Month: October 2016

Mapping Sonya’s Cochlear Implants

While I frequently discuss Sonya’s cochlear implant mappings on the blog, I haven’t really shown you what they are like, with the exception of her initial mapping/activation.

A MAP is a program that optimizes a cochlear implant user’s access to sound. The audiologist connects Sonya’s processors to a computer. Sonya then hears a series of beeps and the audiologist measures her response.

As an infant, measuring this response was rather tricky. The audiologist might observe a change in eye movement, a head turn or Sonya might stop moving. All of these behaviors indicate that Sonya was hearing the sound. Upon seeing such behavior, the audiologist would light up a black box with a toy playing the drum (or something similar). This would condition Sonya to look at the box when she heard the sound. Thus, the audiologist was able to get a sense as to which sounds Sonya could and could not hear.

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An example of a sound booth where audiologists will screen for hearing loss

Now that Sonya is two, her mappings are a bit different. When Sonya hears a sound, she puts a coin in a piggy bank. She is still working on this skill, but it is a much easier/accurate way to determine whether or not she hears the sound.

First the audiologist sends the sound directly to Sonya’s processors. We don’t hear it. Only she does. Then, the audiologist turns her processors on to detect noises in her environment. In the videos below, you can watch Sonya listen to the sounds through her processors at first – putting a coin in a pig each time she hears the sound. Then, she will repeat sounds, which shows us that she is hearing the sounds in her environment as well. The sounds that Sonya is asked to repeat are called “Ling Sounds”. Ling Sounds are different sounds which vary from high to low pitch. They are considered the range of speech sounds needed to acquire language.

Here is part 1 of Sonya’s latest mapping:

Here is part 2:

ling-sounds

Sonya’s speech therapists use the below Ling sound symbols when working with Sonya . When Sonya is presented with an airplane, for instance, she knows to make the “ah” sound. It’s another way to make sure she is receiving the auditory input necessary to speak.

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Здравствуйте Sonya!

When Sonya was two weeks old, we hired Nina. We feel extremely lucky to have found her. Nina hails from Ukraine, but has lived in the US for more than fifteen years. She recently became a US citizen! She speaks English, Russian and Ukrainian. In her past life, she was a veterinarian. Nina is a loving nanny and Sonya absolutely adores her (as do we).

Nina speaks to Sonya exclusively in Russian. Sonya understands Russian well, but is just now starting to speak it.

Historically, speech therapists recommended against teaching children with hearing loss more than one language. The fear was that learning a second language could interfere with the mastery of the majority language and further delay speech. Our speech therapists, however, disagree with this concern. They believe that as long as we are consistent in our approach with Sonya, regardless of language, she should be able to learn Russian alongside English.

Nina regularly comes to Sonya’s speech therapy sessions. In the early days, I didn’t bring her, but realized quickly how important it was for Nina to understand the strategies we were using so that she could implement them at home, and that we are consistent in how we speak with Sonya, regardless of language.

When Nina and Sonya play, Nina narrates everything they do. It is something I try to do, but struggle with, as I am naturally an introvert. Nina repeats the same word over and over, “na, na, na!” (take, take, take!”) or “die, die, die!” (give, give, give). “Maladietz” (good girl). Nina also brings Sonya amazing gifts like a Russian cow that sings “ochie chornia” a traditional Russian song.

We also encourage our Russian-speaking relatives to communicate with Sonya in Russian. When Sonya is with a Russian speaker, she is encouraged not to respond in English. For example, when Nina asks her a question in Russian and Sonya responds with a “yep!” Nina says (in Russian of course) “Do not say ‘yep’ say ‘da’.” Sonya now responds to Russian with Russian.

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sonya-and-nina

I realize it is pretty extraordinary that someone like Sonya, born with profound hearing loss, might someday (hopefully) be bilingual. But, there is also a chance it won’t happen. As Sonya gets older, we will continue to review how Russian is influencing her ability to acquire English. Given that she has been receiving oral/auditory therapy since she was just a couple months old, we hope she will be able to take on the differences in pitch, sound contrasts and intonation necessary to acquire a second language. That said, one never knows. Some people are just better at learning languages than others, and we will have to adjust our expectations accordingly.

In other news:

Every three months, Sonya has a mapping. A mapping is the process by which Sonya’s audiologist determines the amount of electrical stimulation each electrode delivers to the auditory nerve. Here is a link to her first mapping – when the cochlear implants were first activated. Her latest mapping took place last week at NYU’s Cochlear Implant Center . We noticed later that day, however, that she was having difficulty replicating certain sounds – specifically the “mmm” sound and the “ooo” sound.  I took the below video last night of her trying to repeat these sounds. We will be going in for another mapping tomorrow, to readjust the electrodes so that she properly hears these sounds. Never a dull moment!

Cochlear in the Classroom

Several weeks ago, Sonya started a twos program! Considering the fact that she has undergone speech therapy at the Center for Hearing and Communication since she was just four months old, including group speech therapy with other kids her age, Sonya was more than prepared. I on the other hand….wasn’t quite as prepared.

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Sonya’s group speech therapy at CHC

And the issue was not Sonya’s preparedness. Rather, my ability to understand and demonstrate to her teachers how to use her FM System.

While Sonya’s cochlear implants allow her to hear a great deal in a quiet setting, many children who wear them still have difficulty hearing a teacher’s words when there is lots of background noises and over long distances. An FM system is an assistive listening device (or ALD) which helps a child hear the teacher and their classmates above the noise of a typical classroom.

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Sonya in her new classroom – not quite in her comfort zone – but she quickly acclimated 🙂

To get a sense of how hearing loss is worsened when confronted with such conditions, take a look at the following eye-opening demonstration:

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Sonya and me in the classroom. I am wearing the Roger Inspiro FM System around my neck.

As we walked into the classroom, I realized that it was up to me to ensure that Sonya’s teachers understood how to use this bulky and not exactly user-friendly piece of equipment.

I found myself fumbling with it and with Sonya’s processors to ensure it was working. I got a bit obsessed making sure that her processor lights were blue (indicating that they are connected to the FM). I thought I was somewhat on top of it until the yoga portion of Sonya’s school day began. The yoga teacher of course was happy to wear the device, but I realized it was not working at all. The microphone which is supposed to attach to the teacher’s collar kept slipping off, and the FM system around her neck became tangled. It was obviously uncomfortable for her. She did her best, but the technology just could not keep up with a physical class.

At some point, I just felt helpless. Sonya is not old enough to describe what she is hearing. She can’t tell the teacher whether she is hearing their voice, or if the FM system is just picking up static (which sometimes happens if the system picks up unintended sound signals and needs to be switched to a different channel). I was not prepared and I didn’t have the knowledge to serve as her teachers’ teacher in this regard.

Thankfully, the CHC is able to come to the rescue. They will be sending a hearing loss educator to the classroom next week to explain how to use these devices to the teachers (and to me too).

In other news, Cochlear recently released its newest assistive listening device, the Mini Mic 2+. Unlike the FM, which has several components, the Mini Mic is an all-in-one device that is light and simple to use.

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Cochlear’s new Mini Mic 2+

I am a big fan of the Mini Mic (as I have dscussed before). We have used the older model a ton, be it at the American Museum of Natural History, at noisy restaurants or even on airplanes. The newest device has a much longer battery life (11 hours compared to three) and includes a low battery indicator light. You simply turn it on, make sure Sonya’s remote is switched to the Mini Mic setting, and you are set.

The device might just be a perfect solution for a toddler attending preschool. At $395 it seems like a no brainer, but I have decided to consult with our audiologists first. I will keep you posted as to what I learn!

In the meantime, look forward to learning if other parents have tips or suggestions on using the FM System in school. What works for your child? Have you also found that toddlers are just too young for such advanced equipment?