Kat Reading

Kat Reading

Thursday, July 2, 2009

JTC Week 2, Day 2


Ugh, I spent too long writing this morning and got a very late start.

We had an audiology appointment this morning at 9. We did a CI audiogram and reset her hearing aids and did a hearing aid audiogram. The results:

250 HZ- 25 db
500 HZ- 30 db
1000HZ- 30 db
2000HZ- 25 db
4000HZ- 15 db

Speech perception- "ahhh"- 20 db, "eeee"- 25 db, "ooo"- 35 db, "sss" 25db, "shh"- 30 db, "mmm"- 35 db.

I am not comfortable with the 35 db "mmm" and "ooo". I think her MAP needs to be tweaked. I think she is able to hear better than that. Now her hearing aid is hearing at much better levels too. It is set as "high" as her CI in several frequencies. That also has me worried. I am scared that the hearing aid (distortion) will overpower the CI (clarity).

Our first speakers today were an audiologist and surgeon from the House Ear Institute. They were talking about cochlear implants. I learned quite a bit about insertion. I learned about the "rear window" of the cochlea and that if you insert the electrode through the membrane there it can help to prevent damage to residual hearing (NO guarantees though, always be prepared to lose all hearing with a CI)

I also had the surgeon take a look at Miss Kat's brand new audiogram. He said that he did not feel that she should be a candidate for bilaterals. In fact, he seemed to question her getting the first CI. He said that there are too many benefits to "natural" (better word would be acoustical) hearing to go ahead with a CI on that side. I don't know what I think. I kinda feel like hearing aids are garbage! They have never helped Miss Kat. Maybe that is why I am so concerned about turning the aids up. I feel like they give her nothing but garbled speech. Why would I want to turn that noise up??

We also had a huge discussion about candidacy requirements and the politics involved in them. There is a mother here with a 5 year old who just got an implant about 2 months ago. She is profoundly deaf and never had hearing aids (or language) before a year ago, because she is recently adopted internationally. Her mother really wants to get a second CI but has been told it will not happen. She is frustrated because she is being told "earlier is better" and "two is better than one", but then is being denied that for her child. Why doesn't her daughter deserve the best too?

I can understand both sides. I know that the mother wants the very best for her child, but the professionals also have a point. They said that a CI (in a child) is meant to facilitate language learning. If a child is, say 6, and they don't have language and they get a CI and the parents spend the next 5 years working (very hard, as opposed to a very young child who naturally acquires the language)and then by some miracle they DO make 5 years progress, they are still 6 years behind! And school, doesn't get easier, the child will struggle so much. And that is the BEST case scenario! What is most likely to happen is that the child will make some progress, gain some benefit, but will never become an oral language user (and perhaps an implant non-user as well). And the CI will simply result in a huge delay in the child learning a language that they CAN use. It is a complicated issue. The professionals see it as being responsible, the mother sees it as discriminatory and judgemental.

The next class was called "Auditory Learning". It was about the "levels" of hearing and the 6 db rule. The levels are:

1. Detection- this is simply telling if there is sound or not.

2. Discrimination- this is telling the difference between two sounds.

3. Identification- this is knowing and labeling a sound.

4. Comprehension- this is understanding the meaning of the sound.

SO, if I walk outside and tell you to listen, and you hear that there is noise, that is detection. I tell you to listen, and know you can hear the difference between the two sounds I am pointing out, that is discrimination. I tell you to listen for the birds, and you hear it, and know it is birds tweeting, that is identification. Now, I tell you to listen, and tell me what kind of bird it is.....you don't know??? Why? You can hear perfectly, why can't you tell the difference? Because you don't know yet! It is something you need to learn. Just like Miss Kat needs to learn what the sounds she is hearing means- that is comprehension.


melissa said...

Interesting post! I am enjoying your posts about the JTC! Good job!

Dianrez said...

"The professionals see it as being responsible, the mother sees it as discriminatory and judgemental."

I can see that the parent will have more optimism than the doctor and based on knowing her child, would have higher expectations of usable hearing comprehension. Should the doctor bow to the parent's judgment?

What surprised me is that the doctor is capable of being realistic in projecting success in use of the CI based on several factors. That is probably being responsible and possibly concerned about the child's mental health weighted down by such parental anxiety and expectations.

Is this how it happens: the doctor says one thing, the parent applies pressure, the doctor backs down and does the surgery anyway?

I'd like to hear more about the doctors' expectations and their viewpoints. Deaf adults don't see this kind of dynamic about them.

Miss Kat's Parents said...

The mother had to fight long and hard to get the first CI and has been told flat out that unless the child shows PROFOUND progress and becomes a star user, she will not be getting another.

It is not unusual for parents of older children, especially ASL users, to be denied a CI.

melissa said...

You shouldn't have to be making perfect progress to get another CI, that's just wrong