Wednesday, July 17, 2013

Therapy ideas for SLPs who travel to client’s homes, daycares, and schools

By Gina Cato, Chief Speech-Language Pathologist with contributions from the Center's Speech department

The traveling SLP has many challenges when providing therapy outside of her office.  How many therapy materials can possibly fit in a therapy bag?  At the Center for Hearing & Speech, each SLP travels to several off-site locations, including Agape Academy, Grace Hill Head Start, Grace Hill Child Development Center (two locations), City Academy, Hilltop Child Development Center, Lemay Child & Family Center, St. Cecilia School and Academy, and Stella Maris Child Center.

These are some therapy activities that we’ve used when we travel to area daycares and schools.  The activities are functional for the child, yet require only a few supplies that typically can be found in classrooms.

  1. Work on following auditory directions in the child’s classroom.  For example, practice following classroom routines such as, “Turn in your paper and line up for lunch.”  Practice placing items in various locations when the client hears directions, such as, “Put the truck on the shelf,” or “Put the puzzle on the table.” 

  1. Use photos of the client’s school environment to teach vocabulary and practice articulation goals.  For example, use photos of the school fish, the classroom shelf, and a toy elephant to practice the /f/ sound and improve receptive / expressive classroom vocabulary.  For children who need alternative / augmentative communication, place photos on a small, metal ring or in a photo album. 

  1. If the child’s goal is to improve listening comprehension, borrow books from the classroom teacher’s weekly library to read with the child during therapy.  The child may be more likely to answer questions about a story in the classroom if she’s familiar with the vocabulary in the story. 

  1. If the child is working on answering “where” questions, have the child answer questions about items in the classroom.  For example, ask, “Where do I find crayons?”  The child says, “in the box.”  Find the items in the classroom according to the information the child gives you.  The child has instant feedback about how accurately he answered your “where” questions.

Thursday, June 20, 2013

Tips to Protect Your Hearing Aid in the Hot Summer Months

by  Lara Noble, AU.D., CCC-A, Chief Audiologist

Moisture is a common problem affecting hearing aid performance in the midst of the hot summer months.  The following tips can help guard against moisture related problems.

·         Clean your hearing aid daily! 
·         Use the brush and wax loop tool to remove any wax
·         Check battery door for dark colored corrosion; clean out door with a dry cotton swab.
·         Check tubing for moisture droplets; get tubing changed if it is hard.
·         Dry it out!
·         If moisture gets in your hearing aid, place in your drying chamber if you have one.  If you don’t have one, simply remove the battery and put in a cool, dry place with battery door ajar.

·         Check your desiccant beads!  If you are using a drying chamber, be sure that the beads are the appropriate color for optimal performance.  

Friday, May 10, 2013

My Hearing Loss Story

Guest post from Center Volunteer, Sarah Young

Sarah is currently a nursing student at St. Louis University and a regular Center volunteer in our Audiology department.  Graduating high school and preparing to leave for college is a big transition period, and for Sarah, it especially was one, since she learned for the first time that she had hearing loss. Here is her story from learning she had a hearing loss, accepting it and receiving her first pair of hearing aids a semester later while she was home for winter break.  

I first found I had hearing loss as a senior in high school.  I had gone to my doctor for a physical and he tested my hearing, the first time since third grade.  At first I thought  I had “failed miserably” (his words, not mine) because of his heavy accent.  I must have had trouble understanding his instructions and so hadn’t reacted the way I was supposed to.  After visiting an audiologist, though, I learned that he was right, I had mild bilateral sensorineural hearing loss.  I can’t hear certain tones above a certain decibel (unit of measuring how loud sound is) in both of my ears because the hairs used to transmit those sounds are dead.  There’s no cure for sensorineural hearing loss but using hearing aids and hearing protection can reduce my chances of damaging my hearing further.

            Finding out I had hearing loss was simultaneously frightening and relieving.  My audiologist explained that having hearing loss can make you tired very easily because your ears are trying really hard to hear what’s going on.  I’ve never been a morning person, but hearing that explained why I legitimately sometimes didn’t hear my alarm clock go off  and would find myself getting tired in classes that shouldn’t have made me tired, especially because I had gotten a good amount of sleep the night before.  It gave a possible reason for my speech impediment that required 6+ years of therapy in elementary school.  However, despite giving some answers, it left me with a lot of questions.  Would I lose more of my hearing?  Would I still be able to be a nurse as I intended?  Would I need hearing aids? 

            I went off to college a few months later and noticed that in some classes, specifically those that were large, lecture style, I had trouble understanding the material because I couldn’t hear what was being said. When I came home for Christmas that year, my audiologist found out I had lost a little more of my hearing and after hearing of my troubles understanding some of the professors she suggested we try hearing aids for me. At first I didn’t really know if I actually wanted to get them.  Hearing aids were for people who had worse hearing loss than I had.  You only saw kids my age with hearing aids if they had had them since they were little.  I was afraid people would judge me for them. However, most of these fears went away the day I got my hearing aids.  My audiologist ordered a set that would meet my needs but were small enough so that even with my hair up you could barely tell I was wearing them.  My thoughts that I really didn’t NEED those hearing aids changed after she put them in and turned them on.  The best way to describe that moment is like when someone with a really loud voice is talking to a crowd and you can hear them but it’s still sort of muffled and then they get a microphone.

            Five days after I got my hearing aids I had to go back to school.  It was a huge adjustment, too.  When you wear hearing aids, they help, but they still have a lot of imperfections.  Often times I can hear the people whispering behind me in class clearer than the professor lecturing in front.  Anytime there’s any sort of loud noise they amplify it, and often times feedback comes along for the ride, too.  They cause a lot of earwax and you constantly have to carry batteries with you.  Hearing aids cost a lot and batteries are expensive ($11 for an eight pack).  However, they’ve been a bigger help than not; my grades improved, I could pay attention easier in class, and when hanging out with friends I didn’t miss as much of the conversation as I used to.  I absolutely love having my hearing aids, despite the drawbacks sometimes.

            Nursing school with hearing aids is different.  I use a special stethoscope because I can’t hear some sounds with a normal one.  I had to go to each of my instructors and explain that I had hearing loss, so that when we did parts of the health assessment where you had to listen they would understand why it took me longer.  For clinicals, I struggled with the decision over whether or not I should tell my patient I had hearing loss.  I was worried they would judge my competence as a nurse based on the fact I wear hearing aids and needed some assistive equipment. The patient I did tell was super understanding and I’m glad I told.

            I still have concerns when it comes to my hearing loss.  I don’t let myself dwell on those, though.  All it does is make me worry about things I shouldn’t worry about.  Honestly, there are worse things than hearing loss to live with, and the only real difference it’s made to my life is that I have to remember to put my hearing aids on in the morning.  Otherwise, I’ve adjusted well and don’t even really notice them anymore.  In fact I’ve had to start making sure I take my hearing aids off before I do something like taking a shower because I forget I’m wearing them.  Most people can’t tell that I wear hearing aids or that I have hearing loss, and when they do, they think it’s really interesting because I’m 20 years old and most people associate hearing aids with old people.  Hearing loss has ended up being a good thing for me:  it’s made me become a harder worker; it’s allowed a different sort of bond to form between my dad and I (he has hearing loss too, from his time in the Air Force); and when I’m stuck in one of those ice breaker games where you have to share an interesting fact about yourself I don’t even have to think of anything.  That being said, though, I would still advise everyone to take care of their hearing because even a little bit of hearing loss can make things more challenging.

Wednesday, May 1, 2013

“How do I know if my child needs help with language skills” And “How is language different from speech?"

By Gina Cato, M.A, CCC-SLP, Chief Speech/Language Pathologist

Seven-year-old Jenny was playing “I Spy” with her family. Jenny listened intently as her sister described the next item. “You use this to stay dry in the rain, and it has a handle.”

“A hammer!” Jenny said.

There are many reasons why a child could guess “hammer” instead of “umbrella” in this situation. In Jenny’s case, she has a language disorder. Jenny has problems with understanding and using the meaning, formation, and social rules of language to communicate effectively. Jenny participated in a speech/language evaluation with a Speech/Language Pathologist (SLP) when she was in Kindergarten.

In Kindergarten, Jenny’s teacher noticed several signs that Jenny was struggling to communicate. Jenny tried, but didn’t follow her teacher’s spoken directions well. If her teacher gave two steps to follow, such as, “Put your paper on my desk and find your pencil,” Jenny would find her pencil but didn’t follow the first step.  Jenny often looked at her classmates to figure out what she was supposed to do.  Jenny liked to talk, but her teachers and classmates often couldn’t figure out what she was talking about. During circle time, Jenny talked about her new puppy at home, but nobody knew she was talking about a puppy until much later. She said, “He eat food. He drinked water. He played ball.”

One or all of these problems may be signs that Jenny has a language delay or disorder.  By the end of Kindergarten, children can usually follow one to two directions in a sequence, talk about an event, and retell a story.  The American Speech-Language-Hearing Association has more information on its website about language development. Go to Here you'll find a series of articles describing expected language skills from birth to fifth grade.

If you think your child has a language disorder, the Center for Hearing & Speech can help.  The Center’s certified Speech/Language Pathologists (SLPs) provide language evaluations consisting of standardized tests and informal observations. The language evaluation takes    one-and-a-half to two hours. Afterwards, you will receive a formal report explaining the results. Based on the evaluation’s findings, the SLP may recommend language therapy and/ or classroom modifications. 

Please call 314-968-4710 or visit our website at for more information. Financial assistance is available to those who qualify.

Friday, March 15, 2013

How Much is Too Much?

by  Lara Noble, AU.D., CCC-A, Chief Audiologist

Have you ever wondered what sort of impact loud sounds can have on a person’s ability to hear? Do you ever wonder “How much is too much?”

 Think about four or five everyday situations, such as using head phones to listen to music on an MP3 player, riding in a convertible with the top down, attending a major league sporting event, riding in a car with the stereo volume cranked up really high, or maybe, just attending a concert or a musical performance at a local theater.

Every one of these situations has the potential to do serious permanent damage to your hearing, but the good news is that the danger is totally avoidable, if you know “How much is too much.”

Noise levels are measured in “Decibels”, and anything over 85 decibels is generally considered potentially harmful and anything over 90 decibels is almost certain to cause damage to your hearing.

So, once you figure out how much is too much, here’s what you can do to protect yourself and those around you. Keep the volume down on personal audio devices; “half volume”is a good rule of thumb. Limit listening time by giving your ears frequent breaks. Be aware!

If you think something is too loud, it probably is.

Wednesday, February 13, 2013

Does Your Child Need a Speech Evaluation?

By Gina Cato, M.A, CCC-SLP, Chief Speech/Language Pathologist

“A I saw a beh a a ebeh!” said four-year-old Johnny.

Hmm, what could Johnny be saying? You remember, then, that he went to the zoo that day. Conversations with Johnny can be difficult. If you know what he’s talking about, you sometimes figure it out.

By four, children’s speech can be understood most of the time. They still have some speech “mistakes,” but you can usually understand a four-year-old child without much interpretation. Johnny does need a speech evaluation. By three, children are usually placing sounds on the end of words that have consonant sounds.

Here is seven-year-old Susie’s report about the trip to the zoo. “And I saw a beh (bear) and an ewephant (elephant)!” Susie’s speech is easy to understand but it’s not clear. Susie also needs a speech evaluation. By seven, children usually use all speech sounds correctly most of the time.

These are general guidelines, but a speech/language pathologist can be consulted any time you have concerns about your child’s speech development. A speech evaluation can help us answer several questions:

1. Are my child’s speech problems normal for his age?
2. What speech sound patterns are present?  For example, like Johnny, does he usually leave off the ending sounds in words? Like Susie, does she say “w” when the word has an “l” sound?
3. Does my child need speech therapy?
4. What will she work on in speech therapy?

The Center provides speech/language evaluations and therapy programs for people of all ages. Call (314) 968-4710 for information. Financial scholarships are available. Visit the Center’s website to learn more about speech sound development:

Thursday, January 31, 2013

Welcome to Hear Speech St. Louis!

Welcome to Hear Speech St. Louis, the official blog of the Center for Hearing & Speech. We are excited to launch this new blog to spread awareness of communication disorders and to provide an educational resource that supplements our website,

Hear Speech St. Louis will bring you the latest industry and healthcare information, share stories, offer tips and techniques to help identify and cope with hearing loss and speech problems.  We will also inform you of what’s happening with our programs and upcoming events and share opportunities to get involved with and support the

We invite you to be an interactive reader!  Please participate in discussions, comment on articles, and share topics on your personal Facebook and Twitter pages.  If there is a topic you would like to see on Hear Speech St. Louis, please let us know by contacting us here:

Thank you for visiting, please bookmark Hear Speech St. Louis and come back soon, we will have updates weekly! 

Hear Speech St. Louis officially launched January 2013.