AVT link- very interesting

     I have been doing a lot of internet searching on hearing impairment and related issues.Since things here are different , there is a lot of motivation to learn and am not scared to ask questions unlike in India.Last 2 months have given me loads to work upon, think, ponder over and it is good to get inputs from the net, bloggers,doctors, surgeons,audiologists and of course hearing device users.It is not important what technology you follow, whether CI or hearing aids. There are pros and cons to both. You can get plenty of these points of view on the web. Fundamentally, I have learnt that through good AVT and a focused and dedicated approach, I am able to develop normal speech in my child. I have nothing agianst any particular technology but then after seeing some good resulty with my daughter's speech and meeting some of my audiologists older students (5 year old to 45 year old) leading perfectly normal lives, I do not feel that any intrusive application is yet necessary. This is a decision, that we can take anytime. Last but not the least, if deafdude1.blogspot.com  is anything to go by, then I see definitely an alternative to CI in the near future. Lets wait and watch.
      I also came across this blog which confirms my belief in AVT. The site is very interesting and some very important aspect of AVT is there.Also for my reference, I have kept the advantages and disadvantages page on my blog, from her point of view, which I found interesting.
http://www.auditoryverbaltraining.com/ha-ci.htm

http://www.auditoryverbaltraining.com/

Lets see what future holds for the hearing impaired.

Reading and writing

   Since we have 10 days of autumn break,we are all working on Prisha's reading, writing and thinking skills.Initially it seemed a very tough and uphill task as the 4 months of long break seemed to have just taken a toll on her mind and eventually speech too.The kick start was difficult but the last 2-3 weeks of work is making a difference.The whole concept of putting her thoughts to language and then to put it into writing is a journey by itself.  I remembered the transition was tough for my son too when he was 6, but I was more worried about Prisha may be because of her being hearing impaired.Now we have taught her to break the word and she is able to slowly break her own words and loves reading by herself with me around. At times she does gets lazy but after a giggle at herself, she does it.We are working on T,D,B,P sounds which sound very similar and she slowly making out the difference.The rest she is not having problems.The new settings are making her hear a lot better and we are talking to her at normal voice levels.She loves it while I read to her and in between I stop and ask her questions, relate it to our lives and at the end I summarize the story , followed by her summary.I help her out with that.She is able to hold the story in her mind along with the chain of sequence, we slowly get it down into words.It is turning out to be fun for us.

Painting,sticking and working on the puppet

A write up on the procedure

Love the results

    She was reading about Santa in a story book and she wanted to make a Santa puppet for herself.So we looked around for material and yesterday we made a lovely puppet followed by a write up on it.This write up included the material required followed by the steps to make the puppet.It was a day well spent as the outcome was wonderful and we all LOVED it.

Another visit for aided audiogram

   Friday was the 2nd visit to Geers for tuning Prisha's hearing aids.I explained to Prisha that she needed to pay attention to sounds so that Mrs.Zellhorst could tune her aids better and she would hear well.Fortunately Prisha's autumn break started and so she needn't be rushed from there to school.She loves going to school and hates it if we miss it.
   We received the same warm welcome and Prisha was asked to sit and make herself at home, which she did with all the toys kept for the kids.She got me the kaleidoscope and was so fascinated by it.She asked me what it was called and I helped her to learn the new word.To this ,we got a "wow" from Mrs. Zellhorst as she said it was wonderfully corrected and she said it very well.I have to see still how speech therapy,a very important part of hearing impairment, is done in Germany.She is amazed at how quickly Prisha takes corrections,responds to sounds while doing pure tone and audiograms and is so well conditioned that she is able to tell how she wants her settings and is sensitive to changes immediately.I thank Alaka ma'am for it!!
    Prisha was then taken for her pure tone test again and we started with the test.She performed very well and responded to all frequencies very well.First it was decided not to change the settings but on 2nd thoughts some more adjustments were made.Her binaural aided audiogram now is at 40 db at 1K and 2 hz , 50 db at 4K and at 60-75 db for higher frequencies, which is great.We need not strain.She responded to all of it Audiologist is now suggested us to change the left HA as it is tuned to its full capacity but more changes are given in that ear, it would support her right ear better.As of now it only helps in directionality.So she is going to make changes slowly.A new HA from Phonak  would be tried on her this Friday where it would give her more amplification in higher frequencies.That would give her more clarity and eventually we would see the change of both HA , maybe to Phonak as they are programmed specially for kids.We are going slowly as too much change would affect Prisha too much.

The new pipes are conical from inside

The entry is smaller and the side into the ear bigger

    Another change is the ear mold. Prisha's impressions were taken for new molds, where there is scope for more ventilation in the ear leading to fewer infections.I would get them this Friday hopefully.She is also putting special tubes which are conical, thinner at the HA side and bigger in the ear canal, so that would give her additional 5 db raise in the hearing, which is great too. I am very excited about this change and look forward to her better hearing. I have to now work on increasing her vocabulary. She forgets the new words and needs to be reminded more.This is normal in HI kids.Normal kids can learn 10-12 new words everyday, it is as low as 5 words for HI kids.This was told to me by Ma'am and she said just work on her reading, it would eventually show in her speech.Yesterday she wrote a small summary of the book she read 2 times with by husband.That was very encouraging.Need to just help her so that she can express herself more.She does get stuck sometimes at what she needs to say. need to get back her fluency back that she had.It is so true, the regression is very quick in these kids and they can't be left without the environment of language and learning.Lesson learnt.

Audiometry in Germany

   Well, last one month has not been easy for us.I had my share of sleepless nights with the school wanting the latest audiograms and the person who was to do it was out for a long vacation.So my journey here in Germany has again been mixed and in some ways quite like in India.We have to be alert and fight our case and hang on to our beliefs.
   We did have an appointment with a leading ENT surgeon who specializes in CI.As we got his contact through a friend and we needed some place and reference to start with, we got her aided and unaided audiograms there. Prisha has been trained very well and I have full faith in her as far as my training with her goes. She has been conditioned so well that she was a surprise for audiologists in India since she was 2.5 and now here in Germany too.The audiologist was very impressed with the way Prisha conducted herself during one test after the other. She lost it a bit when for the BERA , she was wired up, but she stood there.
    Seeing the aided audiogram with this clinic was SHOCKING. According to this one , Prisha's aids were just a bit tuned to barely hear.Her right showed an average of 75 db and right was 110 db average.When we met the Doctor, he said Prisha was not hearing too well with HA and would benefit only with CI.But when I asked if she wasn't hearing, how had she been able to pick up so much last 3 yrs (they were tuned then last), he said since is intelligent!!! But I feel if she was not hearing, what good would be her intelligence?? To be able to speak intelligent stuff or even day to day things, isn't hearing required?Does he mean that all deaf people who have no speech, are not intelligent? Are those deaf people,who make those paper bags and doing vocational training to earn their living, less intelligent?It is just that they have no speech and language that is required for education to do the big white collar jobs.Given a chance of oralism, am sure , they too would hold big jobs too.When I asked him if the HA could better her hearing capacity, he said no, as the aids have a limit and these HA have been tuned to the best.I was so depressed but I was convinced that as usual, I was being cornered into thinking that it was only CI that would benefit.He said he could not understand her speech, but my friends say they never need interpretation from me for her and nor do her friends, even those who don't speak the Indian English have no problem.I was convinced that this place was not for me and so left the place.We have seen some bad cases of CI and are convinced, the complications are not meant for US.

Audiologist at Geers was impressed with my contraption for
securing hearing aids,she also gave one to us which is close
to our design.Not bad!!

    The next journey was tough, trying to understand in a foreign land what is good for us as friends around have limited understanding of this subject and I have seen more of sign language here. I googled ( always my savior )and started looking for Audiologist since I don't need an ENT now. we know she is deaf and needs only an audiologist to work for her. Came across this company called "GEERS". They have branches across the country.I asked for recommendation from Siemens too since we have aids from them.At Geers, we made small changes and were referred to their company for only kids in a place 30 kms away. Since the audiologist was away on vacations, we finally made it to her yesterday.Prisha was mentally prepared by us to give her best and we decided to start afresh.

Reward for being so attentive and good

   After the full case history, we went in for the unaided audiogram and Prisha was great as usual and gave excellent results. She took the entire frequency range from 125 to 8K. In the right she is able to hear the entire range but needs aids to boost her hearing.The left was bad and can only be a support ear and for directionality. The aided audiogram was done with present settings and results were not good. The audiologist had not aided them to her requirements and were not used to their full capacity.Why was this? she is known to be a crook by all.I was suspecting fowl play earlier too but had no options till now.I was refused a copy of her hearing levels graphs of HA by her.Had she done this so that Prisha would not respond and I would go to her for CI which she has been telling me in various ways? she has implanted kids as young as few months just after detection without waiting for HA trials.Nobody talks against her since we all depend on her for things.The audiologist here , if she was surprised at the results, did not show it. Maybe she was being professional.I have always been very vocal about this topic and so am not a favorite of people involved in this field in India.have learnt not to trust anyone except my instincts and my inner voice and ask questions.Our defense mechanism is very high too.I spoke to Mrs.Hudlikar in India and she said that had my input and pressure to perform wasn't there for Prisha, she wouldn't have spoken!All these 3 years, Prisha had been straining to hear and I was shouting to make myself heard ! I plan to take this up seriously in future once I settle Prisha's hearing issues and the school.

      Next, the audiologist plotted her on a graph and then she made new settings afresh according to her.But Prisha is very sensitive (thank God, I keep pushing her into listening and keep talking and questioning her) and said she was hearing loud and soft like waves. We decided to take a break and go around a bit for her to get used to the new settings. But she looked SOOO miserable and kept saying , she could't hear. So we went back and asked and were told that since Prisha was used to her old settings, the new change was too much for at one go and all changes need to be made slowly.So old settings, increase of 10 db and hey presto, Prisha was happy!! She was hearing clearer louder and better.Both the aids were brought closer to the speech banana which was far away till now.we need to go back on Friday and the lady would then raise all the frequencies into the speech banana and so she would hear even better.I had tears welled up in my eyes.We did the test for direction too with the 5 speakers in different direction and Prisha scored on all 5.She was doing it for the 1st time and was a bit confused but her eyes would 1st look at the speaker and then her mind made her look around not being to sure of herself.2.5 hours we were there and she gave in her BEST. I was so proud of my little girl and she was loaded with goodies from the clinic.The audiologist complimented on our team and she said she had never seen this kind of work in her career.She has been long in the field and was surprised at our work where Prisha has been conditioned well, my husband looks into the technical part and I am into training Prisha.She was surprised when I did my own tests with Prisha from behind her to understand her new settings and Prisha scored 10/10 on it and she was not lip reading me at all.She said in her long span of job, never has she seen mothers working this way with their kids here in Germany.I was humbled and thanked her immensely for her very involved work.She did such a fantastic job and did it with so much dedication and I am so glad I have someone we can trust.
   Yesterday after a long time I slept well, ate well and just chilled out.I read the stories to Prisha without having to be loud.I did not have to shout across to the room as she responded to even softer calls.I have submitted the aided audiogram and would the final one soon to the school. I would be scanning all the audiograms on my blog that I have till date.Huge differences but it would be able to show how alert parents need to be.