Surgery for speech?

[rwilk]

DD (5) has recieved speech services on and off since she was 15 months. Currently, she's receiving services because she is difficult to understand at the sentence level, but is understandable at the indivdual word level.  The district wants to cut off services because she can make the correct sounds---she just doesn't.  

 

We sought a second opinion to see what was going on and have more support for continued services.  We just had a speech eval today, and they said that the issue isn't primarily with speech/mouth movement, it's a problem of enlarged adenoids.  The adenoids block the air flow, and so during a sentance, she does not voice all the sounds correctly since she runs out of air.  The suggestion was either to 1) wait 6 months and see if she compensates for the issue or 2) consider an ENT apt to get an opinon on an adenoidectomy.

 

I'm so hestiant to consider surgery for a speech issue, because I worry about the safety of surgery.  Has anyone had similar experiences with adenoidectomies and speech?  Do they actually fix the issue?  Would you consider a surgical fix for your child?

 

Thanks!

[maize]

My son's nasally speech was what originally sent us to an ENT for evaluation around that same age, his adenoids were blocking 95% of his nasal passage.

 

The surgery is very straightforward and recovery was easy, not nearly as bad as a tonsilectomy. He was totally normal within two days.

 

It didn't fix all his speech issues but it did help.

[maize]

Meeting with an ENT for an evaluation certainly couldn't hurt.

[kbutton]

Coming from a second opinion, I would give some credence to the idea and consider meeting with an ENT. If the school said adenoids, but it's never come up anywhere else, I would be leery.

 

However, I would want to be sure that apraxia isn't part of the deal--if it is, adenoids alone won't cut it. Or, she could have the adenoids out, but struggle with proper breath support because it's "different" now with no adenoids, and she still doesn't know how to breath properly. Apraxia can be mild vs. a child not having any or very few speech sounds. My son had all but one of his speech sounds at six (with no therapy) at the word level, and iffy at the sentence level. He made extra effort for strangers who didn't easily understand him. Eventually, he started losing speech sounds and his overall control floundered as demands for speaking increased--he was not using the proper muscles to make the sounds, and it was fatiguing. So, he has apraxia, but it's mild. Apraxia deals with the whole motor aspect of speech, including breath support, forming the sounds, and then stringing it all together/sustaining that control. 

 

If you think you'd like the adenoids taken care of regardless of the speech issues, then I would just have it done. If it doesn't fix everything, then you could find out if she needs breath support training or a different approach to speech after the adenoids are out of the way.  

 

[Crimson Wife]

Adenoids is one of the structural anomalies mentioned in passing in my textbooks but it's out of the scope of practice for SLP, so the ENT referral is appropriate. The ENT can tell you whether or not surgery would likely benefit your child.

[geodob]

While I'd heard of Adenoids,  your post made me interested in finding out what they actually are?

 

Where up to around the age of 5.  They play a role in capturing bacteria and viruses, that pass through the back of our throat.  When we are breathing or eating.

The adenoids and tonsils, stand as our first line of defence. Where they will produce anti-bodies, to destroy the bacteria and viruses.

In a sort of natural vaccination process?

 

From birth, the Adenoids continue to grow larger.

But then, around the age of 5 to 7, they start shrinking and virtually disappear in the teen years.

 

The Adenoids become enlarged, while fighting an infection.

Then reduce in size, after the infection has passed.

But in some cases, can remain enlarged.

 

So that while her Adenoids were observed as 'Enlarged'.  

Further observations are needed, to identify with this was just temporary, or permanent?

 

Though enlarged Adenoids, will also cause Sleep Apnea and snoring.

They can also block the Eustachian Tubes, that drain fluids from the ears.  Resulting in ear infections.

 

I'll attach a link to an article that talks about how Enlarged Adenoids effect speech. Where understanding how it effects speech? Could be used while observing how ytour DD speaks?

 

http://www.banterspeech.com.au/how-do-adenoids-and-tonsils-and-their-removal-affect-speech/

[rwilk]

While I'd heard of Adenoids,  your post made me interested in finding out what they actually are?

 

Where up to around the age of 5.  They play a role in capturing bacteria and viruses, that pass through the back of our throat.  When we are breathing or eating.

The adenoids and tonsils, stand as our first line of defence. Where they will produce anti-bodies, to destroy the bacteria and viruses.

In a sort of natural vaccination process?

 

From birth, the Adenoids continue to grow larger.

But then, around the age of 5 to 7, they start shrinking and virtually disappear in the teen years.

 

The Adenoids become enlarged, while fighting an infection.

Then reduce in size, after the infection has passed.

But in some cases, can remain enlarged.

 

So that while her Adenoids were observed as 'Enlarged'.  

Further observations are needed, to identify with this was just temporary, or permanent?

 

Though enlarged Adenoids, will also cause Sleep Apnea and snoring.

They can also block the Eustachian Tubes, that drain fluids from the ears.  Resulting in ear infections.

 

I'll attach a link to an article that talks about how Enlarged Adenoids effect speech. Where understanding how it effects speech? Could be used while observing how ytour DD speaks?

 

http://www.banterspeech.com.au/how-do-adenoids-and-tonsils-and-their-removal-affect-speech/

This was facinating.  Thank you so much for sharing!  

 

 

 

 

Coming from a second opinion, I would give some credence to the idea and consider meeting with an ENT. If the school said adenoids, but it's never come up anywhere else, I would be leery.

 

However, I would want to be sure that apraxia isn't part of the deal--if it is, adenoids alone won't cut it. Or, she could have the adenoids out, but struggle with proper breath support because it's "different" now with no adenoids, and she still doesn't know how to breath properly. Apraxia can be mild vs. a child not having any or very few speech sounds. My son had all but one of his speech sounds at six (with no therapy) at the word level, and iffy at the sentence level. He made extra effort for strangers who didn't easily understand him. Eventually, he started losing speech sounds and his overall control floundered as demands for speaking increased--he was not using the proper muscles to make the sounds, and it was fatiguing. So, he has apraxia, but it's mild. Apraxia deals with the whole motor aspect of speech, including breath support, forming the sounds, and then stringing it all together/sustaining that control. 

 

If you think you'd like the adenoids taken care of regardless of the speech issues, then I would just have it done. If it doesn't fix everything, then you could find out if she needs breath support training or a different approach to speech after the adenoids are out of the way.  

She does have apraxia, as well as general motor dyspraxia.  She has problems controlling many of her muscles, so I'm guessing even if the adenoid issue were fixed, she might need continued speech help. I think at this point, I'm leaning against surgical intervention just because I hate the idea of surgery for her. If it 100 percent would fix it, or if she were having other problems related to the adenoids maybe it'd be different.

 

 

 

My son's nasally speech was what originally sent us to an ENT for evaluation around that same age, his adenoids were blocking 95% of his nasal passage.

 

The surgery is very straightforward and recovery was easy, not nearly as bad as a tonsilectomy. He was totally normal within two days.

 

It didn't fix all his speech issues but it did help.

Hmm interesting.  I guess I didn't realize exactly how much they could block up.  I'm glad to hear it was a mostly easy process.

[Ottakee]

Obviously the ENT can tell you more for your case but our son's speech improved about 75% or more once we had his tonsils and adenoids removed at age 8 (he came to us at 7 1/2).  It was a huge difference.