Pure tone update

I love my teddy

She is 7 year old now

Pizzas for birthday lunch

   After more settings done on the Naida IX , Mrs W had asked us to wait for 3 weeks and give a feedback on her hearing.I noticed that she is actually picking up things she never did earlier.Her intonation has improved and she is softer.We Indians are louder and more expressive in our talking, and so she is louder with us.A few days back she had 2 friends at our place and after they left I realized she was softer for a long time.So maybe we have to tone ourselves down a bit.The good thing is she is now actually hearing a lot more and listening to our conversation and asking us more questions like-what did you mean by this, what did you tell mum about,why did you say that etc.
   We got her puretone again to see her levels of hearing since she is used to the settings last 3 weeks.She performed very well and is now hearing at 35-40 db average and this falls in the speech banana.Her amplification is great right now and she does not want it louder.We are waiting for Mrs.Z to be back from her illness in 4 weeks and so would get her to do more fine tuning for Prisha as she is an expert and has experience too.She also was taught a few German words and a speech audiometry was done on her in German as this is not possible here in English.Prisha performed well and got all correct at 40 and 50 db too.So we are happy with that.Her directionality was great earlier, we need to work on that.So we are finally finalizing on this hearing aids and are now getting ready to pay the difference in amount.So now we are going to just work on her and also work on finding a good English speaking speech therapist.A down on that front right now.Hoping for the best.
     This 15th prisha turned 7 and we took her out shopping and she picked up things that she wanted.She was too excited and she had told me we should wake her up in the morning with a gift all wrapped up and sing the birthday song for her.Unfortunately we could not pick up the gift before and so rushed to pick part of her gift from the supermarket while she slept.My son called up a little later that prisha was awake.We asked him not to put on her aids and we crept into the house to wrap the gift and for once we were glad she wasn't hearing :( .We got her aids, put the aids on and sang her the birthday song.She was thrilled.

Update on Naida IX

       Since we got the new Naida IX, we have been noticing all the changes in her hearing and all things around it.I was back from India after a week and had just got the new aids before leaving.Once back home I realized Prisha was talking loudly again and was asking me things again or "not listening well".So we did go last week and had got filters changed but still this week, I felt she was listening as well as when she had got Naida III.We went back, got her new mold for the left ear and then decided to do her puretone audiogram.While the test was being done, I was a bit taken aback as she was not responding to many tones.My heart just started to sink.After the test the result was not too good.She was hearing at 35db when earlier she was at 20db!!Mrs.W was surprised too.She asked if Prisha's earlier tests were done at about the same time, but those were after school when she was really tired.And these days she has holidays.So that was ruled out.then she thought it could be back ground sound suppression.In India, our audiologist had switched that off and over the years Prisha had learnt to distinguish on her own the various sounds and had learnt to pay attention to voices even with amplification of only 60db.So mayb, just maybe, with Naida IX she is not able to hear better with suppression.So she switched of that.But still no effect and so she has now amplified by about 15 db for her to hear better and we are finding that we now have to talk softer and Prisha too is softer.So we observe next one week and next Friday we shall go again and see what changes need to be made.We have to still find out why was she hearing better with Naida III.Is it because Ix has more channels and so the tuning makes the peaks and gains flatter?We would find out answers to our questions soon.We trust the company a lot and am sure they would make sure Prisha gets the best help possible.

FM system not needed

'H' is the tube to be changed

    Today we were at "Geers" to get her hearing aids tuned more finely but sadly Mrs.Wiesel was unwell and another audiologist was there to help us with issues.We were told that there could be some water deposit in the filters of the HA.These filters are present in the transparent tube in front of the BTE.This happens specially in the winters with the difference of temperatures in and outside the house.The snow and moisture in the air can clog the filters and despite keeping the aids every night in the de-humidifier.It does not dry up as much and we need to unscrew the transparent tube and replace with a new one every few weeks.We did that and Prisha could make out the difference instantly.It was decided that we shall see for a few days and if we still feel Prisha needs more amplification, we shall do so when Mrs.W is back as she is a specialist with kids in absence of Mrs.Z and knows Prisha's case well.So we shall watch.
    Another thing that thrilled us was a small incident while the audiologist was putting Prisha's HA back into her ears.While she was doing this my husband was talking to her from near her and I was across the room and I started to question her and Prisha was responding to me.She answered everything well and the audiologist was beaming with joy behind.I looked puzzled.She said that Prisha was so well conditioned auditorily that she did not need even an FM system!!I was surprised.She said that Prisha was hearing very well at 20db and also her training over the years have made her respond to sounds very well and she felt except maybe at supermarkets or at celebrations or at other public places where she might need access to direct sounds from us, she did not need FM at all.She added that in Germany, she would not find such a conditioned child at all ! The parents would work here for about 4-5 months but after a while let it go.Our 6 years of dedicated work with her, where focus was on listening, it finally paid off.I am happy for Prisha but yes, our work needs to continue as we have to make up for lost learning due to her under amplification. I am so thankful to Mrs.Hudlikar.Its thanks to her that we are seeing all these positive feedbacks in our lives.Prisha leads a near normal life.

The big Indian wedding

Prisha dancing on stage

   We went to India on the 4th of December for an engagement and a wedding of 2 of Prisha's cousins. Well what a jam packed programme and what fun we had.Prisha enjoyed every bit of it.She danced and sang on the musical night and was dressed at her best in all the Indian attires.Thanks to her aunt Nisha who visited us, she was taken care of while I did all the things that needed my help.The 3 days of celebrations were something that she thoroughly enjoyed and participated in.She was the centre of attraction with all spirit and many reltives we have not seen in many years were very happy to hear her talk and respond to sounds like normal kids. We did loads of compliments and we did feel how much efforts have gone in to get her where she is with all sorts of wrong amplifications and advise in India from our audiologist, our job was tougher.
We did meet an ENT specialist and we were told how well she was talking and it was not there so with other kids.he did talk about CI and related issues and I would have loved to have detailed chat with him about it and about the conditions of speech therapy and lack of awareness etc in India, but time fell short.We were there just for 5 days and with all the celebrations, I missed on that.All in all a lovely trip!Posting some pictures of her.
    I have also noticed that Naida IX has been great for her but she may need more amplification as there are times she does not hear things and needs repetition.We heard her hearing aids and feel we need to increase her loudness for her to hear better.So we have an appointment tomorrow morning where she gets her new mold for the left ear {needed change again as sound was leaking}, lets see what changes and fine tuning are needed.She definitely has suffered long term due to bad amplification in India, we need to work harder on her speech .She is alright with regular day to day speech but finds it difficult to express anything new in her own words. She halts and her intonation is forceful and it worries me.She is very spirited and her speech therapist in school loves that fact that she takes all the corrections very well and never gives up.We need to find a good English speaking speech therapist outside the school too.Despite our efforts, we have not been able to find one here.Speech therapy in English is quite a weak area in Germany.So we have to work on her all by ourselves, following our instinct.She has made huge improvement in that last 4 months here but the graph has to be steeper still.We are not giving up but are working full force.Loads of reading ,writing, corrections and input in all ways possible.We are here at home for our winter break and so we hope to make the most of the 17 days and make sure that when she is back at school, she is more clear.The school too is finally realizing our efforts after their initial resistance to our working with her.By next June we definitely hope to see her at par with the curriculum {the IB curriculum was difficult for her to follow with its open ended style, where she had to express herself more}.Keeping our fingers crossed.

Riding the horse to the bride's home

Upgraded to Naida IX

   Today was the day for hearing aids trial of Naida IX.Prisha had her ballet and she did not want to miss it.Requested her teacher for a special favour.She was put with the youbger group at 4 pm and so we could meet the new audiologist Mrs.Wiesel who is looking after Prisha as Mrs. Z is still sick and would be in the hospital for surgery.Mrs.W is again a lovely person and gave us loads of information and we love it that Geers really looks after their customers and each person working is so sincere.We love them all!
  Out came the new HA with Fm attachments.Looked very big and since they were already set to her required needs, Prisha wore her new NAIDA IX.She loved them instantly.She said she hears more clearly and loudly and when I asked her if she wants the ones she wore before, she refused! That means there was a huge difference.Mrs.W told me that this model has 20 channels as opposed to the 6 in Naida III and so were tuned for finer details and it would help Prisha make the details in the consonants specially. They are also great for focusing on speech more and also they make listening to music also possible.We are happy.We tested her and she was able to make out all the differences and is happy with them.We tried the FM , she said it was wonderful and liked it that she could listen to us from so far.But we do have issues and our reservations on the FM system.Like Prisha's teacher pointed out, that she is always walking around in the class and is talking to each child and it would interfere with Prisha's concentration when she is talking and helping other kids.She told us Prisha was listening very well in class and she did not feel the need to wear an FM but she is willing to try.We are going to India for a week for a wedding and after we are back she would go to class with and FM.We would like prisha to have the FM when we are in the wedding as the 4 days are going to be full of celebration, music and dancing to bollywood songs and running around in public places and  it would help Prisha to be in touch with us always. New journey again and lets see how we are able to work on this new path.

Naida IX

   Prisha's hearing has definitely improved in the last 1 month with Naida III.This has 6 channels.She is picking up new sounds and tsking corrections much better and we too have to stress our voices lesser.So we thought that we should try out Naida IX which has 20 channels and can be fine tuned much more for clarity.Till now under insurance the amount is covered by insurance and so the FM and these are covered.But we decided to pay up the difference and upgrade so that she can get better hearing.We ordered them and today we got the news and we are going on Monday to try them out.We are really excited.We want to see how well she performs with the 20 channels and how she likes them and if she can make out the difference, it would definitely affect her speech and we would decide to keep Naida IX.The FM system too is arriving soon.We asked the class teacher, she ready to try it out but does not feel necessary to have it as all the teachers feel that Prisha is very attentive, gives eye contact and understands things told her.So we shall still keep it with us so that we can use it in public places specially when we are in India for the wedding on 8th Dec of her cousin.It a whole new journey.We still haven't been able to get any English speaking speech therapist in Germany.Next week we do have an appointment with a center who is ready to interact with Prisha and see what we can expect.So next week , our another round of appointments and trials.Look forward to some more positives.

Speech audiometry

    Here in Germany, Prisha got new hearing aids and they are covered under insurance.For this we needed to get a prescription from an ENT specialist from here.A good friend introduced us to a very good ENT specialist who has a good knowledge on the subject and is not one of the pushy ones ( we had one before who pushed us to depression about his views on Prisha's hearing and was pushing CI ). She did Prisha's aided and unaided audiogram and she was so happy to see that prisha was very responsive to sounds and aided was at 20 db too here.She looked at the reports and said that she was so glad to see her hearing levels and said there was no reason to believe that hearing aids are not helping her.She said she was "NOT A CANDIDATE FOR COCHLEAR IMPLANT" .I could just not believe my ears and would have actually gone and hugged her.I felt like going to the other ENT  specialist and showing him these reports and results.But he is not worth it.I feel somewhere, if a child is not auditorily trained(conditioned) enough to pay attention to sounds, even if he hears the softest ones he should respond ,he would probably miss them out  and then the hearing thresholds would be elevated and so maybe the hearing aids too do not help and then they are asked to go for CI.Prisha has been trained to pay attention to even the softest sounds and so she has been able to amaze her audiologist from the time she was 3 yrs when she 1st went for an aided audiogram.So it is very important that while one is training the child in AVT, the child should be conditioned well.I would play games with her when she was just a year old and it took Prisha 6 months when any sound and she would start looking for the source of sound.I would constantly draw her attention to various sounds and before the test too, i would tell her she has to concentrate hard and get the best test possible.I would explain how the test would be done and as an example I too would sit with her and concentrate. Children follow their parents and are sincere if the parents give the task the required importance.As a result, her thresholds are really quite accurate and the hearing aids work well with and she is able to say what she wants loud and what she wants soft.This is one of reasons, it excited mrs.Z to do her job with more interest.She could not believe the results of Prisha's tests each time we sat down to tune them .When her new aids were tuned, Mrs.Z's colleague made some changes  as we had gone back for rectification, and there was distortion in the aids. Prisha told me that when she said "mummaaaaaaaaaa" at aaaaaaaa, she heard the sound like a telephone ringing.Mrs.Z was so happy that Prisha is able to make out those very small differences and so tuning it to her needs is possible.The ringing sound was the amplification of the sounds from inside the circuit of the aids to due over amplification.So she made some more changes and the issues were settled.
     Last week, in absence of Mrs.Z, we went to meet Dannielle who was there at Geers to help us in her absence.She is also very good with kids and her work and knowledge is great.She put in the new molds and made few more changes and put the sound recovery on.This mode helps to reduce the feedback from the hearing aids.She said as her responses to sounds are good, and so she would like to do a speech audiometry for Prisha in German.In Germany speech therapy in English is not available and even if some do it, it is not upto the mark.And so even speech audiometry in English too is not available.We have trained her with the 'ECHO" too where, she just says whatever she hears without worrying about the meaning of it.This is also very good auditory training and even normal babies do that and is a very important part of speech development in babies.So I explained to prisha about the process and we decided to go for it.She knew not a single word of German and knew numbers only from 1-29 that too not so well.She started and we were quite pleased as she got a little over 50% correct! The aidiologist was pleased and said this was good as she did not know the language and for that thsi is good enough.She has given us the list and numbers from 1-99 which we neeed to practice and then do the speech audiometry in German to get an understanding of how well she is able to hear.Look forward to that now.

Prisha has new hearing aids

At the portfolio day in school

Good work done Prisha,we are proud of you

   I needed to do this post long back.But was waiting do just see the outcome and not feel too pleased at the beginning.The audiologist at Geers had told us she would try new hearing aids Naida III from Phonak in the left ear to help her hear better. Mrs Zellhorst had already increased her hearing capacity to maximum with the Siemens Artis but she needed to change and do better with her hearing.But when we reached there she said (I too was of the same opinion) she would like to change for both ears as the same group hearing aids make for better hearing.So we had Naida III for both years, which are capable of compressing high frequency sounds into low frequency range.So they do not miss out anything and are great for the hearing loss.
   So 15th of October it was , and what a day!! Prisha was given new hearing aids, molds and tubes and they were already tuned to the required levels.The moment we switched them on, prisha just opened her eyes wide.She looked a bit shocked if I could say so.We asked her how they were, she said good. Then we started her puretone test.She started to respond so well slowly that Mrs.Z too looked amazed.She signalled my husband to show no response on his face as that can affect the way the kids respond too.I could see with the corner of my eye, how happy and emotional they looked.I could see their eyes slowly turning misty.After the test, she looked so happy and proud and I loved the fact that Mrs.Z was so involved that she seemed a part of our happiness.We love you Mrs.Z!! She tuned it so well that her aided audiogram was at 20db!!!!Prisha was actually hearing such a vast spectrum and that too without our being loud! It was 1st time in her entire hearing age! We all had tears which we tried to hide.Prisha too smiled shyly and said she was hearing very well with the new aids.On the way home she was so tired and wanted to sleep in the car.She started to complain to us that she couldn't sleep as the sound of rain was disturbing her! We were so happy at this complain and just enjoyed that moment.Next few days we started to observe her and we need actually not strain our voices. Which was such a relief for us.I then realized that just because I was loud and so focused on her speech and language , she was able to pick it up inspite of the low amplification.I will follow up on it and will not rest till I question my audiologist back in India.Was it done on purpose, so that out of frustration I would consider CI , which has been a case in India with many?I would take this up seriously.
   We have had to many changes since then, the mold was giving trouble and we went to correct it and small changes with the gains.And then we had a set back, Mrs.Z fell sick and has to go through a surgery and may not able to come to work this year. We have been praying for her health.She is such a lovely person and kids love her and so do we!
   Prisha has been hearing pretty well in class.The teacher at school are happy and say she is very attentive.We too worked hard at home to put what she had lost in so many years.She had issues in school as he wasn't hearing enough and plus concepts being new, accent to deal with and to top it our laid back attitude for 4 months in our transition here, took a toll on her language.We have been working on her slowly and steadily last 6-8 weeks and are seeing results.She is reading, writing and using new vocabulary.I had kind words pouring in from the German teacher,Art teacher,Drama teacher, where they told me she was very focused, attentive, good eye contact, good concentration and they had no issues with her.Which was great for us.We also had her class portfolio last week and we saw her work.Her maths was new to us and so we could not do any support from home, but in her unit of inquiry, we saw a huge change.Her weekend news was good to see as we revised that from home.There was a page in the beginning, where she could not say a word and the teacher just about could not make her a thing, to her relating and teacher writing out and she copying, to her copying from the board to now she writing the whole week end news by herself! To add to it , her drama teacher came in to us and gave such a positive feedback.She said prisha is a beautiful child and she gives undivided attention,quick response to actions and vocals.She was skeptical about her response initially when she knew about her impairment.But she is thrilled at the way prisha follows all instructions spot on and is very expressive with herself and she told us we must continue what we are doing with her.That was great news after the very very depressing news from school 6-8 weeks ago.From rock bottom, we had climbed up.
   Yesterday was her parent teacher conference.We were going with not too much great feedback from the school.We were surprised, as the teacher gave a great feedback. She said, prisha was very attentive, caring,happy child who loves coming to school ,extremely hard working (who would know it better than us) ,followed all instructions and had made a huge leap in her understanding and comprehension and literacy skills.She said we needed to now just fill the gaps here and there and work on her being able to work on her being able to express herself in her own words and longer sentences.She needed to able to summarize the stories in her own words and sequences.She gave us tips on that and she also agreed to meet me every 2 weeks to give me a feedback and things to work on her which was fantastic.She also said she was willing to give Prisha the required push too and help us reach our goal, which is total integration by next June.She also told us that, a speech therapist comes to class everyday for 15 mins to help Prisha understand where required and if she felt she needed more focused work,Mrs.K took her separately in another class alone.We have now all agreed to work in better co-ordination with each other. I am very pleased with my meeting yesterday and hope to keep climbing up from the rock bottom that we had hit 6-8 weeks ago.So, we "Keep Walking".

John Tracey clinic - the beginning

Sharing this lovely video of the beginning of John Tracey Clinic.Reaffirms my belief on oralism.When they could believe in speech for the deaf then, then why not now?
http://www.youtube.com/watch?v=ychu9o5Oghc&NR=1

Also sharing the link of the blog which has discussions on oralism
http://kokonutpundits.blogspot.com/2010/11/video-john-tracy-clinic-storythe.html

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.