Tuesday, August 31, 2010

Audiology Round Two

Friday we hopped in the car for a trek back to Cleveland to follow up on Aiden's ugly audiology results from a few weeks ago. At that time, we left with four new programs to work up to. By this past Friday, we were on program 3, ready to change to program 4, but I held off as I wanted to see how he did with P3 and I didn't want him testing with a new program.

The results looked much better than last time, but still weren't where we want them to be. Aiden did pretty well behaviourally in the booth for his right ear, but as the left ear testing began, hyper mode kicked in. Maybe I shouldn't have bribed him with all those m&ms during the right ear testing.

Anyway, these were the results from three weeks ago:

and after gradually turning up the levels in the low frequencies on both ears, and the high frequencies on the left ear, the newest audiogram looks like this:

Good progress was made in the lower frequencies, which is wonderful. He is right where he needs to be for the mid frequencies and right ear high frequencies (except the measure at 8000 hz, which I don't believe is accurate), but the left ear at 4000 Hz we need to watch as well as both ears at 8000 hz. These higher frequency results are most likely due to Aiden's not wanting to "play" anymore. We couldn't get a SRT on his left either. We decided not to make any map changes at this time, but to move on to P4, and come back in two weeks for another recheck.

Overall, I am very happy to see the improvements. It is so important that he has a stable map to continue his language development. I definitely want to see the lower frequencies come up a bit and get a more accurate result on his left ear all around.

So two weeks from now we'll head back to Cleveland for another soundbooth and any mapping changes needed. Since we switched to P4, Aiden has repeated some very good /e/ sounds (which have always been very nasally), a good long i - which he now says "bye" and "hi" instead of bah and hah like someone from the deep south, and repeats the /m/ and /oo/ immediately when said at a good distance, mouth covered, unlike he was before.

Thursday, August 26, 2010

Wisconsin 2010

Last Wednesday, at about 8pm, I decided the kids and I
needed to get our mom/grandma fix before the summer
was over, so early the next morning,
our 8 hour trek across the Midwest began.

There's nothing better than an unplanned roadtrip.
Pure excitement all around.

We didn't get our annual camping trip with grandma this year,
due to a roadtrip to Texas by my mom to support a very
good friend's husband's unexpected passing,
but even in our short unexpected trip,
Aiden still experienced a lot of new firsts.

He played in the rain,
went to his first amusement park, Bay Beach,
which is very old school,
(so were there .25 cents-a-ride prices)
saw his first Ferris Wheel.
He rode many fun rides like the boats, airplanes, trains,
and BUGS, which he requested each by name,
and of course, we couldn't pass by
the race cars, which he asked for the "pahle ar".
He rode a carousel, all.by.himself (such a big boy)
where we saw another little boy with bilateral CIs,
but weren't quick enough off the ride to stop them
to say hello.
He got to sing Happy Birthday to his 81 year "young"
great-grandma, whom I am VERY close to and LOVE
the fact that her and Aiden's great-grandpa get to see the miracle CIs
provide him, whom they were very
concerned about, but now can't get over just how
well he HEARS and TALKS.
Something they never dreamed of.

Not necessarily a first, but still too cute -
getting into mischief with his second-cousin as they
scoped out the glass bowl of m&m's, pulled them
off the counter and munched up handfuls
before an adult stepped in and stopped the sugar fest.
Always fun at Uncle Mike's and Aunt Jane's house!
(where he had his first ride on a riding lawn mower,
and at the end would yell, "YAYYY")
He even had some firsts with language.
"gampa" and something I couldn't even try to spell out
for grandma, but he definitely tried.
"tan tu" (thank you) out of nowhere and all.the.time.
Before this trip it was all sort of a humming.

Another summer, another trip to my stomping grounds.
A place where I feel at home, and my kids do too.
Full of laughter, love, and new experiences.
Full of GRANDMA, for all of us.
and I just love every.single.bit.of.it.

Tuesday, August 17, 2010

Be Bi Ba (Be Right Back)

Aiden is finally starting to speak using two words and is even starting to throw in some three word sentences here and there. A lot of them (the three word sentences) are hard to understand because his articulation with putting three words together isn't quite there (he's two, definitely to be expected), but you can tell through whatever activity we're doing and the syllables he uses.

We understand one quite well though as he stares us right in the eye, holds up his left index finger, and very matter of fact states, "Be bi ba" (be right back). He doesn't move until we give him the "okay" or "where are you going" (to which he completely ignores) or some sort of confirmation that we heard him. If we say nothing, he keeps repeating it and pointing that finger until we do.

The funny thing is that he's totally serious and doesn't want us to follow. If I try to follow, he'll push me away and say "go". The little stinker is letting us know nicely that he'll "be right back" as soon as he's done doing whatever it is HE IS NOT ALLOWED to do. i.e. sneak out the front door, head upstairs to his brother or sister's room, play in the bathroom sink, sit on the cat etc.

It's too cute not to capture, so I grabbed my Flip the other day, captured the "be bi ba", and followed him. You'll also hear him use his latest FAVORITE boy word and put to use our prepositions we've been working so hard on!

(don't forget to turn off the music first!)

Monday, August 16, 2010

A Dance With Mom

Many years ago, one of my sister-in-laws gave me a beautiful music box for Christmas.
Not just your ordinary music box, but one that brings you back in time.
It plays flimsy like records, each with their own song, that have all these
grooves and slits that are used to produce the music with the help of
a very delicate record needle. Very early 1900ish.
The records that came with it are songs like "Edelweiss" from one of my
favorite old time movies, The Sound of Music,
and many Christmas songs sung from different eras.

In our family, we love to share our belongings, especially if we know someone
else will enjoy it just as much. My grandma loves listening to music and
even more so, loves things that are different. I knew she would absolutely love
this music box and all the songs that came with it, so I gave it to her a
couple years back to enjoy and hum along to. On my last trip home to Wisconsin,
she had it nicely boxed up to hand back to me. As it sat in my living room,
still boxed up waiting to find a place, Aiden pulled me over to it, wanting to check it all out.

and he loved it.
he loved getting the records lined up correctly to play and then intently watching
the tiny ballroom dancers dance around in circles as the music played.

I sat and watched, smiling ear to ear, as he swayed back and forth
listening to the music and admiring the dancers.

After two or three songs, he turned to me, took a hold of both my hands, and with
a shy smile on his face, and cheeks a little blushed,
said, "daz" (dance); then proceeded to lead me in a dance,
hand in hand, round and round, in the middle of our kitchen,
just like the ballroom dancers.

Melted my heart.

Friday, August 13, 2010

Not So Pretty

In my last post, I begged Aiden to perform in the soundbooth and to my surprise, he did beautifully. Aiden has typically been very good at repeating the Ling Six Sounds (ah, oo, ee, s, sh, m), which truly helps at home, but not so much in the soundbooth where they test using pure tones.

At one time, Aiden would try to repeat the sound of the tone, which at least showed us he heard it, but he's dropped that. We're trying to steer him away from Visual Response Audiometry (VRA), which is where Aiden has been trained to look at a toy light up in a box every time he hears a sound. I've never liked this though, because Aiden is constantly looking for that damn toy to light up, even if there's not sound. We've been conditioning him in using Play Audiometry or the "listen and drop" method for quite some time. (for friends and family, remember taking hearing tests and they always wanted you to raise your hand on the side you heard the sound? Well, for Aiden, he holds an object (ball or peg or whatever it may be) to his ear and then when he hears the tone, he should drop the ball in a bucket, or place a peg on a board etc.). This doesn't always work since Aiden likes to decide if he wants to "play" this game or not, which can make for testing in the soundbooth, quite difficult.

For those of you who know Aiden, know he likes being his own boss. So this time around he decided he'd take on his own way of showing us he heard a sound by yelling out "YAHOO" or "YAY" each time he heard it and would then drop the ball. Hey, whatever it takes right?

By playing along with him, we were able to get reliable results from how he was hearing from 250Hz to 4000Hz. We were in the soundbooth for nearly an hour with Aiden cooperating with his YAHOO's and YAY's the whole time. I am so proud of my little trooper!

Now, on the other hand, the actual picture of his audiogram is not so pretty. Take a look.

He had better results in the low frequencies with his hearing aids (about 45 to 50db). Seriously.

His SATs (speech awareness thresholds) were 30db for his right and 20db for his left.

For those newer to an audiogram, it is a graph that provides a look at the levels Aiden is hearing. The top of the chart shows 125 to 8000 Hz which are low to high pitches from left to right AND the left side of the chart shows 0 to 130db which is soft to loud intensity of sound from top to bottom. Normal hearing lies at 20db or better across all frequencies (pitches).

I took his audiogram and mapped it out on the speech banana so I could see exactly what Aiden was missing. It looks like this ... (sorry you have to squint your eyes to really see it).

The two straight red lines on 20db and 30db is where we WANT Aiden's results to be, and particularly closer to the 20db mark as possible. We do take into consideration that Aiden is two, he had just sat through an hour plus of AV therapy, that it was late in the day, and that he's probably hearing a little better than what he chooses to respond to. BUT, I have to admit his YAY's and YAHOO's were right on, and even if you add on 5 to 10db to some of the lowest points, he's still missing out on some sounds of speech. Not good at all in my book.

I used a purple L and line to indicate his left CI results and a blue-green R and line for his right CI.
  • All the sounds above both the purple and blue-green lines, he is not hearing at all, like the /z/ and /v/ (which he had /z/ at one point constantly imitating a bee). It also shows he's not hearing m, d, or b, but he does use them in his speech, so he probably is hearing them somewhat, but definitely not the /m/ with his right CI and definitely not as well as he should be with the left.
  • All the sounds between the purple and blue-green lines he's hearing with only the CI the sound is BELOW. For example, it shows he's hearing i, a, and o with his RIGHT, but not the LEFT.
  • All the sounds below both lines, he's hearing with both CIs. For example, h, sh, and ch.
I am VERY FRUSTRATED with all the mapping issues he's been having and I just don't understand why we can't get him between 20db and 25db across the board. Honestly, this is the same boy who was hearing at 15db to 20db across ALL frequencies for the first four to five months with his CIs and we haven't seen 20db since (except for at 8000 hz with his left CI). Ever since the appointment I wasn't too excited about, about a year ago, that continued to get worse and ultimately led to these results, we've been trying to get his maps back on track but can't seem to find that destination.

The hardest part about it all is that Aiden does repeat the lings AND his vocabulary is growing. Yet, in the same breath, it really is pretty indicative of his ling checks at home. We've been having trouble with him repeating the lower frequencies, particularly /m/ and /u/, but he rocks out the higher ones (/s/ and /sh/) even when whispered. Hence my crazed mom madness lately about getting him in to see the audiologist every couple of months. Follow your gut ...

... and although we've seen his vocabulary growing the last few months, you can tell by this audiogram, that he's compensating for lost sounds in one ear with the other ear.


So with all said and done, we left with four new programs on each CI to work with over the next few weeks. They increased the T&Cs (threshold and comfort levels) for the lower levels (up to about 1000Hz) on his right and left CI, as well as the 4000Hz level for his left CI. About every four days we'll switch to the next program and watch Aiden's reactions very carefully. We go back in about three weeks to do another soundbooth check and pray the new programs are working and we see better results.

I feel like we're back to square one. Again, we've seen some great strides with Aiden the past six months (I'm in the process of documenting his recent IFSP review), but we're still not where we need to be, not with that audiogram. I'm not one for guessing games, so until we get this right, we'll be making frequent two hour treks to the audiologists office.

Let's just hope Aiden continues to cooperate, even if it is through "YAHOO's" and "YAY's"!

Tuesday, August 10, 2010

Note To Aiden

Dear Aiden,
About a month ago we headed to see Dr. Michael for a mapping appointment. You decided you weren't going to drop the balls in the bucket when you heard a sound, but instead bounce them all over the room. So we busted out the chips for you to "feed" the pig. You decided you didn't want to feed the pig like we needed you to feed the pig. In essence, you showed us who was in charge and who wasn't going to cooperate no matter what tricks we tried to pull. So we took a break, a little walk, and came back to try again. Nothing. Nada. Nilch. Your mind didn't change. Four hour round trip drive and nothing. As hard it was for mommy to leave with no results, I appreciate your strong willed nature and the huge possibility that you're just SPENT with two years of appointment after appointment.

Today dear son, we are heading to see Dr. Don for AVT. We haven't seen Dr. Don since June and I hope you are very excited to share your newest experience book showing all the fun you've had all summer. Just as important, we are seeing Dr. Don and Dr. Michael's friend to check how your "ears" are hearing. You have not been responding well to lower frequency sounds with your right ear AND we are still trying to get you back on track to hearing at levels better than 30db across all the other frequencies besides the higher ones (which you're rocking at 15 to 20dbs ... yes, you sure do know that /s/ and /sh/ and speak them VERY well in all parts of a word).

So I ask you, my strong minded little wild one, as hard as it is for you to sit still, and as much as we know you are "in charge" of what happens in the sound booth, please, please, please cooperate today. Yes, I'm begging you. and remember, ice cream will be waiting at the end along with a fun filled night with your cousins! All you gotta do is listen and drop. Listen and drop.

Love you!

p.s. how about m&m's? ya, m&m's AND ice cream!

Thursday, August 5, 2010

A New Tradition

Every year the kids and I head to Wisconsin for our annual camping trip with grandma, but this year, due to a very unfortunate event, we weren't able to go. Therefore, we chose to get our camping fix locally over a long weekend with four other families.

aiden was in his element,
content the whole time.
he pointed to his ear over and over.
"was a?" he'd say, as he
heard birds screeching, leaves rustling,
fire crackling, cicadas chirping.

he RAN to keep up with all his cousins
and friends, and when he couldn't
keep up, they never left him behind.

his quote of the weekend (and newest three word phrase),
that was said over and over and over again,
"be ri ba" (be right back),
as he'd hold up his index finger, look us right in the eye,
then run off to catch up with the others.

It was a weekend of hangin' with cousins and friends
of all ages, no fighting, no arguing,
just joking and pure enlightening laughter.

It was a weekend of spinning tops and decorating the patio with chalk.

of playing baseball (which Aiden hit his first ball by himself!)

of flirting.

a weekend of paddle boats and canoes,

of fishing and snapping turtles

of complete pure innocent silliness from the younger ones

and the older ones alike.

it was a weekend of laughter.
of great food. of great company.
kids ages 2 through 40 something joined the outdoor festivities,
although us 10 " grown kids" were outnumbered
by the 16 kids aged 2 to 15,
we all had equally amount of fun.

it was a weekend we decided to start a
new tradition, it was our first annual
friends and family camping trip,
with many, many more to come!

Tuesday, August 3, 2010

Park Full of Prepositions

One of the things we're working on with Aiden right now are prepositions. Aiden has been using up, down, upstairs, downstairs, in, out, and on in the correct context for quite some time now, so we've been focusing on under, over, on top, and through. Once he begins to master these, we'll move on to others.

Besides using them in our everyday language as we play or speak with Aiden, I have found one of the best places for prepositions is the park, it is loaded with prepositional language! I've taken many different pictures from trips to the park to create an experience book which not only helps with prepositions, but also with"ing" verbs, and identifying all the fun playground equipment.

Aiden is walking OVER the bridge to go DOWN the slide.

Kailyn is hanging UPSIDE DOWN on the monkey bars while Aiden is standing UNDER them.

Aiden is climbing UP the rocks to get to the TOP.

Aiden is riding on the see saw UP and DOWN.

Kailyn is sitting ON TOP of the rocks.

Aiden is swinging from the bar at the TOP of the slide before sliding DOWN.

Aiden is climbing THROUGH the tunnel.

Aiden is sliding DOWN the slide.
(LOVE how this slide is not plastic either! PERFECT for not having to worry about static and failed processors!)

Not only has the park been good for language, but has been tremendously helpful with Aiden's low muscle tone, balance, and sensory integration. We are really starting to see some good gains, and I believe all the time playing outside and at the park have a lot to do with it. He is not stumbling near as much as he used to, he's starting to run, and by the end of any trip to the park, he's ready for a nice nap.

This is what I call some good ol' all inclusive fun play therapy ... and the best part about it, he doesn't even realize how hard he's working!