Childhood Communication Center

Apraxia is a motor speech disorder in which the brain has problems planning to move the parts of the body (lips, jaw, tongue) used for speech. Children with apraxia know what they want to say, but their brain has difficulty coordinating the muscle movements needed to say the words.

Aural atresia is when a child is born without an ear canal. The inner ear and auditory nerve are usually normal, but the external ear and middle ear are typically malformed. Atresia can occur in one or both ears. A child with atresia in only one ear can also have hearing loss in the "normal" ear. Aural atresia is often associated with microtia (PDF) and craniofacial microsomia.

Delays or disorders of speech development can be caused by many things, including problems with breathing used to produce voice, problems with structures used in speaking (such as the lips or tongue) and/or problems with coordination of those structures. Delays or disorders of language development can be caused by problems hearing or understanding the language of other people, or by problems affecting parts of the brain responsible for learning and memory.

Hearing loss can occur for many reasons, including genetic causes, infection, trauma or damaging noise levels. If hearing loss goes undetected early in life, it can interfere with development of speech and language skills.

Hoarseness is the voice quality produced when something interferes with the normal vibration of the vocal folds. The most common cause of temporary (short-lived) hoarseness in children is swelling (inflammation) from a cold or flu. Hoarseness can be caused by nodules, polyps, cysts or other growths on the vocal cords. Children who strain their voices may also have hoarseness.

Inducible laryngeal obstruction (ILO) is when the vocal fold muscles (vocal cords) close and block the airway, making the throat feel tight or making it hard to breathe. Normally, the vocal folds stay open when you breathe in or out.  Vocal folds move to the middle of the throat when you talk. They close completely to protect the airway when you swallow. During episodes of ILO , the vocal folds close when they should be open. If this happens during exercise, we call it Exercise-Induced Laryngeal Obstruction (EILO). Read more. (PDF)

Microtia is a small or missing ear. Children with microtia are born with the condition. Some may have a small ear that has all of its internal parts. Others may be missing parts inside the ear. Read more. (PDF)

In velopharyngeal dysfunction (VPD), parts of the throat and roof of the mouth do not work right during speech. When a child has VPD, their soft palate does not always contact their throat when they talk. This lets air escape through their nose during speech. If VPD is severe, it may be hard to understand your child’s speech. Read more or watch All About VPI (video, 00:03:14).

Audiology is the diagnosis and treatment of hearing loss. We are experts in identifying and evaluating hearing loss in newborns and young children, as well as in teens and young adults. We provide a full range of hearing tests, and offer complete rehabilitation services, including hearing aids and FM systems. Read more.

Augmentative and Alternative Communication (AAC) is all forms of communication except for oral speech. AAC aids, such as picture boards or electronic devices, can help children with serious speech or language problems express themselves. Read more.

Aural habilitation helps children with hearing problems improve their ability to use the sound that they can hear and express themselves in spoken language. At Seattle Children's, we offer many kinds of aural habilitation services. Read more about our aural habilitation serivces (PDF). 

Learn more about our Cochlear Implant Program.

Cochlear implants are small, surgically implanted electronic devices that can help provide deaf or hard-of-hearing children with a sense of sound. They work by directly stimulating the hearing nerves with electrical signals. The cochlear implant team at Seattle Children’s Hospital provides a complete range of services, including:

• Evaluating children to see whether they will benefit from an implant
• Programming the device(s)
• Ongoing care for children with implants
• Auditory training to build spoken language skills for children with cochlear implants
• Speech and language evaluations for children with cochlear implants
• Psychosocial evaluations and support for children with cochlear implants

Read more about our Cochlear Implant Program (Spanish [PDF]).

The Childhood Communication Center offers educational outreach audiology services for Seattle Children's patients who attend school in a district without educational audiology services.

This support may include:

• Educational resources about hearing loss and communication strategies in the classroom.
• Training about hearing technology for teachers and school staff.
• Onsite or remote technology support, including basic support for hearing devices and cochlear implants. We also troubleshoot use of FM and assisted listening devices in the classroom.
• Classroom observation and assessment of listening environment(s).
• Recommendations to meet the needs of specific students.

If your child’s school district does not have educational audiology services and you are interested in this service, talk to your child's audiologist at Seattle Children’s.

Hearing Loss Clinic brings together experts from a number of areas to assist children with hearing loss and their families, and to identify a cause of the hearing loss. Many families find Hearing Loss Clinic helpful after a new diagnosis of hearing loss, and during major transition periods for the child and/or family. Read more. (PDF)

Ear, nose and throat specialists (otolaryngologists) provide medical and surgical therapies to treat ear problems that cause hearing loss. They also work with audiologists and speech pathologists to evaluate and treat children with communication disorders. Read more.

The Psychiatry and Behavioral Medicine team at Children's provide therapy and treatment of behavioral and emotional concerns. We diagnose and treat mental health issues and coordinate care with educational, medical and other providers. We also provide a range of group settings such as a teen support group and a variety of summer programs. Read more about mental health services for DHH children and their families (PDF).

Our Speech and Language team evaluates children and teens who have conditions that affect their ability to communicate. We assess your child's unique needs and develop short- and long-term treatment plans to ensure that you and your child find the services you need at school and in the community. Read more.

Our team of speech and language pathologists; ear, nose and throat specialists (otolaryngologists) and orthodontists assess and manage your child's speech problems associated with VPD. We work closely with the Craniofacial Center.

Our voice specialists and speech and language pathologists work together bringing years of clinical experience and expertise to each patient history and assessment. The examination may be enhanced by state-of-the-art videostroboscopy (an examination that uses video synchronized with a strobe light to detect problems with the function and motion of the vocal cords by watching them move in slow motion) in a friendly, informative clinic environment. By watching the exam on video as it occurs, patients and parents receive immediate information about their condition. The Voice Clinic team treats: Chronic hoarseness, raspiness, breathiness, weakness, dysphonia, vocal cord immobility or paralysis, paradoxical vocal cord movement, performance voice issues, or voice problems after airway trauma or surgery.