Harper, a 3-year-old in a pink jacket with tan sleeves, is supposed to have her hearing checked, but she’s having none of it. Margaret Fries ’19, a Butler senior from St. Louis majoring in audiology, is trying to coax Harper to raise her hand when she hears a tone through the headphones she’s wearing.

“It’s not scary,” says Fries, one of nine Butler Communication Sciences and Disorders students at Children’s Day In preschool to administer speech and hearing tests as part of Professor Ann Bilodeau’s Community Screenings class. “I promise.”

Harper sits silent and stone-faced, so Fries tries Plan B—a set of rubber-tipped darts known as play audiometry. Fries shows her the set of green darts with blue suction tips. She tells Harper to hold a dart up to her ear and then stand it on the table after she hears a tone.

Before long, Harper is actively participating. When she’s finished, she utters two words to Fries: “Thank you.” “It started out a little tough,” Fries says afterward, “but you just have to change up methods. We always like to start with raising their hands—that’s just the easiest way—but most younger kids don’t do that, or don’t want to do that. So then we move on to play audiometry. If that doesn’t work, high-fives or some way of getting them to recognize they are hearing the sound is next. It sometimes takes a while.”

Fries and her classmates have gotten plenty of practice. During the spring 2018 semester, they administered more than 500 speech and hearing tests at almost a dozen locations. Nearly a quarter of the children they tested needed some kind of follow-up attention.

Bilodeau, Director of the Butler Speech and Language Clinic, says what they’re doing in this preschool and other places they visit fills a gap in the healthcare system. Typically, children are screened for hearing and speech disorders from birth to age 3, and then again when they’re in school. But from ages 3-5, services aren’t readily available.

“There aren’t enough speech-language pathologists to see all the kids who need to be seen,” she says. “All the preschool directors are so grateful, the teachers are so lovely when we come, and the parents are lovely.”

At this preschool, located at a United Methodist Church near 54th and Illinois streets in Indianapolis, the Butler students are separated into two rooms. One is for hearing tests, which are administered using an audiometer, a machine that measures the ability to hear different sounds, pitches, and frequencies, and one is for speech.

Breanna Corbin ’19, a senior from Indianapolis studying to be a Speech-Language Pathologist, is in the speech room, working with a preschooler named Ruben. She opens a colorful book and points to the pictures.

“This is the woman’s …”

“Foot!” Ruben says.

“And you write with …”

“A pencil!”

Dozens of questions follow. While Corbin is administering the test, Shelby Miller ’19, a senior from Fishers, Indiana, who’s studying to be a Speech-Language Pathologist, explains that the Butler students in this room are checking to make sure the preschoolers can produce specific words and sounds and can identify colors, shapes, and body parts. They evaluate the children based on articulation, fluency, and voice intelligibility.

They also see whether the preschoolers can carry on a conversation. Ruben certainly can. When he coughs, Corbin asks if he needs a tissue. She helps him blow his nose. Ruben tells her that when it’s time to use hand sanitizer, he holds his hands together. “Like a book!”

“When I first started doing this,” Corbin says afterward, “it took a lot of adjusting. I’d never worked with kids before, so it required adjusting to what the kids say. They’re going to be silly, but that’s how kids are. Now, it’s knowing what to expect, knowing that you’ve got to be patient. You have to take time to talk to them but also keep them on track.”

By the time the Butler students have finished their work at Children’s Day In, they will have seen nearly 40 children. Christy Whaley, who runs the preschool program, says Butler is providing an important and much needed community service.

“I’m a teacher at heart,” she says, “so my former background wants the Butler students to encourage the students to come in and let us be their guinea pigs. And it really works out—the parents love having the opportunity to have their children have free screenings. This is a perfect age group for the students and a perfect setting.”

Whaley said every time Butler Communication Sciences and Disorders students have visited her preschool, they have diagnosed at least one preschooler who needs further attention.

“Even if you catch just one a year, it’s worth having,” she said.

The Butler students all will go on to graduate school for advanced degrees in Audiology and Speech Pathology. Courtney Rooker ’19 a senior from St. Joseph, Michigan, said getting into the community to administer these tests gives them needed experience.

“In Butler’s program, you get a lot of hands-on opportunities in the clinic, at school, and then here,” she says. “Kids can be anxious and nervous and difficult to work with, so that’s definitely been a huge learning curve for me, especially the patience part of it and teaching them what to do. But this is an amazing experience that Butler offers.”