Ear Responsible

Its been awhile, I know.  Just haven't felt like writing much I guess.  I know its time when something gets cooking deep in my brain.  Eventually it makes it to the surface. 

My son asked me today how many years of college I had completed.  The answer is 8 yrs.  My undergraduate degree is in Communication Disorders which covers the foundation for audiology and speech language pathology.  Originally I thought I would be and SLP.  Then as started some of my clinic rotations doing articulation therapy.  I realized I was not patient enough to help a 6 yr old learn how to say the /r/ sound at the beginning, middle, and end of words correctly.  Bless those SLP's out there that are amazing at their jobs and help our kids speak well.  Because of this brief training I am always listening to sounds of all the kids I am around.  I usually do not intervene unless its a big concern but parents ask someone around you if your child is saying their words correctly.  We hear them correctly because we are their parents.  But someone outside your immediate family will give you an honest opinion. If your kid is two and they don't have quite a few single words and are not putting two words together.   Its a good idea to have an evaluation done.  If they are 3-5 and have lots of words but are still difficult to understand, get an eval.  If they are 7-8 they should be saying just about every sound correctly, if not get an eval.  I know some SLP will probably say this is all wrong but its what I remember... So its a good rule of thumb for me. 

Audiology.  Its all about sound.  How we hear, what we hear, and how we interpret what we hear.  Audiologist do lots of things.  They do basic hearing testing, hearing aids, balance disorders, auditory processing disorders, cochlear implants, etc...  I've done most of this at one time or another but early in my studies I focused on a new discovery (well it was at the time) called Otoacoustic Emissions.  The cochlea or inner ear (that snail shaped thing) is pretty cool.  If you present sound to the ear it will send an echo back.  Audiologists realized that this was a great way to screen newborns.  They don't have to raise their tiny hands when they hear the beep.  It was my beginning to newborn hearing screening.  I wrote my thesis on it and never looked back.  Now, I have my dream job.  It came a little earlier than I expected but I get to work part time, supervising a newborn screening program, and do all the diagnostic testing on those babies that do not pass.

A few weeks ago, I was taking a little road trip with my sister and she asked me what is was like to tell a hearing parent that their child was deaf.  ....  Its really hard. 

I thought for a moment of an infant and mother I had worked with...

Mom came in for a follow up hearing screen, her baby did not pass again.  He was scheduled for a diagnostic test called and ABR (Auditory Brainstem Response Test).  I was getting area of skin prepped for the wire leads I would attach.  Mom was doing okay.  She was a little nervous and told me about some piano lessons she had rescheduled.  She told me all about her piano playing experience and the music her other children were involved in. We connected as I told her about my music background.  She told me about her family and the area they lived.  She asked questions about what I was doing.  The appointment started out really well.

As I began the test I knew immediately that the ear I was testing was not responding.  I turned the volume up and was at the max limit of the equipment.  Mom could hear the click nearby coming from the insert in her baby's ear.  He was fast asleep.  She stopped talking and was very quiet.  She looked at me and said, "He isn't hearing that is he?"  I said no, he is not hearing it.  She nodded.  I told her I needed to do a little more testing to that ear and then we would switch to the other ear.  She nodded.  When I switched to the other ear, there was no response.  I quietly explained what I was doing and what I was looking for.  She was very calm and said that she thought he might be deaf because he didn't respond to loud sounds at home.  When the test was completed, I spoke to her in depth about her son's hearing.  She asked all the right questions.  She asked about what the options were, and how to get going.  She was on autopilot. 

After she asked all her questions she was quiet and emotionless.  I knew that she was not digesting the information.  I placed my hand on her knee and told her that I wanted her to do something very important.  I told her to place her newborn on her chest and sing to him like she did her other babies.  She needed to bond with him.  I wanted her to bring him to the piano and let him feel the vibrations of her music.  She stared at me with an open mouth and tears started to stream down her face.  "He won't hear my music" she stated. 

She had already asked about cochlear implants and indicated it was the direction she wanted to go, so I said in response, "he won't hear your music right now, but he will feel the vibration, sense the emotion from you, and be comforted when you hold him to you like you did with your other babies.  With cochlear implants he will hear your music, it will be just a little while longer than you expected." We talked for awhile longer, I got her follow up appointments made, completed the referrals for early intervention, and answered more questions.  When she left I knew she had finally allowed the information to set in.  I knew this was just the beginning of a very long road but I knew she would be okay. 

I held it together for the remainder of the day.  When I got in my car my tears started.  I cried all the way home. 

Most days my job is really wonderful.  Some days its really hard.  I know I don't always get it right.  But I will always try to do my best.  The infants and parents I work with deserve the best and its up to me to try and read their body language, to try to say the right thing even if its a hard thing to hear.