We recently had a mapping appointment for Drew's cochlear implants. At nearly five years post implant, we see Drew's audiologist about every six months, just to make sure that he continues to hear well and that his equipment, both internal and external, is working optimally.
I was able to capture this video of Drew in the sound booth. I thought it would give you an idea of what hearing impaired children go through in order to be able to hear. I can not tell you what an awesome job Drew does in the booth. His ability to perform conditioned play during pure tone testing is amazing (although he prefers making baskets to doing a puzzle), and his stamina is unlike any child I know. He can sit in the booth for just about one hour providing us with detailed information on just how well he is hearing. Quite honestly, I attribute a lot of his success with his cochlear implants to his ability to perform in the booth because his audiologist has all of the information she needs to properly program his implants.
This mapping appointment was unique, as we begin to peruse options for Drew's transition to mainstream Kindergarten. During this booth test, we were really looking to get a good idea of how well Drew hears in noisy situations, and his potential need for an FM System. You will be able to see how difficult the noise testing is. On the NU-CHIPS test, without noise, Drew scores nearly 100% every time. In a sound to noise ratio of +10, Drew's score drops to 80%. Now, this is still a really good score, but this testing does not take into account degraded listening situations, for example when noise, distance and reverberation are all present, which occurs in auditoriums, cafeterias and even classrooms.
We determined that we are going to use an FM System with Drew next year, bilaterally. This will provide a clear path for the teachers voice to reach Drew's ears, and will eliminate any possibility of a noisy classroom effecting his learning. There will be many situations where Drew will not be using an FM, at home, during his sporting activities and daily life, so we don't anticipate that his ability to listen in noise will diminish.
Showing posts with label Mapping. Show all posts
Showing posts with label Mapping. Show all posts
Friday, April 6
Monday, May 10
Dining with Drew
We celebrated Mother's Day with a dinner out at one of our favorite local restaurants. We had a rather large party of 10 to celebrate the day, at a very busy, loud restaurant.
When we took our seats we didn't give much thought to the seating arrangements, other than the fact that Drew and his sister were required to sit by either me or their Daddy. Sometimes restaurant behavior can rapidly deteriorate without a parental unit nearby.
Anyway, Drew sat with his back facing the center of the restaurant. And he would not stop talking. The entire night. Didn't matter if someone else was talking at the table, his mouth was moving. And he was talking. Loud. To the point where he was wearing on my last nerve.
Then it dawned on me - he couldn't hear. I leaned down and asked him if he could hear, and he said "No, it's too loud," and popped both of his ears off.
Lesson learned. Drew needs to sit as far away from the center of a noisy restaurant as possible. And I need to talk with his audiologist about getting some additional mapping programs for noisy situations added to his processors. Now that he is able to tell us with more accuracy how he is hearing, I think we can give these additional programs a try.
This is the first time in quite awhile I have really noticed his hearing compromised by noise. I think it's time to see his audiologist.
When we took our seats we didn't give much thought to the seating arrangements, other than the fact that Drew and his sister were required to sit by either me or their Daddy. Sometimes restaurant behavior can rapidly deteriorate without a parental unit nearby.
Anyway, Drew sat with his back facing the center of the restaurant. And he would not stop talking. The entire night. Didn't matter if someone else was talking at the table, his mouth was moving. And he was talking. Loud. To the point where he was wearing on my last nerve.
Then it dawned on me - he couldn't hear. I leaned down and asked him if he could hear, and he said "No, it's too loud," and popped both of his ears off.
Lesson learned. Drew needs to sit as far away from the center of a noisy restaurant as possible. And I need to talk with his audiologist about getting some additional mapping programs for noisy situations added to his processors. Now that he is able to tell us with more accuracy how he is hearing, I think we can give these additional programs a try.
This is the first time in quite awhile I have really noticed his hearing compromised by noise. I think it's time to see his audiologist.
Wednesday, July 22
Audiology
We made some tough decisions about a year ago, and changed locations for Drew's audiological services. After just two mapping appointments, Drew's new audiologist decided to move to Cleveland, Ohio, and to a practice that does not perform pediatric cochlear implant mapping. Ugh. So, once again we were left without audiology services. We are very fortunate that our new audiology program quickly filled the open position, with a highly skilled audiologist, which we met with for the first time early last week.
Drew was an excellent patient for his new audiologist, allowing booth testing to be conducted for over one hour! With Drew's amazing ability to perform conditioned response, we got our best audiogram results ever. I was so pleased with the way the testing was performed by the audiology staff, and with how well Drew did giving very reliable results.
After the booth test, Drew's new audiologist told us that he was not happy with Drew's responses in the booth! The audiologist felt that Drew's maps could be programmed better, and that we shouldn't simply accept responses at 25 db. "Drew can do better than this," he said.
Oh, it was like being in heaven! Finally, someone that doesn't simply accept that Drew can talk, but actually reads accurate testing results and wants to make improvements. Heaven, I tell you! I've finally, after two years, found my match! Please don't leave us, new audiologist!
How did we celebrate? A trip to Kings Island!
Monday, December 8
Tough Decisions
I guess the title really says it all. We have made some really difficult decisions recently regarding our Cochlear Implant team and the service level being provided to Drew. I am always reluctant to share these types of situations, as I have no way of knowing who is reading this blog, and I don't want to upset or offend anyone. However, I don't think that we are the only family that will experience these types of issues, so I want to be candid and share our story, in hopes of helping others in our similar situation.
We shared with you a few months ago that we have been having difficulty with Drew's new therapist through our Cochlear Implant team. After continuing to try to work through the issues, it became abundantly clear that this new therapist was never going to provide the level of service to which we were accustom, and have grown to expect. While she improved in areas of "lesson plans" and "homework," we continued to struggle during the session themselves. There were points of uncomfortable silence, where it seemed like she didn't know what to do or say, and was searching for something else to do.
I never felt like this new therapist ever really made an effort to "learn" or understand Drew. One glaring example, during our final session, was when working with the Ling 6 sounds. Drew has clearly mastered detection and imitation of these sounds over the past 17+ months. When we do a Ling 6 test with Drew, we test each ear individually, at a distance of 9-12 feet, with background noise, like the television or radio. During our final session, this therapist thought testing the Ling 6 at a 1/2 foot distance in silence, with both ears on, would be a good idea.
Overall, I felt that she really lacked the personality it takes to be the type of therapist our hearing impaired child needed. She was very passive and quite shy. And personality, no matter how many meetings I request, and suggestions I give, is not something that can be changed. So we decided to readjust our therapy schedule. We are now seeing our therapist through the Early Intervention program weekly, and we have added a weekly (in home) music therapy through We Joy Sing. Drew continues to have preschool one day a week, and beginning in January will be taking a gymnastics class. All of this combines to make an excellent language calendar, and keeps our boy very busy!
While we have been going thorough this struggle with therapy, we have also been having problems with Drew's audiology team. I have to say that this whole process has been very difficult. It's so difficult sometimes to advocate for your child, especially when he or she is exceeding expectations. I have often felt like my concerns are automatically dismissed because my child can talk at age level.
The problems surrounding audiology began in September, at Drew's mapping appointment. It had been nearly five months since Drew's last mapping appointment, and turned out to be a total disaster. Drew was asked to complete a language evaluation, which took the first 50 minutes of the appointment. This could have been completed at home, or therapy, to not waste precious mapping time. Then Drew's audiologist proceeded to look at his maps for about 10 minutes. That's 10 minutes combined. For both ears. Our audiologist wasn't even going to put Drew in the sound booth! She did so only at my request. The booth test lasted about three minutes and then we were sent on our way. During the appointment, Drew's audiologist only made adjustments to the map of his right ear.
I calmed myself down over the next few hours, but could not shake the feeling that Drew was not properly mapped. I contacted other parents, who all found the fact that no adjustments were made to an ear after five months quite odd. Then, the paperwork from the appointment was sent out incorrectly, indicating that changes had been made to his left ear, when in fact they were made to his right. The whole ordeal left me questioning whether or not Drew was appropriately mapped.
Within days, Drew's Dad and I began to notice that Drew was confusing the /o/ and /m/ sounds. Even at a close distance. His therapist noted this as well. This was alarming, and I brought my concerns to Drew's audiologist. I insisted on have a full booth test done for Drew, including results for each ear individually. Drew's audiologist was very open to this and scheduled the appointment for the following week. But the booth test was again disappointing, as she only tested Drew with both ears on, and only did environmental sounds. When the audiogram was complete, she handed to it me and said that everything was fine. I immediately noticed that Drew was hearing at 25db for the low frequencies, and around 20db for higher frequencies.
I continued to question Drew's maps. The one thing I knew was that Drew continued to confuse the /o/ and /m/ sounds. I felt like something was wrong with Drew's maps.
I decided to take Drew for a second opinion, at another CI program in our state. I did not tell the audiologist of any of my concerns. I simply wanted her to evaluate, on her own, Drew's maps, looking for reassurance that everything was OK. This new audiologist started the cochlear implant mapping appointment with a booth test (something I had asked our old audiologist for, to no avail). The new audiologist was able to test each ear individually, with the booth test lasting over 50 minutes! Coming out of the booth I felt such a sense of relief, knowing that we would have a very clear understanding of exactly what Drew was hearing with each ear.
Within minutes of analyzing Drew's two audiograms, the new audiologist looked and me and said, "Are you noticing Drew confusing the /o/ and /m/ sounds at all?"
I nearly feel off of my chair. "Um, yeah, that's exactly why I'm here," I thought. I told the new audiologist that Drew had been confusing those two sounds. Within fifteen minutes the new audiologist had made the necessary adjustments, and I watched as she tested Drew in front of me, go from confusing the sounds to clearing recognizing them. My confidence was instantly restored in Drew's maps.
But I left the second opinion appointment that day with a tough decision to make. Should we continue to have Drew mapped with his original audiologist, or move all of our services for audiology to a different hospital? This question has weighed heavily on my mind for the last two months. I have thought about this question a lot, and have finally come to the decision that we are going to move Drew's audiology services to another program.
I have had several conversations with our old audiology department about my concerns, and I was really starting to feel like there was an attitude with our program like, "Lady. Your kid can hear. What else do you want? Maybe he will confuse the sounds sometimes. At least he can hear something." At one point, we were even told that we have really high expectations. It just became clear that no matter what I do, I will never have the confidence in our former audiologist as a result of this situation. And since our program only offers one mapping audiologist, we have no choice but to go elsewhere.
I guess the moral of this (really long) story to parents is to follow your gut instinct. If you don't feel like you child is hearing something, go with that feeling and have it checked out. If we would not have sought out a second opinion, who knows when Drew's map would have been adjusted appropriately, and think of all the language time we would have lost as a result. As parents, we know our children best and really need to follow our feelings. This has been a really hard decision to make, as we have such respect for our surgeon and the program he is trying to build, but we have made a decision in the best in interest of Drew.
We shared with you a few months ago that we have been having difficulty with Drew's new therapist through our Cochlear Implant team. After continuing to try to work through the issues, it became abundantly clear that this new therapist was never going to provide the level of service to which we were accustom, and have grown to expect. While she improved in areas of "lesson plans" and "homework," we continued to struggle during the session themselves. There were points of uncomfortable silence, where it seemed like she didn't know what to do or say, and was searching for something else to do.
I never felt like this new therapist ever really made an effort to "learn" or understand Drew. One glaring example, during our final session, was when working with the Ling 6 sounds. Drew has clearly mastered detection and imitation of these sounds over the past 17+ months. When we do a Ling 6 test with Drew, we test each ear individually, at a distance of 9-12 feet, with background noise, like the television or radio. During our final session, this therapist thought testing the Ling 6 at a 1/2 foot distance in silence, with both ears on, would be a good idea.
Overall, I felt that she really lacked the personality it takes to be the type of therapist our hearing impaired child needed. She was very passive and quite shy. And personality, no matter how many meetings I request, and suggestions I give, is not something that can be changed. So we decided to readjust our therapy schedule. We are now seeing our therapist through the Early Intervention program weekly, and we have added a weekly (in home) music therapy through We Joy Sing. Drew continues to have preschool one day a week, and beginning in January will be taking a gymnastics class. All of this combines to make an excellent language calendar, and keeps our boy very busy!
While we have been going thorough this struggle with therapy, we have also been having problems with Drew's audiology team. I have to say that this whole process has been very difficult. It's so difficult sometimes to advocate for your child, especially when he or she is exceeding expectations. I have often felt like my concerns are automatically dismissed because my child can talk at age level.
The problems surrounding audiology began in September, at Drew's mapping appointment. It had been nearly five months since Drew's last mapping appointment, and turned out to be a total disaster. Drew was asked to complete a language evaluation, which took the first 50 minutes of the appointment. This could have been completed at home, or therapy, to not waste precious mapping time. Then Drew's audiologist proceeded to look at his maps for about 10 minutes. That's 10 minutes combined. For both ears. Our audiologist wasn't even going to put Drew in the sound booth! She did so only at my request. The booth test lasted about three minutes and then we were sent on our way. During the appointment, Drew's audiologist only made adjustments to the map of his right ear.
I calmed myself down over the next few hours, but could not shake the feeling that Drew was not properly mapped. I contacted other parents, who all found the fact that no adjustments were made to an ear after five months quite odd. Then, the paperwork from the appointment was sent out incorrectly, indicating that changes had been made to his left ear, when in fact they were made to his right. The whole ordeal left me questioning whether or not Drew was appropriately mapped.
Within days, Drew's Dad and I began to notice that Drew was confusing the /o/ and /m/ sounds. Even at a close distance. His therapist noted this as well. This was alarming, and I brought my concerns to Drew's audiologist. I insisted on have a full booth test done for Drew, including results for each ear individually. Drew's audiologist was very open to this and scheduled the appointment for the following week. But the booth test was again disappointing, as she only tested Drew with both ears on, and only did environmental sounds. When the audiogram was complete, she handed to it me and said that everything was fine. I immediately noticed that Drew was hearing at 25db for the low frequencies, and around 20db for higher frequencies.
I continued to question Drew's maps. The one thing I knew was that Drew continued to confuse the /o/ and /m/ sounds. I felt like something was wrong with Drew's maps.
I decided to take Drew for a second opinion, at another CI program in our state. I did not tell the audiologist of any of my concerns. I simply wanted her to evaluate, on her own, Drew's maps, looking for reassurance that everything was OK. This new audiologist started the cochlear implant mapping appointment with a booth test (something I had asked our old audiologist for, to no avail). The new audiologist was able to test each ear individually, with the booth test lasting over 50 minutes! Coming out of the booth I felt such a sense of relief, knowing that we would have a very clear understanding of exactly what Drew was hearing with each ear.
Within minutes of analyzing Drew's two audiograms, the new audiologist looked and me and said, "Are you noticing Drew confusing the /o/ and /m/ sounds at all?"
I nearly feel off of my chair. "Um, yeah, that's exactly why I'm here," I thought. I told the new audiologist that Drew had been confusing those two sounds. Within fifteen minutes the new audiologist had made the necessary adjustments, and I watched as she tested Drew in front of me, go from confusing the sounds to clearing recognizing them. My confidence was instantly restored in Drew's maps.
But I left the second opinion appointment that day with a tough decision to make. Should we continue to have Drew mapped with his original audiologist, or move all of our services for audiology to a different hospital? This question has weighed heavily on my mind for the last two months. I have thought about this question a lot, and have finally come to the decision that we are going to move Drew's audiology services to another program.
I have had several conversations with our old audiology department about my concerns, and I was really starting to feel like there was an attitude with our program like, "Lady. Your kid can hear. What else do you want? Maybe he will confuse the sounds sometimes. At least he can hear something." At one point, we were even told that we have really high expectations. It just became clear that no matter what I do, I will never have the confidence in our former audiologist as a result of this situation. And since our program only offers one mapping audiologist, we have no choice but to go elsewhere.
I guess the moral of this (really long) story to parents is to follow your gut instinct. If you don't feel like you child is hearing something, go with that feeling and have it checked out. If we would not have sought out a second opinion, who knows when Drew's map would have been adjusted appropriately, and think of all the language time we would have lost as a result. As parents, we know our children best and really need to follow our feelings. This has been a really hard decision to make, as we have such respect for our surgeon and the program he is trying to build, but we have made a decision in the best in interest of Drew.
Tuesday, September 2
Cochlear Implant Mapping For Children
Nationwide Children's Hospital is holding a Hearing Team Support Series which discusses important topics for families of children with hearing loss. I attended the Individualized Education Plan session in July and this past week I attended the session on Cochlear Implant Mapping. The presentation was excellent, and I learned a lot of technical information regarding implant mapping, specifically for young children, that I did not know. Cochlear Implant Mapping is very technical, and even a year later, I still have a difficult time understanding it all. As parents, we play a crucial role in the mapping process, so it is important that we understand as much as possible about this technology.
The information I will provide was taught at the presentation and is correct, to the best of my understanding, and is specific to the Cochlear Brand of implants. There are slight differences between the three manufacturers, so the terminology used may vary slightly from one manufacturer to the next. If you feel that any information provided is inaccurate, please leave a comment so I can research further.
There are three parameters of sound that the audiologist is programming during the mapping session that allows the implant to translate external sound into the electrical signal that stimulates the auditory nerve, allowing for perception of sound. These three parameters include pitch, loudness and tempo.
With normal, acoustic hearing pitch is heard from 20 - 20,000 hertz (Hz). Cochlear Implant maps provide pitch across 120 - 7200 Hz, which are the primary speech frequencies. The hertz distribution is coded among the available electrodes providing electrical stimulus for the cochlear implant recipients. Individuals with cochlear implants do not hear the entire distribution of sound like a person with normal hearing. For example, the Middle C of a piano is at a pitch of 250 Hz. As you move down the piano, the hertz get lower and lower, so an individual with electrical hearing can not tell the difference in the pitch of the sound outside of the parameters of their map. Programming the pitch across the electrodes is critical for hearing all of the nuances of speech. Consider the "eeee" sound, for example. "Eeee" is not just one sound, but a collection of sound across different frequencies. In order to develop speech equivalent to hearing peers, pitch programming is essential.
The loudness, or intensity of the sound affects the voltage required to run the map. With acoustical hearing there is a loudness range of about 120 decibels (db). With electrical hearing, there is a range of roughly 40 db's. This is called the dynamic range and it is the difference between the threshold level, T-level and Comfort level, C-level. The T-level is lowest level of stimulation needed to hear. The C-level is the maximum stimulation of sound that can be comfortably tolerated. The difference in the dynamic range is no more than 40 db's for a person with a cochlear implant. For our children, patient participation is not practical, so the audiologist must find a different way to establish the T and C levels. Neural Response Telemetry is software provided by Cochlear that provides the audiologist with with the levels need for an individual to hear. There can be some minimal variability in what the computer suggests as T and C levels for the patient, so the audiologist with also use their past experience, updated information from parents, teachers and therapists and hearing tests (in the sound booth, with conditioned response when age appropriate) in order to program the processor.
I found this area of the presentation to be the most interesting. When looking at the dynamic range, this means that the map actually takes really soft sounds and increases them to the T-level, and it takes very loud sounds and decreases them to the C-level. This finally explains why Drew is so loud sometimes! He has no idea how loud his screams actually sound to me, with my natural acoustic hearing. We can roughly estimate, knowing that the goal for cochlear implant recipients is to hear at 20 db, that Drew is hearing his loud screams at what we would know 60 db's to sound like. With a dynamic range of only 40 db's (versus my range of 120 db's), Drew has no idea how loud he sounds! (I don't know why I didn't understand this prior to this course, but finally his behavior is making sense to me! As a side note, if any parents with older cochlear implant children have any suggestions on how to help Drew understand that he is actually louder than what he hears, please leave a comment.)
The final area of the programming revolves around tempo. This is referring to how fast the speech is coded. With the newest cochlear implant technology, speech can be coded between 250 - 1800 Hz. In layman's (my kind of) terms, this means how many times per second sound is coded through the electrodes in order to stimulate the auditory nerve fibers. This provides the recipient with detailed information on the timing of sound. The default is 900 Hz, which means that the processor codes sound 900 times per second. This can be tweaked for each individual, but apparently faster is not better, because if the sound is coded too fast, the recipient can have a difficult time interpreting sound. For children have little participation in the mapping process, most audiologists use the default settings.
During the time of activation, and shortly thereafter, mapping sessions are quite frequent. As a map is established, there are several ways that a parent can identify the need for a mapping session:
The information I will provide was taught at the presentation and is correct, to the best of my understanding, and is specific to the Cochlear Brand of implants. There are slight differences between the three manufacturers, so the terminology used may vary slightly from one manufacturer to the next. If you feel that any information provided is inaccurate, please leave a comment so I can research further.
There are three parameters of sound that the audiologist is programming during the mapping session that allows the implant to translate external sound into the electrical signal that stimulates the auditory nerve, allowing for perception of sound. These three parameters include pitch, loudness and tempo.
With normal, acoustic hearing pitch is heard from 20 - 20,000 hertz (Hz). Cochlear Implant maps provide pitch across 120 - 7200 Hz, which are the primary speech frequencies. The hertz distribution is coded among the available electrodes providing electrical stimulus for the cochlear implant recipients. Individuals with cochlear implants do not hear the entire distribution of sound like a person with normal hearing. For example, the Middle C of a piano is at a pitch of 250 Hz. As you move down the piano, the hertz get lower and lower, so an individual with electrical hearing can not tell the difference in the pitch of the sound outside of the parameters of their map. Programming the pitch across the electrodes is critical for hearing all of the nuances of speech. Consider the "eeee" sound, for example. "Eeee" is not just one sound, but a collection of sound across different frequencies. In order to develop speech equivalent to hearing peers, pitch programming is essential.
The loudness, or intensity of the sound affects the voltage required to run the map. With acoustical hearing there is a loudness range of about 120 decibels (db). With electrical hearing, there is a range of roughly 40 db's. This is called the dynamic range and it is the difference between the threshold level, T-level and Comfort level, C-level. The T-level is lowest level of stimulation needed to hear. The C-level is the maximum stimulation of sound that can be comfortably tolerated. The difference in the dynamic range is no more than 40 db's for a person with a cochlear implant. For our children, patient participation is not practical, so the audiologist must find a different way to establish the T and C levels. Neural Response Telemetry is software provided by Cochlear that provides the audiologist with with the levels need for an individual to hear. There can be some minimal variability in what the computer suggests as T and C levels for the patient, so the audiologist with also use their past experience, updated information from parents, teachers and therapists and hearing tests (in the sound booth, with conditioned response when age appropriate) in order to program the processor.
I found this area of the presentation to be the most interesting. When looking at the dynamic range, this means that the map actually takes really soft sounds and increases them to the T-level, and it takes very loud sounds and decreases them to the C-level. This finally explains why Drew is so loud sometimes! He has no idea how loud his screams actually sound to me, with my natural acoustic hearing. We can roughly estimate, knowing that the goal for cochlear implant recipients is to hear at 20 db, that Drew is hearing his loud screams at what we would know 60 db's to sound like. With a dynamic range of only 40 db's (versus my range of 120 db's), Drew has no idea how loud he sounds! (I don't know why I didn't understand this prior to this course, but finally his behavior is making sense to me! As a side note, if any parents with older cochlear implant children have any suggestions on how to help Drew understand that he is actually louder than what he hears, please leave a comment.)
The final area of the programming revolves around tempo. This is referring to how fast the speech is coded. With the newest cochlear implant technology, speech can be coded between 250 - 1800 Hz. In layman's (my kind of) terms, this means how many times per second sound is coded through the electrodes in order to stimulate the auditory nerve fibers. This provides the recipient with detailed information on the timing of sound. The default is 900 Hz, which means that the processor codes sound 900 times per second. This can be tweaked for each individual, but apparently faster is not better, because if the sound is coded too fast, the recipient can have a difficult time interpreting sound. For children have little participation in the mapping process, most audiologists use the default settings.
During the time of activation, and shortly thereafter, mapping sessions are quite frequent. As a map is established, there are several ways that a parent can identify the need for a mapping session:
- Decrease in child's auditory reaction or alertness to sound
- Decrease in vocalizations and/or vocal play
- "Slushy" production of previously mastered speech sounds
- Any sign of physical discomfort, such as eye or facial twitches
- After one month of use, the child should tolerate their everyday program all day. If they require a quieter map to start the day, consult with the audiologist.
- Difficulty operating external equipment
- Irritation to the skin under the transmitting coil/magnet
- Refusal to wear sound processor all day
- Child complains of difficulty of hearing
I have found the following on-line resources to be helpful when trying to learn more, and understand, cochlear implant mapping for children:
Friday, January 4
Do You Hear Me Now?
Drew had his six month mapping appointment this week. He was such a good boy for the booth testing and his mapping. All I need is a box of Cheerios and Drew is one happy little boy!
Drew's audiologists had not seen him since November, so they were both thrilled to see how vocal Drew has become. He has all sorts of little words he babbles, in a repetitive, sing-song manner, all the time. I always enjoy seeing people that haven't seen Drew in a while because they help remind me of just how far Drew has come. When you are involved in day to day life it is hard to see just how much progress is made over several months time.
Drew's primary audiologist suggested that we begin his mapping session with a booth hearing test. She wanted to see exactly what Drew was able to hear at the very low and very high frequencies. We know that Drew has been hearing in the 15-20 db range across the mid-range frequencies, however, she felt as though she didn't know how well he was hearing at the very low and very high frequencies. Usually we do the booth testing at the end of the mapping session, when Drew is worn out and not giving us reliable results. It is very important that Drew hear in the 15-20 db range at the highest frequencies so that he is able to hear the /sh/ and /s/ sounds, as those are high frequency speech sounds.
I was very happy today that two audiologists did his booth hearing test. One audiologist administered the sounds and the other looked for responses. This is the best (and should be the only) way to have a booth test for such a young child. The audiologist began with the low frequency sounds at 30 db. Drew alerted and localized immediately. (And he actually enjoyed the dancing Goofy, a different response than before). She then moved down to 20 db, and again he alerted and localized. We were all pleased.
I was sitting in the booth, holding Drew on my lap, thinking about how happy I was that he was not only hearing but localizing the sounds. All sorts of emotions were running through my mind as I sat in that booth. I was trying very hard to be as quite as possible, trying not to talk about all of the exciting thoughts running through my head. Suddenly, the audiologist in the booth with us said, "Good Drew, you hear that." Drew turned and looked at the dancing Goofy. The other audiologist spoke into the booth, "That was at 10 db."
I sat in that booth stunned. Not only was he hearing at 10 db, but my deaf son had just heard a sound that I had not heard! I looked at the audiologist in disbelief. I said, "I didn't hear that." They played the sound again. Again, Drew responded and I never hear it! I really could not believe it. I've had a bit of a cold, so we all figured that I must have a little fluid in my ears that is preventing me from hearing this low frequency at 10 db. But can you believe that Drew heard it? Amazing. I've said it before, but cochlear implants are truly that, amazing!
The audiologists then tested the higher frequency sounds. As they suspected, Drew was not hearing the high frequency sounds nearly as well, only showing a noticeable response at 30 db. Drew's mapping audiologist took those results and turned up the high frequency electrodes enough for him to be in the 15-20 db range. I am confidant that we have a very appropriate map at this point, and Drew's audiologist is as well. This appointment was by far the best mapping session Drew has had.
With the change in his map, we will be working a lot more on making sure that Drew is responding to the /s/ and /sh/ sounds. He does so in therapy, but those are isolated, quite settings. We will be working with these sounds in typical environments. I am confidant that with his new program Drew will be able to start producing these two sounds.
Drew's audiologists had not seen him since November, so they were both thrilled to see how vocal Drew has become. He has all sorts of little words he babbles, in a repetitive, sing-song manner, all the time. I always enjoy seeing people that haven't seen Drew in a while because they help remind me of just how far Drew has come. When you are involved in day to day life it is hard to see just how much progress is made over several months time.
Drew's primary audiologist suggested that we begin his mapping session with a booth hearing test. She wanted to see exactly what Drew was able to hear at the very low and very high frequencies. We know that Drew has been hearing in the 15-20 db range across the mid-range frequencies, however, she felt as though she didn't know how well he was hearing at the very low and very high frequencies. Usually we do the booth testing at the end of the mapping session, when Drew is worn out and not giving us reliable results. It is very important that Drew hear in the 15-20 db range at the highest frequencies so that he is able to hear the /sh/ and /s/ sounds, as those are high frequency speech sounds.
I was very happy today that two audiologists did his booth hearing test. One audiologist administered the sounds and the other looked for responses. This is the best (and should be the only) way to have a booth test for such a young child. The audiologist began with the low frequency sounds at 30 db. Drew alerted and localized immediately. (And he actually enjoyed the dancing Goofy, a different response than before). She then moved down to 20 db, and again he alerted and localized. We were all pleased.
I was sitting in the booth, holding Drew on my lap, thinking about how happy I was that he was not only hearing but localizing the sounds. All sorts of emotions were running through my mind as I sat in that booth. I was trying very hard to be as quite as possible, trying not to talk about all of the exciting thoughts running through my head. Suddenly, the audiologist in the booth with us said, "Good Drew, you hear that." Drew turned and looked at the dancing Goofy. The other audiologist spoke into the booth, "That was at 10 db."
I sat in that booth stunned. Not only was he hearing at 10 db, but my deaf son had just heard a sound that I had not heard! I looked at the audiologist in disbelief. I said, "I didn't hear that." They played the sound again. Again, Drew responded and I never hear it! I really could not believe it. I've had a bit of a cold, so we all figured that I must have a little fluid in my ears that is preventing me from hearing this low frequency at 10 db. But can you believe that Drew heard it? Amazing. I've said it before, but cochlear implants are truly that, amazing!
The audiologists then tested the higher frequency sounds. As they suspected, Drew was not hearing the high frequency sounds nearly as well, only showing a noticeable response at 30 db. Drew's mapping audiologist took those results and turned up the high frequency electrodes enough for him to be in the 15-20 db range. I am confidant that we have a very appropriate map at this point, and Drew's audiologist is as well. This appointment was by far the best mapping session Drew has had.
With the change in his map, we will be working a lot more on making sure that Drew is responding to the /s/ and /sh/ sounds. He does so in therapy, but those are isolated, quite settings. We will be working with these sounds in typical environments. I am confidant that with his new program Drew will be able to start producing these two sounds.
Friday, July 27
Mapping is All Greek to Me!
Drew had his third mapping appointment yesterday. Before they began to update his map they put Drew in the sound booth to see what he was hearing currently. Depending on the frequency, he was hearing somewhere between 25 - 40 db! Can you believe it? Just one month ago a jet engine could be roaring right next to him and he would not have heard it. Now he is hearing within the speech range. Unbelievable! I sat in the sound booth with him ready to cry each time he would turn and look in the direction of the sound. I held it together, but I can't help to get emotional when he hears things that he has never heard before!
There was a audiologist from Cochlear at his mapping yesterday. It was simply coincidence, but nonetheless, very exciting. She looked over his map and made some suggestions to his audiologist on how to tweak his map. We are working to make sure that each of the 22 electrodes is programed for optimal hearing on all frequencies at about 15-20 db.
One thing that has been really interesting/perplexing to his audiologist is that his right ear requires a much more powerful map than his left ear. This can happen as a result of scaring in the ear, normally from repeated ear infections. The reason it is so perplexing is that Drew has never had an ear infection and does not have fluid in his ear. It was nice to have the Cochlear audiologist recommend turning up the power on the right ear to ensure he is hearing all frequencies the same. I think it made our audiologist more comfortable with her decision to turn up the power on his right ear again. It also made me feel better about his map in general. It is really nice to have a "second opinion," especially in an area that is so complicated.
During the whole appointment the audiologists (there were three total) were talking about NPT's, hugging the "T" line, impedance levels, the list goes on and on. I felt like I was in a room where everyone was speaking a foreign language. It makes it really hard on a parent when you want to know everything that is being done to your child so you can understand what you need to do to help, but everyone except you speaks a different language. As far as I was concerned, it was like they were all speaking in Chinese and I only understood English! I think I need to go back to college and take some classes on this stuff so I can understand it better! Now if I only had TIME to do that...
Drew is now on his most powerful map ever and is responding to just about every sound around him. Last night the most amazing thing happened. We were all four playing together, working on language and doing some of our "homework" from therapy. Drew crawled over to his sister's table and chair set and was trying to pull up on the chair. He is getting really close to being able to pull up on his own, so I watched him and then helped him just a bit. Once up, he was able to stand and hold on to the chair all by himself. That's not the amazing part. He stood there for a while not moving his legs or struggling to remain standing. It took me a minute to figure out what he was doing. Drew had found that there is texture on the seat of the chair. He was standing, raking his nails over the texture and LISTENING to the sound his fingernails made when he drug them across the texture. Can you believe it? It was the most amazing moment and made me cry. Even Drew's Dad had a little sniffle at that one!
Wednesday, July 11
Therapy, Mapping and Mom's Out of Town
What a busy week! I am at my company's annual National Sales Meeting in Washington, D.C. Drew's Dad is a single parent this week and Grandma has been taking Drew all around Columbus for his appointments. Life is hectic. But so rewarding.
Drew had his first Auditory Verbal Therapy (AVT) on Monday morning. He did great! I haven't been able to read the full report, but according the the therapist and Grandma, he was able to detect a good amount of the ling sounds at close range, with his right ear performing just a bit better than his left. The therapist even said that she saw a huge difference in him, a bilateral kid, than what she initially sees in children with just one implant. Drew is already able to localize many sounds. This never would have been possible without bilateral implants.
Drew also had his second mapping this week. By all accounts, from the audiologist, Grandma and his teacher of the Deaf (who attended the appointment), Drew did great! I haven't seen the full report yet, but they were able to correctly program more electrodes in each ear and turn up the volume quite significantly. He left the appointment again with four new maps, which we will turn up gradually over the coming weeks. Drew's next mapping is scheduled for July 26th.
Later on Tuesday, Drew's Dad reported that Drew heard the "snapping" noise the fasteners make in his high chair when he was getting Drew ready to eat dinner. Just amazing! He is hearing new sounds everyday, responding to those sounds and is overall a very happy little boy.
One of Drew's therapists emailed me his therapy plan for the coming months. In the immediate future Drew will be able to identify the presence of sound, absence of sound and all of the ling sounds at close range, 3 feet and 6 feet away. This seems very reasonable and attainable, especially considering that Drew hasn't even been hearing for two weeks and has already made noticeable progress. I continued to read: Drew will respond to his name, wave "good bye" without visual cutes, meaningfully say "Mama" and "Dada". Can you believe it? My deaf little boy is going to be able to call me "Mama". What a wonderful world we live in!
Drew had his first Auditory Verbal Therapy (AVT) on Monday morning. He did great! I haven't been able to read the full report, but according the the therapist and Grandma, he was able to detect a good amount of the ling sounds at close range, with his right ear performing just a bit better than his left. The therapist even said that she saw a huge difference in him, a bilateral kid, than what she initially sees in children with just one implant. Drew is already able to localize many sounds. This never would have been possible without bilateral implants.
Drew also had his second mapping this week. By all accounts, from the audiologist, Grandma and his teacher of the Deaf (who attended the appointment), Drew did great! I haven't seen the full report yet, but they were able to correctly program more electrodes in each ear and turn up the volume quite significantly. He left the appointment again with four new maps, which we will turn up gradually over the coming weeks. Drew's next mapping is scheduled for July 26th.
Later on Tuesday, Drew's Dad reported that Drew heard the "snapping" noise the fasteners make in his high chair when he was getting Drew ready to eat dinner. Just amazing! He is hearing new sounds everyday, responding to those sounds and is overall a very happy little boy.
One of Drew's therapists emailed me his therapy plan for the coming months. In the immediate future Drew will be able to identify the presence of sound, absence of sound and all of the ling sounds at close range, 3 feet and 6 feet away. This seems very reasonable and attainable, especially considering that Drew hasn't even been hearing for two weeks and has already made noticeable progress. I continued to read: Drew will respond to his name, wave "good bye" without visual cutes, meaningfully say "Mama" and "Dada". Can you believe it? My deaf little boy is going to be able to call me "Mama". What a wonderful world we live in!
Tuesday, June 26
Mapping A Cochlear Implant
For nine months now Drew's Mom and I have been researching hearing loss, sign language and cochlear implants. We've learned a great deal, but we have had difficulty finding information on one particular part of Drew's adventure.
How do they set, adjust, or "map" the cochlear implant once it is functioning to let someone hear?
I found this article entitled "Mapping a Cochlear Implant" and found it helpful to understand how exactly they get it to work. It is also timely, as we will be meeting Cyndi Warner on Thursday to have Drew's bilateral cochlear implants activated for the very first time!
How do they set, adjust, or "map" the cochlear implant once it is functioning to let someone hear?
I found this article entitled "Mapping a Cochlear Implant" and found it helpful to understand how exactly they get it to work. It is also timely, as we will be meeting Cyndi Warner on Thursday to have Drew's bilateral cochlear implants activated for the very first time!
Thursday, May 10
Activation Scheduled
Drew's activation of his bilateral cochlear implants has been scheduled for June 28! I think I might need another countdown clock...the day he will start with his hearing journey.
Drew and his Gam-ma now have a special day to share with each other. We will always celebrate Gam-ma's birthday and Drew's hearing anniversay on the same day. Can't wait for Gam-ma's (oh, maybe I shouldn't share the age?) birthday this year! What a wonderful day June 28th will be when Drew hears his Dad and I tell him we love him for the first time.
Looking forward to June 28th. Happy Hearing, Drew!
Drew and his Gam-ma now have a special day to share with each other. We will always celebrate Gam-ma's birthday and Drew's hearing anniversay on the same day. Can't wait for Gam-ma's (oh, maybe I shouldn't share the age?) birthday this year! What a wonderful day June 28th will be when Drew hears his Dad and I tell him we love him for the first time.
Looking forward to June 28th. Happy Hearing, Drew!
Subscribe to:
Posts (Atom)
