Wednesday, April 28, 2010

Part Two- The Pediatrician

This is continuing my last post about a student in need of Early Intervention Services. I am breaking this down into several posts because I feel often it is the details that shift the outcome. Often I feel a child's services and identification gets painted with broad strokes when the answers are hidden in the details. I also feel there is a distance between the families, doctors, specialized service providers, and school teachers that waters down and sometimes renders the service useless.

The parents called the pediatrician who was very supportive and wanted to have them come to her office for an appointment. The tone I got when the conversation was relayed to me was she wasn't sure there was an issue but would help the parents any way she could. There was about a week waiting for this appointment.

They took her for the appointment and the news back I received was my student had a really bad infection in both ears and failed the hearing test administered in the office by the pediatrician. The parents were told they needed to treat the infection before they moved forward. They put her on antibiotics for two weeks and scheduled a return appointment.

Meanwhile they were referred to an ENT who felt the who issue was related to the infection and fluid and if needed they could give her tubes. They were told to wait for the infection to clear before worrying about a hearing lose. They were told that if this was the issue she should be just fine once the ears clear up. They see it all the time.

An SLP friend told me that is not always an effective course of action.

I am a parent who remembers the waiting. I continued to document my observations and teach her ASL. It was interesting to me that she never showed signs of pain in her ears. It was a surprise that the language delay was not a factor. Her delay was severe in my opinion and it may be an indicator that this has been an ongoing infection, hearing lose, processing disorder, motor control or something else hindering her language acquisition over an extended period. At this point it is all medical focused on the infection. The duration of the infection didn't seem to be a concern. I was thinking about the whole child. Regardless of the source of her delay she needs to catch up with her language if she is going to experience productive brain development. She needs language for typical social emotional development. She needs language for typical abstract critical thinking skills. At this point her expressive language hindered that.

So my strategy was to provide a natural language while we wait. ASL is very natural for her. It allowed her to participate. I was also worried that if there was a hearing lose that would benefit from hearing aides the sooner we know that the better. Of course we would have to wait to fit them given the current condition of her ears but that information would be so helpful. At this point I am not sure if she has any lose since she responds most of the time to conversation and environment. I want an accurate hearing test. I suggest they ask for an ABR.

I was also working on her social strategies and verbal confidence.

At the second appointment the parents were told the infection had not responded to the antibiotics and a stronger one was prescribed. The pediatrician washed her ears out which was very uncomfortable. She tells them it would be wrong to put her though more tests right now so no ABR.

When I talk about "breaking the fourth wall" I imagine life trying it out. Let the audience interact an become part of the play. Let the professional see the audience and really interact on a humane level.

Weeks have gone by. In a child's life it is more like dog years.

Next stop..... the audiologist

1 comment:

  1. I never realized how fortunate we were that Duncan's eval to therapy went so quickly (and that everyone along the way was "on it."). I really feel for your student and her family -- and, for you. It must be painful to "hurry up and wait."