Friday, October 9, 2009

Our first meeting with Dr. Woolley ENT at Children's Hospital then Speech Therapy - September 1, 2009

Although it was not that long of a wait I was anxious to hear the results from Ella Marie's MRI. The MRI scanned her brain and ear to make sure there was not a reason that Ella Marie would not be able to have cochlear implants. Fortunately the scans were perfect. I was told beforehand that it was rare that a child would not be able to receive them if they needed them, but it is also rare that she has hearing loss at all so of course I worried. Dr. Woolley was extremely nice and knowledgeable. I thoroughly enjoyed meeting with him. He reminded me of Dr. Shea in Memphis...very smart but personable as well. He has performed over 300 cochlear implant surgeries. We discussed that we do not know the cause of the hearing loss but it could be due to a gene called connexin 26. 1 in 31 people have connexin 26. Dr. Woolley said it is not that uncommon for a 1 in 31 person to meet a 1 in 31 person and then there is a 25% chance that the child would have hearing loss. We will be meeting with Dr. Robin and his genetics team at a later date to start the genetics testing. These results will then be sent back to Dr. Woolley.

We are in the pre-implant candidacy stage. At the Hear Center we will complete more tests with Ella Marie's hearing aids to determine if the hearing aids give enough amplification before going the surgery route. More than likely they will not and she will have implant surgery. Looking ahead she could have one implant at 10 or 11 months of age and the other one 3 months later or we could do both of the surgeries at once around a year old. The parent in me only wants Ella Marie to go through 1 surgery but the educator in me wants her to hear more from at least one ear earlier. The therapists and audiologists from The Hear Center and Dr. Woolley at Children's will guide us in this decision.

Dr. Woolley told us that the factors for success for a child with cochlear implants are the age of implamentation and the parent support.

Surgery is about 2 hours if only one implant is done at a time or 5 hours for both implants in the same surgery (if both implants are done at the same time, the audiologist has to also come in to complete some things). The child loses a lot of blood during the surgery so if both implants are done at the same time we would have to wait until at least a year old.

Finally, we discussed that Ella Marie would have a CT scan about 10 days or 2 weeks before the surgery. This is his "map" for her surgery. It cannot be done yet because she is so little so she would grow between now and the surgery.

After our appointment, we went to the Hear Center for Ella Marie's weekly speech therapy. Below I will list the skills and information we went over:

  • When we are talking about suprasegmentals we are looking for "DIP" from Ella Marie. "DIP" stands for duration, intensity, and pitch. When working with a child that has a hearing impairment, we want them to hear and produce speech with different lengths, intensity (how loud or soft) and with different pitches (high v. low). When we are practicing with Ella Marie we make sounds where the pitch changes throughout the sound like oooooo. We might start out low and end high or like a roller coaster go high and low. Since we do not know what pitches Ella Marie hears the best at we must make our sounds cover as many pitches as possible. It is important to try to get her to mimic our voice as well.
  • Next we discussed the importance of doing shared reading/read alouds with Ella Marie. We should read a minimum of 10 books a day with her. Our sound of the week is oo. So when we are reading we may say oo look at the bear on this page. He is so big or oo I am going to turn the page. We are just trying to get her to start to mimic our sound. Kelli said ah is usually the first sound a baby makes. Ella Marie's first sound was oo and she used it for a long time and dropped the sound and moved to ah. When we read aloud to Ella Marie it is important to have her really focus on the pictures. We can provide acoustic highlighting by changing our pitch when we read. This not only makes it more interesting for her, but will also help us see which pitches she responds to.
  • We discussed the importance of "Peek-a-Boo" books. Not only are these great for reading aloud, but Ella Marie can be more engaged with these books while practicing the oo sound. We can also play peek-a-boo with her with scarfs, fabric or objects.
  • We discussed that our sound of the week was oo and it is the lowest frequency sound. The ah sound is in the center, and the long e sound is a high frequency pitch. This week while we practice the oo sound with her we are supposed to use it every chance we get. For example when we change her diaper we should say ooooo you have a dirty diaper lets put on another one. Or ooooo someone is at the door.
  • We are continuing to sing songs while stopping different places in the song for her to vocalize which in turn will tell us to continue the play or the song. We want her to know that her voice has power.
  • We are supposed to listen to her vocalizations and imitate them while pointing to our ear and saying "I heard you Ella Marie."
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