Two Divergent Paths

Last week we begin looking at the effects of second hand smoke on babies. We hypothesized the two divergent paths children may take depending upon whether or not they had been exposed to second hand smoke. Let’s now take our two hypothetical children along their separate development trajectories. What happens to the child who is exposed to second hand smoke? How is this different from the child who has been protected from this exposure? We will begin with the exposure of the young child to second hand smoke and follow the effects on learning and school experience. The effects are like falling dominos.

The exposure to second hand smoke upon the respiratory system of young children causes fluid in the inner ear. When we have fluid in the inner ear the sounds of the environment and the sounds of language in our environment are not clearly heard. Our two hypothetical children hear differently. One hears only some of the sound frequencies and hears these intermittently depending upon how much fluid has collected in the inner ear. If the mother and doctor are aware of the problem, the child will most likely be given antibiotics. If the problem is persistent he may have drainage tubes surgically placed in the ear. Even if these measures are taken, this child will always have a large percentage of time when his hearing is jeopardized. He cannot figure out which sounds to tune into and which sounds to ignore. He is on a path to delayed language acquisition and problems in sound production. He is also on a path towards attention deficit, a very serious barrier to being ready to learn.

Our other hypothetical child hears the sounds of the environment and language clearly. This fortunate child easily learns language learns to locate sounds in his environment. He discriminates which sounds to tune into and which environmental sounds are unnecessary to his learning. When it is time for school, he is ready to tune in and learn.

Let’s move ahead to preschool. The child who has been exposed to second hand smoke does not follow directions easily. Why not? Either he has not heard clearly what the teacher says or his brain has not had enough practice tuning out the noises in the classroom to focus on the words of the teacher. The sounds of the door opening, a child coughing, or any of the sounds that bombard us each minute distract him. He really isn’t ready to learn as our other child whose hearing has always been good and whose brain has figured out what sounds are unimportant and can be disregarded.

So our troubled little one gets further behind and he’s only in preschool. If he isn’t speaking well, he may be referred for an evaluation of his learning. He may need speech therapy. While these interventions are helpful and necessary, the root of the problem is still there: at the most crucial time in his learning, way before his first words, his hearing was jeopardized. Sadly, this was preventable but he can never go back to the child he could have been.

The dominos continue to fall next week. We will look at the learning problems that escalate as the child moves from preschool to school with the challenges of learning to read.

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