- EROM can produce, what I refer to as, ‘The Otitis Media Dialect (OMD)’. What is the OMD?
- The OMD is noted in those who have had (significant) histories of EROM (whether they knew it or not). You can often hear it in their phonemic errors and in their speaking-voice.
- I’m glad you asked for phonemes first. In 1983 Shriberg and Smith ran an amazing study at 2 separate universities. Each one demonstrated the same thing. Those with a significant history of O.M. showed a significant tendency to insert an /h/ at the beginnings of words (replacing the first sound or inserting /h/ in front of a vowel (“hand” for “tan” and “hose” for owes” on the W-22s in noise). They also noted an Epenthetic Stop, I believe we see it when a person puts a stop-consonant at the beginnings of words (like on the W-22s they say “bahm” or something like it for “farm”.
- A very important phonemic error involves the /l/ and to a lesser extent /w/. We studied chinchillas, many years ago, and found that with middle ear fluid (similar to O.M.) that the middle formant of /l/ disappeared. That is, a ramp from slightly higher to lower frequency vanished. When there was fluid in the ear, even when we amplified the response to make up for the conductive loss, on the spectrogram, that ramp was gone! That made the remaining 2 formants look exactly like the vowel. Because of this and/or other reasons there are a lot of vowel confusions and/or vowel plus /l/ confusions in those we have seen with EROM.
- Oh yes, that’s not all. In addition, there were other phonemic problems. Because fluid, especially thick fluid, greatly reduces the weak high frequency sounds like /p/ and /t/. You may have heard of “H and Friends” and “Just the Friends”. They are therapies for /h/ /p/ /t/ and /k/ in the initial position with HaF and JtF for the 3 plosives in the final position.
- The other OMD characteristic that we have noticed are poor low-pitched voices, spoken from the back of the throat. In fact, if you ask the person to say /l/, you may hear a mumble from the back of the throat that sounds like a noisy short-u plus a weak noisy /l/.
- Why? On the spectrogram you will see the high frequency sounds faded-out and lots of noise that may, or may not, be associated with the speech. When you speak with the words aimed at the side of the mouth, you get a kind of a noisy speech. Unfortunately, when we speak from the back of our throats, we also minimize H-and-Friends sounds and other frontal sounds, so their speech is not clear.
- Another thing I found is that the phonemic errors that are associated with EROM take longer to correct. That is how HaF came about. I was curious what speech-in-noise errors were left at the end of WINT therapy. The 4 HaF sounds on WINT represented 30% of the errors. HaF and JtF have been most helpful.
- Itch Cards and Focus that we use in the Buffalo Model are also very helpful for stubborn speech sound confusions, like those above. I’ve added words to Itch Cards for the vowel+/l/ problems and also for Focus cards just the vowels+/l/. My new Itch words to represent the /l/ errors are “old, pool, full, ultra, whittle” (the underline shows the /l/ confusion. You may know that in some cases /l/ sounds like “ittl” to them.
About Buffalo Model Assessment and Intervention
About 35 years ago one of our graduate students checked to see how many SSW references he could find. He found more than 60. Now, I have also been working on a history of the SSW over the past 60 years. I reference 60+ SSW studies (the majority more recent than 35 years.
So just the ones he and I mentioned would be over 100 SSW reference for 50+ years. They include studies in various languages and with many disorders, dealing with site of lesion and APD.
SSW is so powerful, uses multidimensional scoring (so you get lots of details about the disorder). It is reliable and sensitive. It enables people with hearing loss to be tested effectively. It was initially based on an NIH grant with more than 100 subjects with well localized lesions. They were studied by audiologists, neurologists and a neurosurgeon as well as ENTs. This was the basis for the Buffalo Model because those results enabled us to identify 4 major types of APD.
The SSW does not stand alone. There are 3 tests that provide 40 indicators of APD. No APD test or battery has survived so many decades. In the U.S. the SSW has been reported to be the most used central test (by an independent audiology group).
The field of APD has had a history of many people saying that there is no such thing as APD (which has caused countless children and adults to suffer and under achieve in life). Some interested in APD say that short-term auditory memory is not auditory processing. Why do we do this to ourselves?
In the Buffalo Model we work to make our test and test battery as beneficial to our patients as we can. The parents of the children have been our biggest advocates. They see what the benefits have been to their children and would like to see others benefit too.
At 87 years I get such joy seeing my patients improve their lives and seeing their joy.
Be well and keep doing this wonderful work!