Invisible Problem Can Have Long Lasting Effects on Learning & Behavior

Hi Dr. Sherri,

Our son has reading problems right now. He is 12. When he was little, he was diagnosed with having fluid in his ears and we had to have several sets of tubes put in. He had chronic allergies and sinus problems which we understand had something to do with the fluid in the ears. The fluid lasted for quite some time before we realized anything was going on. He was a late talker because of this. He also has problems with saying certain sounds to this day! My question for you is this: can fluid in the ears cause a problem later with reading? Does this have anything to do with problems processing information? Can fluid in his ears at 2 affect him at 12, even after the fluid doesn't exist anymore? We would like to get help for our son, but have tried the tutors and it doesn’t seem to be helping. He doesn’t have fluid in his ears now. Is it too late at 12? Any thoughts? N.N.

Dear N.N.,

No it’s not too late! Fluid in the ears as a small child most certainly can and does affect a child’s ability to blend sounds, understand the beginnings of language and ultimately read. It effects a child's whole processing system. Yes, this is the crux of where auditory processing problems come from. If you can imagine trying to hear and learn your sounds under water, you will begin to get a picture of how these kids are functioning and the frustration it can create. The problem is that if this is happening repeatedly in the formative years, these kids naturally stop trying to absorb the world through their ears because they don't work well, and they begin to use their visual skills more because it is the only sensory skill open to them at the time. This is called compensation and all human beings do it. That is, using stronger skills to compensate for weaker ones. Through sheer amounts of usage and practice with the good sensory skill, the weak sensory skill becomes weaker and weaker. It would be like not using a particular set of muscles for a long time. Eventually, they would atrophy and become unusable. What happens with reading is that, due to the fluid block, the parts of reading or the sounds, never become solid. The child gets fixated on the parts of words as opposed to the words. Therefore, reading stays choppy and never gets fast enough for comprehension to happen. This can be true even after the block is cleared since it occurred for a period of time and the child got used to doing it that way. It becomes habit. Since the parts are slow, the lack of speed of the reading effects the comprehension. In other words, if the parts come slowly, by the time the child reaches the end of a sentence or the end of a paragraph, it doesn’t make sense to him or her anymore because it took him or her such a long time to get there. The bigger problem is that if it goes on long enough, eventually many children with these kinds of problems will turn away from school and reading completely. They begin to avoid the whole process because it is so painful.

In this type of situation, the foundation skills of auditory processing must be trained before even attempting academic remediation. This is why many times tutoring without fixing the processing skills first doesn’t succeed. They have to learn to get successfully past the parts, and be able to handle the whole. Tutoring after fixing the processing can be monumentally successful.

His problems with sounds also do not surprise me. To understand this better, I’d like you to think about what a deaf person sounds like when they speak. Deaf people learn and understand what someone says primarily by reading their lips or using their eyes to pick up what was said. Usually, any sound spoken by a deaf person does not sound as clear as if said by a hearing person. I believe that this is because when lip reading, one cannot see the actual enunciation of a sound and therefore, the sound is not translated clearly to the deaf person. I believe that kids with fluid in the ears function very much the same way. They read lips when they cannot use their ears well. If this happens a lot, they become used to it and do it often. Particularly suspect to me, is the sound of “R.” If you look at the way that sound looks when someone says it, it looks like it should sound muted, which is exactly how many of my client’s sound. Not surprisingly, most of these kids had problems with fluid in the ears when they were young. They learned to say what the sound of “R” looked like rather than what it actually sounded like.

The good news in all of this is that I would bet that your child has excellent visual processing abilities. Throughout the time that your child was not absorbing things through his ears, his eyes were probably working overtime to absorb things. This overuse creates incredible skills, however, it is better to have the use of both visual and auditory in a strong way than just the use of one. This creates much less stress and allows the child to absorb things more easily.

When I used to do school evaluations for services, it would drive me crazy to hear someone refer to someone as a "visual or auditory learner" and then design a plan to fit their strength. I would always get in trouble when I would ask, "what about the weaker skill?" Now, years later, I train both to work simultaneously so there is not a weaker skill.

The even better news is that all of these kinds of skills can be improved significantly through targeted, specific practice. It’s also important for you to know that it really isn’t a hard process to bring these skills up to par. Without targeted practice, however, those skills will probably always be behind. It is definitely not too late now. In fact, it’s the perfect age and the perfect time to get him caught up.

For other parents of very young children who suspect their child may be having problems with fluid in the ears, don't panic while reading this. Just look for the warning signs and catch it early. The earlier you catch it, the less chance the bad habits can form. If your child had any of the warning signs and it is years later, do something about it. Fix the bad habits so the child can start functioning in a less stressful way. Warning signs of fluid in the ears are the following: late talking or late at imitating sounds; chronic colds, allergies, ear infections or sinusitis; many ear aches. In babies, it can look like the child is pulling on the ears, frustrated and not saying sounds. The child can also be very irritable. Also, if your child has a snotty nose a lot, another sign of lots of mucus, it is suspect. If it's in the nose, it can also be in the ears. The best thing to do if you are unsure is head toward the Pediatrician’s office and check it out. Once you know, you can begin to help.

Signs that a child has a auditory processing problem or other processing problem are the following: not listening, not following directions, cannot hold onto more than 1 or 2 verbal directions at a time, fails to remember homework assignments, fails to remember how to do the homework assignment even if it was just explained to him or her, lack of interest in reading and when the child does read, lack of comprehension, off-task behavior and seeming distractibility. These and others can be signs of processing problems. Add to this the fluid in the ears when the child was young and chances are, this is the problem.

Dr. Sherri was a Child and Family Processing and Motivation expert seeing people via webcam. She is currently a writer and consultant, updating her website and will post when done for contact purposes.