years of life.

Individuals with cleft lip and palate may also exhibit dysphonia. This is characterized by breathiness, hoarseness, and low intensity of voice during speech tasks. This is usually due to increased respiratory and muscular effort, and hyper adduction of vocal folds while attempting to close the velopharyngeal valve.

Prof. (Dr) Vivek Kumar Jha

Principal

Department of Audiology and Speech Language Pathology

Sumandeep Vidyapeeth (Deemed to be University)

Vadodara, Gujarat

Mob.No.-9560276840

Email ID: jhavivek98@yahoo.com

The post Speech Language therapy for children with cleft lip and palate appeared first on Health Vision.

INTRODUCTION:

Languages exquisitely structured, complex, and diverse are a distinctively human gift, at the very heart of what it means to be human. As such, language makes for both a particularly important and difficult topic in neuroscience. A dominant early approach to the study of language was to treat it as a separate module or organ within the brain. However, much modern empirical work has demonstrated that language is integrated with, and in constant interplay with, an incredibly broad range of neural processes.

Neuroimaging, and developmental studies of language in the aging brain focusing on converging evidence regarding the highly interactive relationship between linguistic functions and other cognitive functions. A clear and comprehensive model explaining the functional neuroanatomy of language in the neurologically intact brain is still a work in progress. The newest attempts to propose such models represent a consistent shift towards accounts with increasing empirical and conceptual resolution that aim to capture the dynamic nature of the biological foundations of language. Better empirical resolution is now being accomplished through the enhanced level of detail with which temporal and spatial features of language-related brain activation patterns can be examined. Greater conceptual resolution involves the increasing level of specificity with which representations/operations underlying different language functions can be described.

Unlike other areas of neuroscience investigation (e.g., vision, motor action) that have relied heavily on invasive techniques with animal models, the study of language lacks any such model. Furthermore, in language, the relationship between the form of a signal and its meaning is largely arbitrary. For example, the sound of “blue” will likely have no relationship to the properties of light we experience as blue nor to the visual written form “blue,” will sound different across languages, and have no sound at all in signed languages. No equivalent of “blue” will even exist in many languages that might make fewer or more or different color distinctions. With respect to language, the meaning of a signal cannot be predicted from the physical properties of the signal available to the senses. Rather, the relationship is set by convention.

At the same time, language is a powerful engine of human intellect and creativity, allowing for endless recombination of words to generate an infinite number of new structures and ideas out of “old” elements. Language plays a central role in the human brain, from how we process colour to how we make moral judgments. It directs how we allocate visual attention, construe and remember events, categorize objects, encode smells and musical tones, stay oriented, reason about time, perform mental mathematics, make financial decisions, experience and express emotions, and on and on.

Indeed, a growing body of research is documenting how experience with language radically restructures the brain. People who were deprived of access to language as children (e.g., deaf individuals without access to speakers of sign languages) show patterns of neural connectivity that are radically different from those with early language exposure and are cognitively different from peers who had early language access. The later in life that first exposure to language occurs, the more pronounced and cemented the consequences. Further, speakers of different languages develop different cognitive skills and predispositions, as shaped by the structures and patterns of their languages. Experience with languages in different modalities (e.g., spoken versus signed) also develops predictable differences in cognitive abilities outside the boundaries of language. For example, speakers of sign languages develop different visuospatial attention skills than those who only use spoken language. Exposure to written language also restructures the brain, even when acquired late in life. Even seemingly surface properties, such as writing direction (left-to-right or right-to-left), have profound consequences for how people attend to, imagine, and organize information.

The normal human brain that is the subject of study in neuroscience is a “languaged” brain. It has come to be the way it is through a personal history of language use within an individual’s lifetime. It also actively and dynamically uses linguistic resources (the categories, constructions, and distinctions available in language) as it processes incoming information from across the senses.

Put simply, one cannot understand the human brain without understanding the contributions of language, both in the moment of thinking and as a formative force during earlier learning and experience. When we study language, we are getting a peek at the very essence of human nature. Languages—these deeply structured cultural objects that we inherit from prior generations—work alongside our biological inheritance to make human brains what they are.

Current brain-language models emerged in response to the classical Broca-Wernicke-Lichtheim-Geschwind lesion-deficit model of aphasia. In this model, language areas were localized in left-lateralized manner, with certain regions being predicted to lead to specific patterns of language impairment following brain damage. Thus, for example, the left posterior inferior frontal region, Broca’s area, was linked to speech production (where brain damage would result in articulatory problems); the left posterior temporal region, Wernicke’s area, to auditory speech recognition (where damage would yield impaired language comprehension); and the arcuate fasciculus connecting these anterior and posterior regions to repetition (where damage would impair production by repetition but preserve comprehension).

This schematic view of brain-language mappings has given rise to clinical classifications of aphasic syndromes, which to this day continue to guide aphasia research and clinical practice in many circles. Seven major aphasic syndromes have been proposed, with varying behavioral patterns and lesion loci Over time, however, serious clinical, biological, and psycholinguistic inadequacies of these mappings were identified. These include, for example, failure to account for the wide range of lesion-deficit patterns observed in aphasia (e.g., when a lesion to a certain area does not necessarily result in a predictable behavioral profile, or when lesions to multiple regions result in behavioral patterns that would otherwise be predicted for a different area altogether) or an inability to explain changes in behavioral patterns observed in aphasia over time (e.g., when a person first diagnosed with Wernicke’s aphasia presents later, in the chronic stage, with conduction-like behavioral patterns and/or anomic-like patterns). These changes are reportedly experienced by 30%–60% of patients, with anomia being the most common end result of all aphasia-producing lesions.

This model uses a dual-route neuroanatomical architecture—dorsal and ventral streams—borrowed from the field of visual processing and from animal models of auditory processing in primates to explain how auditory language proceeds. The ventral stream, also known as the “what” stream, is implicated in auditory recognition processes required for language comprehension, such as lexical semantic processing, mediated by neural networks projecting to different regions in the temporal lobe. The dorsal stream, termed the “where” stream, provides an interface for auditory and motor processing by performing phonological mappings of sound-to-articulatory representations, sub served by projections from auditory cortical circuits to temporoparietal and frontal networks. This architecture is shown in Figure 1.

Fig.-1: Dorsal-Ventral Streams (Adapted from Hickok and Poeppel)

Limitations of the classical model have been highlighted even further with the explosion of new findings emerging from studies using advanced techniques for measuring real-time brain activity, for example, hemodynamic changes in the brain through functional magnetic resonance imaging (fMRI), intrinsic brain connectivity through resting-state fMRI, or the time course of brain activation during task performance via electroencephalography (EEG) or magnetoencephalography (MEG). With these techniques, many new inter- and intra-hemispheric language-related neural networks have been identified (extending well beyond the core language areas, including cortical networks bilaterally, as well as subcortical circuits.

Price, for example, in a review of standard coordinates of peak activations found in over 100 fMRI studies published in 2009, identified an intricate web of neural networks, mediating different processes implicated in language comprehension and production. These included the following brain-language mappings: activation of the superior temporal gyri bilaterally for prelexical acoustic analysis and phonemic categorization of auditory stimulus, middle and inferior temporal cortex for meaningful speech, left angular gyrus and pars orbitalis in for semantic retrieval, superior temporal sulci bilaterally for sentence comprehension, and inferior frontal areas, posterior planum temporale, and ventral supramarginal gyrus for incomprehensible sentences (e.g., as a measure of plausibility). Speech production was found to activate additional neural networks, including left middle frontal cortex for word retrieval, independently of articulation; left anterior insula for articulatory planning, left putamen, presupplementary motor area, supplementary motor area, and motor cortex for overt speech initiation and execution; and anterior cingulate and bilateral head of caudate nuclei for response suppression during monitoring of speech output. Such data have clearly stimulated a need to create new models of the neuroanatomy of language, with greater neural and psycholinguistic specificity. Ideally, such models would spell out the specific links between formal operations associated with certain language functions, as well as the dynamic spatial and temporal neuronal pathways mediating them.

Conclusion: Results from neuroimaging, lesion studies, and studies of language in the aging brain provide compelling converging evidence for the concept of neural multifunctionality, a concept that has both theoretical and practical/clinical implications—theoretical with regard to models of brain-language relations and practical with regard to rehabilitation of persons with cognitive deficits as a consequence of brain damage.

The question remains, of course, of how a neurally multifunctional language system might work. Borrowing from recent developments in the memory literature, which emerged, in part, to account for apparent overlaps between the neural substrates mediating “what” and “how” memory functions, we propose to adopt a component process framework to language processing.

Under such a framework, linguistic information would be processed through a neural system of component processes, in which region-specific neural configurations contribute to multiple cognitive tasks simultaneously. The component interactions are conceived as “process-specific alliances.” These alliances are small brain regions temporarily recruited to accomplish a cognitive task, given specific task demands. Each component in the alliance has a specific function, and they combine together to give rise to a complex operation. These small neural “groups” disintegrate once task demands are met and are thus distinct from larger-scale networks, whose connectivity continues to be observed at rest. The links among the components in the stable larger-scale networks can affect which alliances are formed, but they do not directly determine them. This approach is aligned with our view of neural multifunctionality of language, whose operations rest on the interaction of “neural cohorts” sub serving multiple functions in cognitive, emotional, motor, and perceptual domains.

The neural multifunctionality approach we propose here will allow the re-evaluation of current concepts of recovery from aphasia, focusing on the dynamic development of new neural support systems in the aphasic brain in service of new functions. We propose that this multifunctionality operates in a multidirectional and reciprocal fashion, such that neural networks engaged in language recovery mutually interact with neural supports of non-linguistic functions so as to give rise to new functional neuroanatomies (i.e., newly established or newly reinforced neural networks) in the neurologically compromised brain.

Also Read: Brain : The King and a King maker 

Prof. (Dr) Vivek Kumar Jha

Principal

Department of Audiology and Speech Language Pathology

Sumandeep Vidyapeeth (Deemed to be University)

Vadodara, Gujarat

Mob.No.-9560276840

Email ID: jhavivek98@yahoo.com

The post Brain and language -An incredibly broad range of neural processes. appeared first on Health Vision.

The importance of treating hearing loss is to understand how entire body and all its symptoms are linked together. If we are not able to exercise regularly this can affect so many aspects of our physical and mental health. Much is the same for hearing loss. Understanding the connections and educating ourself on the ailments can help us to prevent a hearing loss and so much more. Both hypothyroidism and hyperthyroidism can cause hearing loss, and different thyroid conditions can affect not only hearing loss but also tinnitus, and balance disorders.

The two most common problems in thyroid dysfunction are hormone overproduction (hyperthyroidism) and hormone underproduction (hypothyroidism).

Hyperthyroidism is rare, affecting about 1% of the population. It results in the quickening of metabolic processes. Symptoms include nervousness, irritability, weight loss, shaky hands, panic disorder, racing heart and tinnitus. The most common cause of hyperthyroidism is Graves’ disease, an autoimmune response that over-stimulates the thyroid. The tinnitus caused by hyperthyroidism is usually associated with heart rate.

Hypothyroidism, also called under active thyroid disease, is a common disorder. With hypothyroidism, our thyroid gland does not make enough thyroid hormone. The thyroid gland is located in the front lower part of the neck. Hormones released by the gland travel through our bloodstream and affect nearly every part of our body, from our heart and brain, to our muscles and skin.

Also Read: Hypothyroidism- commonest problem faced by women! 

The thyroid controls how our body’s cells use energy from food, a process called metabolism. Among other things, our metabolism affects our body’s temperature, our heartbeat, and how well we burn calories. If a person doesn’t have enough thyroid hormone, his/her body processes slow down. That means his body makes less energy, and our metabolism becomes sluggish.

Fibromyalgia and Chronic Fatigue Syndrome (CFS) are conditions frequently associated with hypothyroidism. Studies suggest that up to 15% of people diagnosed with thyroid problems will end up with fibromyalgia.

Relation between hearing Loss and hypothyroidism

Hypothyroidism is the result of the thyroid not producing enough of the hormone thyroxine. This can cause depression, fatigue, forgetfulness, and weight gain. Thyroxine is also needed for normal development of the auditory system. In fact, about half of the people with low thyroid function have hearing losses.

The Journal of Clinical Endocrinology & Metabolism published a study linking hearing loss and hypothyroidism. The research study looked at how untreated hypothyroidism is known to impair hearing. The study found :
Patients were 3 times more likely to self-declare hearing loss than that for the reference population.

17% of affected patients required hearing support in early adulthood. Hearing loss was associated with the type of congenital hypothyroidism with disease severity. Hearing loss was mostly bilateral (90%), mild to moderate (96%), of the sensorineural type (76%), and compromised higher frequencies.

Treatment

Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levo-T, Synthroid, others). This oral medication restores adequate hormone levels, reversing the signs and symptoms of hypothyroidism. We will likely start to feel better soon after you start treatment. The medication gradually lowers cholesterol levels elevated by the disease and may reverse any weight gain. Treatment with levothyroxine will likely be life long, but because the dosage you need may change, our doctor is likely to check our TSH level every year.

Hearing test

Hearing loss is typically not one of the first symptoms for either hypothyroidism or hyperthyroidism. It is therefore possible to diagnose and treat thyroid issues before they impact your hearing. Common symptoms for hypothyroidism can include depression, fatigue, forgetfulness, and weight gain. Symptoms of hyperthyroidism include irritability, nervousness, muscle weakness, unexplained weight loss, sleep disturbances, vision problems, and eye irritation.

Our hearing and health are connected in more ways that we realize. Identifying changes to our hearing may help to identify other issues that we are unaware of. This is why we at Hearing Consultants cannot stress enough, the importance of annual hearing check-ups to ensure that our valuable hearing doesn’t slip away. The sooner you catch a hearing loss the sooner we can help you get back on track and maintain the hearing we still have.

Conclusion: Studies have revealed that abnormal changes in serum thyroid hormone levels, such as hyperthyroidism and hypothyroidism, can cause both sensorineural and conductive hearing loss. Both hypothyroidism and hyperthyroidism can cause hearing loss, and different thyroid conditions can affect not only hearing loss, but also tinnitus, and balance too. Hearing loss in hypothyroidism was found remediable and even reversible after proper replacement therapy. In a study by Di Lorenzo et al. a significant improvement in the hearing condition was reported in hypothyroid patients, after 6–12 months of L- thyroxine replacement therapy.

Prof. (Dr) Vivek Kumar Jha

Principal

Department of Audiology and Speech Language Pathology

Sumandeep Vidyapeeth (Deemed to be University)

Vadodara, Gujarat

Mob.No : 95602 76840

Email ID: jhavivek98@yahoo.com

The post Hypothyroidism and hearing loss appeared first on Health Vision.

During the winter months, colds, flu, and other respiratory illnesses are quite common. These infections have also been linked to an increase in asthma symptoms. When an asthmatic inhales cold, dry air, the muscles in the lungs may spasm in an attempt to keep the airways open. This irritates the airway lining even more, resulting in coughing, wheezing, and shortness of breath. Asthma symptoms and flare-ups can be triggered by chilly air, especially when it is dry. The dryness of cold air can cause breathing issues for many persons with asthma. Some of the symptoms are coughing, whether dry or with phlegm, wheezing, especially while exhaling, shortness of breath and stiffness in the chest. Symptoms might also be triggered by cold air combined with windy circumstances. The more severe your asthma is, the more likely you are to be affected by cold air.

Tips to manage asthma during winter:

1. Before the winter approaches, make sure your asthma is under control. Consult your doctor to create an asthma action plan, and then follow your doctor’s instructions for taking the medications he or she recommends.

2. If you plan to exercise outside in chilly weather, use your inhaler 15 to 30 minutes before you start. This opens up your airways, allowing you to breathe more easily. Carry an inhaler with you at all times in case of an asthma attack. Warm up for at least 10 to 15 minutes before exercising, and keep your face warm by using a mask or scarf.

3. Make use of humidifiers in your home. Keep them mould-free, and if dust mites and mould are causing your problems, keep your house cold and dry to prevent their growth. Filters in your heating and cooling air ducts should be cleaned and replaced on a regular basis. Ensure that filters are cleaned at the start of each season. Check on a regular basis to ensure that the interior air quality is optimal.

4. If you are sensitive to pet dander, limit your time with them. Maintain a pet-free environment in your room.

5. Hands should be washed often using a hand sanitizer or washing with soap for 20 second to avoid transmitting germs.

Also read: The Asthma Diet : What you eat definitely makes a difference

Refer to the asthma action plan you created with your doctor if you start to wheeze or feel short of breath. Other basic recommendations for what to do if you experience an asthma attack include: Using a quick-acting rescue inhaler, take two to six puffs. The drug should help you breathe more easily by opening up your airways. Instead of an inhaler, you might be able to utilise a nebulizer. A nebulizer is a device that converts your medicine into a tiny mist that you inhale. Wait 20 minutes before taking another dosage if your symptoms aren’t severe but don’t improve after the first few puffs from your inhaler and call your doctor as soon as you feel better.

Despite the fact that winter eliminates seasonal pollen allergies, millions of people suffer from additional winter allergies as a result of their inactivity. In the winter, distinguishing between an allergy and a cold might be difficult. In both cases, sneezing, a runny nose, and congestion are frequent symptoms. Allergies, on the other hand, are the immune system’s reaction to an irritant or trigger, whereas colds are viral infections.  Winter allergens, including moulds, dust mites, and animal dander, can cause illness in the house. Airborne dust comprising lint, fabric fibre, microorganisms, food stuff, and animal dander is circulated by forced-air furnaces. House dust mites, animal dander, and cockroach droppings are three of the most frequent allergens, and they are all worsen in the winter when there is less ventilation causing allergies.

Following are some tips to minimize allergen exposure:

1. Use a humidifier to lessen dryness in the air as dust mites and mould grow at humidity above 60% and temperatures between 60- and 85-degrees Fahrenheit.

2. Avoid using wall-to-wall carpeting, which creates a breeding ground for dust mites. Instead, use area rugs.

3. Cleaning, dusting, and vacuuming should be done on a regular basis, preferably using a vacuum equipped with a high-efficiency particle air filter. Wash linens regularly in hot water to kill dust mites at least 130 degrees Fahrenheit, and use hypoallergenic coverings for mattresses and pillows to keep dust mites contained.

4. Bathe pets once a week to reduce dander, but not more frequently, since too frequent bathing can dry up a pet’s hair and skin and keep animals out of the bedroom of anybody in the family who has allergies.

5. Consult your doctor and pharmacist to see whether using any over-the-counter medicine is appropriate for your symptoms and any adverse effects.

Dr. Pavan Yadav

Consultant – Interventional Pulmonology and Sleep Medicine, Bengaluru

The post Winter allergies and asthma – a guide to manage appeared first on Health Vision.

Hearing is vital to speech and language development and for learning. Audiologists can check children’s hearing and help with any problems and speech pathologists can check speech and language-related disorders. Hearing sounds and words help children learn to speak and understand. A toddler with hearing impairment misses out on these sounds, this may cause problems with speaking, reading, school success, and social skills. It’s important to the kid-tested if you’re thinking that he has trouble in hearing. Getting help early is essential for overall development.

Hearing loss in children can lead to:

• Delayed speech and language skills
• Learning problems in class
• Feeling bad about himself
• Having trouble in making friends

Learning Words:

Children with hearing impairment don’t learn words as fast as people who have normal hearing. They may:

• Learn concrete words like cat, jump, five, and red. However, they will have trouble with abstract words like before, equal to, and shy. They will not use words just like the, an, are, and a.
• Have trouble in knowing the various meanings of a word. Consider the word bat. It can mean a flying animal or what we use to play baseball. A toddler with a hearing impairment might not understand these meanings.
• Fall farther behind children with normal hearing as they grow up. Children with hearing disorders don’t catch up without help.

Learning Sentences:

Children with deafness may have trouble in understanding and using sentences.  They may:

• Understand and use shorter sentences than children with normal hearing.
• Have problems with more complex sentences. They will not use clauses in their sentences. An example of a clause is “When I buy a home, I’ll eat dinner.” they’ll not use voice. An example of this can be “The ball was thrown by Mary.”
• Have trouble hearing word endings, like -s or -ed. They’ll not understand or use plural words, like cats. They’ll not use past/ like walked and possessives, like Bob’s, will be hard to listen to or use.

Learning to speak:

Children with hearing impairment cannot hear sounds well. They will have problems speaking clearly. They may:

• Not use seems like s, sh, f, t, or k. These are quiet sounds that are hard to listen to.
• Not hear their voices after they speak. They will be too loud or too soft. They’ll speak at a high frequency. People might imagine they mumble or sound different.

School success:

Children with deafness have trouble at school. Reading is the toughest for them. Some facts about hearing impairment and college success include:

• Children with mild to moderate hearing impairment may fall one to four grade levels behind without help.
• Children with the more severe hearing disorder might not learn past the third or fourth-grade level. School support will help them do better.
• Children with deafness don’t do as children with normal hearing. The gap between them grows over time.
• Children with deafness will do better at school if they get help early. This includes support from parents and families.

Social skills:

Hearing loss can make it harder to speak with others. Children might not want to speak or play with other kids. Children with deafness may

• Feel alone and like they need no friends.
• Be unhappy at school.

The most important thing you’ll do is to possess your child’s hearing test. With early help, a child may speak or use language furthermore as children who hear. An audiologist can test a child’s hearing. He or she will be able to consult with you about the most effective treatment. This could include medical treatment, hearing aids, or speech and language therapy. There are four major ways during which hearing impairment affects children:

1. It causes delay within the development of receptive and expressive communication skills (speech and language).
2. The language deficit causes learning problems that end in reduced academic achievement.
3. Communication difficulties often result in social isolation and poor self-concept.
4. It’s going to have an impression on vocational choices.

Effects on Vocabulary:

Vocabulary develops more slowly in children who have a hearing disorder.

1. Children with hearing disorders learn concrete words like cat, jump, five, and red more easily than abstract words like before, after, equal to, and jealous. They even have difficulty with function words just like the, an, are, and a.
2. The gap between the vocabulary of youngsters with normal hearing and people with hearing impairment widens with age. Children with hearing impairment don’t catch up without intervention.
3. Children with hearing disorder have difficulty understanding words with multiple meanings. For instance, the word bank can mean the sting of a stream or an area where we put money.

Sentence structure:

1. Children with deafness comprehend and produce shorter and simpler sentences than children with normal hearing.
2. Children with deafness often have difficulty understanding and writing complex sentences, like those with relative clauses (“The teacher whom I’ve got for math was sick today.”) or passive (“The ball was thrown by Mary.”)
3. Children with the hearing disorder often cannot hear word endings like -s or -ed. This ends up in misunderstandings and misuse of verb tense, pluralization, nonagreement of subject and verb, and possessives.

Speeking :

1. Children with the hearing disorder often cannot hear quiet speech sounds like “s,” “sh,” “f,” “t,” and “k” and so don’t include them in their speech. Thus, speech could also be difficult to grasp.
2. Children with hearing impairment might not hear their voices after they speak. they’ll speak too loudly or not loud enough.

Academics :

Children with deafness have difficulty with all areas of educational achievement, especially reading and mathematical concepts.

1. Children with mild to moderate hearing losses, on average, achieve one to four grade levels not up to their peers with normal hearing, unless appropriate management occurs.
2. Children with severe to profound deafness usually achieve skills no on top of the third or fourth-grade level, unless appropriate educational intervention occurs early.
3. The gap in academic achievement between children with normal hearing and people with deafness usually widens as they progress through school.
4. The level of accomplishment is said to be parental involvement and therefore the quantity, quality, and timing of the support services children receive.

Social functioning :

Children with severe to profound hearing losses often report feeling isolated, without friends, and unhappy at school, particularly when their socialization with other children with deafness is restricted. These social problems appear to be more frequent in children with light or moderate hearing losses than in those with severe to profound loss.

Dr. Vivek Kumar Jha                                                                                    

Professor (Speech Pathology & Audiology)

Department of Audiology & Speech Language Pathology

Faculty of Behavioural Sciences

SGT University, Gurugram, Haryana

Email: jhavivek98@yahoo.com

Mob: 9560276840

The post Impact of hearing loss on overall development in children appeared first on Health Vision.

All living beings including humans live in their environment by constantly interacting with it. Numerous changes of various types happen in their environment constantly and the living beings need to change themselves in order to survive and thrive. It is quite systematic that they are continuously receiving information about these changes taking place in their physical environment. It is possible due to the presence of sensory systems in the living beings.

The changes in photic and radiant energy, vibratory energy, chemical and mechanical energy impact the sensory system of living beings though selectively depending upon the intensity of these changes as well the inherent capacity of sensory systems.  When the intensity of these changes is sufficient enough, i.e., above a threshold value, we call it, stimulus, the sensory system shall receive it and the information regarding the changes in physical energy is transmitted to the organism. It happens after a series of transformations taking place within the organisms so that sensory receptors are activated.

It is very interesting to note that as we ascend on the evolutionary ladder, this sensory system becomes more complex, efficient and varied as it responds to variety of physical changes taking place in the environment. Such system not only communicates information efficiently but primes the organism to respond effectively to the changes in the environment. This stimulus – response mechanism is key to the interdependent relationship between the environment and organism. When an appropriate response is made to the stimuli, it is considered to be the adjustment, i.e., contributing to the survival of the organisms.

Hearing impairment

Hearing impairment is one of the most common chronic health conditions in the world. The recent study has proved that  Hearing loss reduces the quality and quantity of couple communication. Considering the centrality of communication between spouses, a person’s hearing loss may negatively affect the relationship. Communication problems manifest  themselves through constant repetitions and misunderstandings. The broad aim of this study is to explore the role of hearing impairment in marital adjustment in elderly couples.

A total of 120 couples between the age ranges of 60 to 80 years came to Audiology clinic for routine check-up at SGT Hospital, Gurugram. The total population was divided into three different groups i.e., Group A (Experimental group I), Group-B (Experimental group II) and Group C (control group). Group A was further subdivided into A-I and A-II whereas Group B was subdivided into B-I and B-II.  Univariate analysis, ANOVA followed by post-hoc Duncan’s were used to estimate the effects of the hearing impairment of the self/partner on marital adjustment and mental health of subjects and their partners with and without hearing aids. All the 3 groups, i.e.; groups with normal hearing, hearing impairment and hearing impairments with hearing aids were selected for the study.

First of all, descriptive statistics was used followed by ANOVA and post-hoc analysis. The result shows that the main effect of group, i.e., (individual with hearing impairment with hearing aids, hearing impairment, normal hearing, was found to be significant (p<0.001) on mental health score. The result shows that the main effect of group, i.e., (individual with hearing impairment with hearing aids, hearing impairment, normal hearing, was found to be significant (p<0.001) on marital adjustment score.

Marital adjustment of individuals with hearing impairment was significantly poor adjustment than normal hearing, hearing impairment with hearing aid was also close to normal hearing. Whereas, the marital adjustment of hearing impairment was found to be worst than hearing impairment with hearing aids. Marital adjustment of partners with hearing impairment was significantly poor adjustment than normal hearing, hearing impairment with hearing aid was also close to better adjustment as well as in normal hearing. Whereas, the marital adjustment of hearing impairment was found to be worse than hearing impairment with hearing aids.

On the basis of the findings of the present study, the following conclusion can be drawn:

1. The individuals with Hearing aid were having better marital adjustment as compared to individuals with hearing impairment. It shows that prescription of hearing aid is helpful for patients with hearing impairment to improve their marital adjustment.

2. Similarly, partners of individuals with Hearing aid were having better marital adjustment as compared to individuals with hearing impairment. It depicts that prescription of hearing aid is not only helpful for patients with hearing impairment but also for their partners to improve their marital adjustment.

Dr. Vivek Kumar Jha

Professor(Speech Pathology & Audiology)

Department of Audiology & Speech Language Pathology

Faculty of Behavioural Sciences

SGT University, Gurugram, Haryana

Email: jhavivek98@yahoo.com

Mob: 95602 76840

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 Are you feeling off-balanced or experiencing sudden feeling of dizziness or losing focus? These might be frightening sensations one can get. Though the sensation may last for only few minutes, it can make people sick and limit their motion. Commonly known as vertigo, this condition is a symptom of an underlying health problem or multiple health problems.

What is Vertigo?

“Vertigo” is one common type of dizziness. The sensation can last for a short time or it can stay for a few hours or days. Vertigo can make you feel like you are moving or like the room is moving around you, even when you are still. Vertigo can be caused by a number of different problems involving the inner ear or brain. One can experience the condition at any time. It can be while walking down the street or while sitting at the office that you may experience the false sense of your surroundings moving around or you moving around it.

Symptoms of vertigo

• Spinning (or the room is spinning around you)
• Tilting or swaying
• You tend to feel off-balanced

These symptoms can be at times frequent or irregular.  You may feel worse when you move your head, change position, cough or sneeze. Depending on the triggers for vertigo, one may also show the following symptoms.

• Nausea or vomiting
• A headache or sensitivity to light and noise
• Double vision, trouble speaking or swallowing, or weakness
• Shortness of breath, sweating, or a racing heartbeat

What causes Vertigo:

Many conditions can lead to Vertigo. It is predominantly due to an imbalance in the inner ear or could be due to a problem associated with the central nervous system. Other common reasons for vertigo is benign paroxysmal positional vertigo which occurs due to the calcium build up in canals of the inner ear and vestibular neuritis which leads to ear infection and that causes inflammation around the nerves that help the body sense balance. Among the other conditions that can lead to vertigo are migraine, head injury, headache, ear surgery, brain stem disease and stroke attack. Certain types of medications can also trigger vertigo. Sometimes, prolonged bed rest can also be one of the causes of vertigo.

When to seek help?

If you are having any symptoms of dizziness or vertigo along with other conditions like headache, fever, you should consult your doctor immediately. Seek help from the doctors when you have the following symptoms along with vertigo.

• New or severe headache
• Fever higher than 100.4ºF (38ºC)
• Double vision or having trouble seeing clearly
• Trouble in speaking or hearing
• Weakness in your arm or leg
• An inability to walk without assistance
• Passing out
• Numbness or tingling
• Chest pain
• Prolonged Vomiting

Risk factors of vertigo:

• An older adult (60 years or older)
• Have had a stroke in the past
• Have risk factors for stroke (eg, high blood pressure, diabetes, or smoking)

Vertigo is not a very dangerous condition, except that the sudden sensation of dizziness or imbalance can lead to discomfort. Few people may experience vertigo or dizziness at irregular intervals and they may not have any of the other symptoms. In such cases it is advised to consult your doctor for the further examination. Depending on the problem the person is facing, the doctor can recommend the following tests.

• Examination of the eyes – Your doctor might ask you to follow an object with your eyes, or focus on something while moving your head from side to side.
• Examination of balance and gait – This test involves watching the way you walk. This is to see whether you lean or tilt to one side while walking and also to check your balance while you stand still.
• Hearing test – Your doctor or nurse will check your hearing in both ears.

Additional tests might include an imaging test, such as magnetic resonance imaging (MRI), to look at the structure of your brain.

Treatment:

Disease-specific treatment — If the cause for your vertigo is identified, then the doctors will suggest medications, procedures, or lifestyle changes. In few cases, treating the underlying condition relieves or resolves vertigo. This will also help in slowing disease progression and improving the overall prognosis.

Relieving vertigo and related symptoms — If the episodes of vertigo that are severe or last for hours or days, then doctor may recommend a medication to relieve severe vertigo and associated symptoms, like vomiting. Treatment with medication is not usually recommended if your vertigo lasts only seconds or minutes.

If you feel you are losing balance while standing and continuous dizziness, it is recommended to visit the Ear and Vertigo Clinic and neuro-equilibrium vertigo assessment team. Visiting hospitals are safe as they are taking all the necessary precautions for patients safety.

Dr. Jyotirmay S Hegde
Consultant-ENT
Head and Neck Surgery
Columbia Asia Hospital, Whitefield 

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Allergic rhinitis, also known as Hay Fever is an allergic response to certain particles and  is a common health condition among adults and children. This condition can trigger an allergic response in the nasal mucosa leading to cold and cough. It is estimated that around 15-30% of the Indian population suffers from allergic rhinitis. As high as 70% of people with asthma may have allergic rhinitis as a co-existing health condition. The population of children having this condition is estimated to be approximately 40% especially in urban areas like Bangalore.

Allergic rhinitis is mostly seasonal and it can trigger due to the pollen particles among children and also due to freshly cut grass or flowers. Few might also get allergic rhinitis throughout the year due to dust mites, concrete dust particles, cockroach residue, animal dander or environmental pollutants. Along with this, a lot of other substances can also trigger allergy like reaction – strong perfumes, tobacco smoke, strong cooking aroma etc can also act as irritants.

Symptoms of allergic rhinitis among kids

Allergic rhinitis is triggered by the entry of the allergy-causing substance into the nostrils of a child who is prone to it. The symptoms are –

1. Stuffy nose with a feeling of constant blockage.
2. Water discharge from the nose (clear).
3. Throat irritation because of the nasal secretions dripping to the back of the throat.
4. Itching of the nose, eyes and ears.
5. Sneezing which happens in bouts of many.
6. Puffy eyes
7. Irritated congested red eyes
8. Cough which is usually dry.
9. Nose bleeds due to excessive rubbing of the nose.

These symptoms may then lead to other issues which include

1. Tiredness and fatigue due to poor sleep because of the nose blockage.
2. Irritable and lack of concentration due to constant itching in the nose.
3. Nose bleeds especially at night due to vigorous rubbing of the nose.
4. Low threshold of developing ear infections.
5. Headaches or heaviness of the head.
6. Excessive itching of the eyes can cause dark circles under the eyes.
7. A crease may develop at the top of the nose due to constant rubbing.

Is allergic rhinitis genetic?

‘Atopy’ or the tendency to develop allergies is commonly seen in a family across generations. However, there is no genetic basis to this argument that it is hereditary. For example if a child is diagnosed with allergic rhinitis then either of the parent may possible have the same condition or one of the other atopic conditions such as asthma, eczema or none at all.

Treating allergic rhinitis effectively

Allergic rhinitis can be treated better if it is diagnosed early. You can also take the support of your paediatrician to identify the symptoms.

Avoiding allergen:

• Avoid outdoor allergens. Keep windows shut especially in the flowering season and avoid dusty places
• Avoid walking on freshly cut grass
• Wet dusting of household surfaces and vacuum cleaning the house helps maintain dust free environment.
• Changing the sheets more frequently will reduce exposure to dust mites.
• Wash hands after playing with a pet.
• Pest control to contain cockroaches.
• Mold prevention especially in bathrooms.

Medications:

There are many medications available for the control of the symptoms of allergic rhinitis. Your Paediatrician will prescribe them in addition to the precautionary measures based on the child’s symptoms. When symptoms are particularly troublesome an allergy specialist will perform tests to try and pinpoint what exactly the child is allergic to. In certain types allergic immunotherapy can be instituted by them. Allergic rhinitis generally gets brushed off as dust allergy among children. It is important to identify the symptoms early and start the treatment.

Dr. Suruchi
Consultant – Paediatrics 
Columbia Asia Hospital
Whitefield, Bengaluru

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Are you running out of the ideas to keep your child busy, and using electronic devices to engage them and free yourselves? Then it is the time to wake up and to avoid using gadgets as your babysitters. Since, the upshot of the device used on your child’s overall development is extensive and consequential.

Being able to communicate is the major exclusive attribute of human beings, which differentiate the human species from the other. SPEECH is the complex phenomenon through which, the expression of ideas and thoughts takes place by means of vocal sounds. Whereas, LANGUAGE is the set of code or conventional signs, which is not necessarily articulated. It can be any sets of signs, signals, symbols or even written words that convey the meaning. Thus, LANGUAGE is the set of code and SPEECH is the act of putting these codes to use.

Development of speech and language:

Speech and language development, is a critical part of child’s development. Child’s first three years of life, is the most important period for acquiring speech and language skills. It’s the significant time where, the brain is re-organizing the neural networks and maturing rapidly. The development of speech and language in an individual, takes place till first 8 years of life.

Brief chart of speech and language developmental milestone.

• 3 – 12 months; Cooing, laughing with sounds, babbling is an important development stage during first year.
• 12 – 18 months; At this stage children often say their first words with meaning.
• 18 months – 2 years; In this phase, their lexicon will be developed and they will start using two words methodically to form short sentences.
• 2 – 5 years; They can speak in longer and more complex sentences. You can expect more abstract and complex conversations at this stage. The child will probably also want to talk about a wide range of topics, and vocabulary will keep growing.
• 5 – 8 years; At this phase your child will be better story teller and narrator. They will start to learn how the sounds within language work together. By the 8 years of age, your child will be able to have adult-like conversations.

Impact of devices on child’s speech and language development.

These days, most of the children are engaging in usage of different gadgets like, telephone, radio, TV, and stereo system. This is really surprising! According to the USA centres for Disease Control and Prevention says that, an average child spends about 8 hours a day watching electronic tools and one of the major negative effects of gadgets use is, speech and language delay.

5 out of 10 speech and language delay case reports, excessive use of electronic devices by their children in the case history forms. Which is the major cause for their child’s delay in speech and language development. Hard to believe right? A Tool used to keep your child busy and entertained is now one of the major causes for delay in speech and language. Due to delay in speech, the child might not be able to express its needs, thoughts and feelings according to the age. Even if it is expressed, it will be difficult for the listener to understand it. According to many researchers, children who spend an average time by looking into electronic screens, will be having difficulty in expressing their thoughts. This condition is called as ‘expressive language delay’.

Back then, there would be 15 to 20 people in a family, living under the same roof. Where, there would be lots of verbal action taking place, and the growing child would be getting continuous verbal input from the family members. These are the days, where hardly 3 to 4 people live in a family (both parents working) and lot of device talking are heard than the humans! This is the circumstance under which our child’s development is taking place.

For any new learning process, “input” plays the vital part. The limited speech input along with the deviated attention of your child, towards the gadgets, can hinder the development of speech and language skills in the child. Every minute the child is spending on the gadgets is the minute fewer that he/she could speak or learn with others by interacting. Gadgets take away your child’s precious and significant time where, lot of learning can take place by talking and communicating with other people.

Excessive usage of gadgets can also lead to other conditions. Such as, attention deficits, learning problems, anxiety, childhood depression. These are the few negative effects of gadgets on your child’s development in this fast-growing world of technology.

Benefits of reduced screen time;

Brain electrical activity researchers have found that, language acquisition increases the brain plasticity and capacity for learning in children. They also reported that, reduced usage of gadgets and more language learning process in the early stages, plays in the rapid formation of memory circuits for coding new information.

Developmental age is that crucial period in the child’s life where, the brain has the capacity to mould itself very easily according to whatsoever input you provide. There are instances where the children can speak more than 4 to 5 languages fluently. That is the capacity of developing human brain. So, don’t take away this significant period from your children by engaging them by providing devices in their hands.

Instead, set the time for using the electronic screen, make them play outside, make them to interact with people more, give them a chance to explain or narrate their topic of interests, give them opportunities where they can create their own stories, peer group interaction is of utmost importance, involve them in artistic activities such as, painting, dancing, singing where, these are the few activities children enjoy the most and also enhances the learning ability in the them.

Hence, interact more learn more!!!!

KAVERI SHEKHAR
Speech Language Pathologist
Nireeskhe Special School, Mysore.
Mob: 97397 95607

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Hearing loss has been shown to be linked to dementia in epidemiological studies and may be responsible for a tenth of the 47 million cases worldwide. Now, published in the journal Neuron, a team at Newcastle University provide a new theory to explain how a disorder of the ear can lead to Alzheimer’s disease – a concept never looked at before. It is hoped that this new understanding may be a significant step towards advancing research into Alzheimer’s disease and how to prevent the illness for future generations.

Key considerations

Newcastle experts considered three key aspects; a common underlying cause for hearing loss and dementia; lack of sound-related input leading to brain shrinking; and cognitive impairment resulting in people having to engage more brain resources to compensate for hearing loss, which then become unavailable for other tasks. The team propose a new angle which focuses on the memory centres deep in the temporal lobe.

Their recent work indicates that this part of the brain, typically associated with long-term memory for places and events, is also involved in short-term storage and manipulation of auditory information. They consider explanations for how changes in brain activity due to hearing loss might directly promote the presence of abnormal proteins that cause Alzheimer’s disease, therefore triggering the disease.

Professor Tim Griffiths, from Newcastle University’s Faculty of Medical Sciences, said: “The challenge has been to explain how a disorder of the ear can lead to a degenerative problem in the brain. “We suggest a new theory based on how we use what is generally considered to be the memory system in the brain when we have difficulty listening in real-world environments.”

Collaborative research

Work on mechanisms for difficult listening is a central theme for the research group, including members in Newcastle, UCL and Iowa University, that has been supported by a Medical Research Council programme grant. Dr Will Sedley, from Newcastle University’s Faculty of Medical Sciences, says: “This memory system engaged in difficult listening is the most common site for the onset of Alzheimer’s disease.

“We propose that altered activity in the memory system caused by hearing loss and the Alzheimer’s disease process trigger each other. Researchers now need to examine this mechanism in models of the pathological process to test if this new theory is right.” The experts developed the theory of this important link with hearing loss by bringing together findings from a variety of human studies and animal models. Future work will continue to look at this area.

REFERENCE: How can hearing loss cause dementia? TD Griffiths, M Lad, S Kumar, E Holmes, B McMurray, EA Maguire, AJ Billig, W Sedley. Neuron (2020)

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