Wednesday, January 26, 2011

Hearing Test Disaster

Ava’s hearing test went about as poorly as such a thing could go. Crying, refusal, not wanting to enter the testing booth, not wanting anyone to go near her ears, and so on.

They did manage to do tympanograms. That’s a test where they insert a probe to a small handheld device into the ear canal. The device changes the air pressure in the ear canal in order to vibrate the eardrum and then measures the results. If the eardrum doesn’t vibrate properly, that usually means that there’s fluid behind it in the middle ear indicating a possible ear infection or negative pressure that might exist at the tail end of a cold. Those things could affect hearing, so the audiologist doing the testing wants to know if something is going on. Ava actually is at the tail end of a cold and her tympanograms did indicate reduced mobility.

Next they tried to do her hearing test. She pretty much refused to cooperate at all. They’re sure she heard white noise at the loudest level, but couldn’t confirm anything else. Sigh.

So, next week we have an appointment with an ENT to check the health of her ears and to attempt to check her hearing again. We need to confirm that she can hear at all frequencies. If there is some hearing loss, we need to know. Finding out is going to be the hard part.

What I’m Doing So Far – Speech Pathologist Edition

First let me say that I’m not an SLP who is experienced in the treatment of apraxia. Please don’t take any information I post here as a substitute for the advice of a good SLP who has a lot of experience and success working with children with apraxia of speech.

This is the follow up to the What We're Doing So Far - Parent Edition.

1. I’m doing a lot of research. I read all the articles in the professional section of the apraxia-kids website that even vaguely pertain to a child of Ava’s age. I read the American Speech Language Hearing Association (ASHA) Position Statement and Technical Paper on Childhood Apraxia of Speech (CAS). I also read several journal/research articles available on topics about CAS. I’ve saved dozens more to read when I have a chance. The first step is to become familiar with the theory.

The second, of course, is experience. I don’t have that yet. That’s why I can’t do all of her therapy myself. I’m hoping to learn from the experience of my First Steps therapist if I’m lucky enough to get someone who is experienced with apraxia. I’m also trying to set up therapy sessions twice a month with a therapist who is very experienced in apraxia. She’s willing to let me observe and to help me plan my sessions with Ava in between our sessions with her. I don’t quite have all of that set up yet, but if it works out it will be huge for Ava and huge for me professionally. I’ll get to learn from one of the best people available in our area.

2. I researched professional books and programs on the topic of childhood apraxia of speech and chose a few to purchase. I haven’t had a chance to read them all yet / work with the materials yet. When I do I’ll give you my opinions on them.

3. I researched (online) several different methods of intervention that SLPs use to work with children with apraxia. I’m still processing this information. I’ll try to write a post soon that summarizes the information I’ve gathered so far.

4. I began doing therapy sessions at home with Ava on a daily basis. She wakes up an hour earlier than her brother from her afternoon nap which gives me an ideal time in our daily schedule to fit it in.

5. I began teaching my husband and my parents simple methods of encouraging more vocalizations from Ava. We don’t want to push her or make her frustrated or self-conscious. However, given that, vocal play can be fun when made into a game. The more vocalizations per day/hour/minute the better. It’s almost a numbers game. We’ll likely never catch up with the number of times a typically developing child talks, but the closer we get the better. If anything, she needs more – many more. Her system needs to be trained through practice and repetition to do what comes naturally to them.

Bye, Bye!

Ava told me “bye, bye” for the first time last night as I was leaving her room after putting her to bed. I was ridiculously excited. And then she said it again completely unprompted as her daddy was taking her out the door for her hearing test. (SLP note: her /ai/ or long I sound is distorted and more like a cross between an /a/ as in the way a baby would say /ba/ /ba/ for bottle and a true diphthong /ai/ - but still!)

Also in the past 24 hours she pointed to me and called me “mama” clear as day and then pointed to her dad and called him “dada.” It was the first time and melted my heart.
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