February is Kids ENT (Ear, Nose and Throat) Health Month! In celebration, here’s a simple list of why every Speech-Language Pathologist (SLP) should love their local ENT (Otolaryngologist – pronounced oh/toe/lair/in/goll/uh/jist). ENT physicians are specialists in the medical and surgical management / treatment of disorders of the ear, nose, throat/neck, and face.
As SLPs, we frequently need the medical expertise and support of ENTs so we can adequately treat the speech, language, and voice needs of our clients. We are often the ones who have the knowledge and direct face time with children and their families to help identify possible reasons for a referral to an ENT.
So, why does healthy functioning of the ears, nose, and throat matter for speech therapy? When people think about speech, they often think about the mouth first. Although this is mostly true, the connection of the ears, nose, and throat to our mouth is not only one of proximity. They share an intimate relationship in the ways they must work together in order for us to complete daily functions such as communicating, swallowing, sneezing, singing, etc.
Ears - We know as SLPs that listening to sounds/words is the primary mode that most people learn to use verbal speech. A temporary ear infection or any level of hearing loss, even temporary, can impact a person’s ability to effectively hear the subtle differences in sounds, words, and the meaning of spoken language. Hearing loss at a young age can affect speech and language development. Therefore it is critically important for SLPs to make appropriate referrals to ENTs (and Audiologists) when concerns related to our client’s ears and hearing arise.
Nose - The roof of our mouth forms the bottom of our nasal cavity. Some speech sounds (m,n, ng) are produced using air that comes out of the nose thanks to the highly coordinated function and opening/closing of our soft palate/velum, the amazing door between our nose and mouth. When airflow if off balance or uncoordinated, typical acoustic quality of the voice is compromised. Additionally, airway restrictions in the nose (or throat) can prevent a person from breathing properly with their mouth in a closed position. Ideal breathing at rest is through the nose. Chronic open mouth breathing posture can result in functional changes of tongue posture, tooth eruption, and face & palate shape over time. This may lead to difficulties with proper swallow function and or articulation of speech sounds. (See the IAOM link below for more information.)
Throat - Our throat or “pharynx” is the passageway for air, food, and liquid. The larynx is housed in our pharynx and holds our vocal cords, which are critical for producing speech! SLPs rely on ENTs to assess the structures and functions of the pharynx as they are not visible without medical instrumentation.
The following is a partial list of common reasons SLPs may refer a child to an ENT as part of the medical team to support speech therapy.
- Parent report of chronic ear infections or concerns / observations related to possible hearing loss (an audiologist may also be on the team)
- Ongoing observations of frequent colds / allergies
- Persistent mouth breathing /open mouth posture
- Suspected tongue / lip tie
- Parent report of consistent noisy sleep / snoring
- Suspected cleft lip / palate
- Irregular nasality of the voice
- Vocal Quality Concerns (Hoarse / Breathy / Effortful / Wet)
- Swallowing Difficulties (Dysphagia)
- Asymmetrical Facial Movements
So on behalf of all SLPs, we send a big THANK YOU to all of the ENTs who join our team to help clients reach their fullest speech and language potential!
Julia Franklin, MS CCC-SLP is a licensed speech language pathologist and co-owner of Echo Speech Therapy. www.echospeechtherapy.com @Echo_Therapy
References & Links
American Academy of Otolaryngology - Head & Neck Surgery http://www.entnet.org/KidsENT
American Speech-Language-Hearing Association www.asha.org
International Association of Orofacial Myology (IAOM) http://www.iaom.com