Tag Archives: Hearing aid

How Hearing Aids Actually Sound (Video)

This is a clever video Eliza found recently, prepared by the Vermont Center for the Deaf and Hard of Hearing. In this video, they recorded the actual sound received by a hearing aid under 4 different scenarios:

Close by with no background noise (the “ideal”)
Far away with no background noise
Close by with background noise
Far away with background noise

This is a great way to “walk in the shoes” of the listener. Scenario 4 is very common in the classroom setting, and very challenging to cope with. I have no doubt it’s exhausting!

After the exposition, they then repeated the same 4 scenarios using an FM transmitter, showing significant improvements. Good stuff.

Here’s the video, keep your eye on the student with the red hat – an Oscar winning performance…

While this video demonstrates hearing aids, I do know many of the Cochlear Implants out there now offer similar integration with transmitter systems. I’m expecting (perhaps wrongly?) a similar experience for CI users.

Regardless of the technology, clearly the teacher and school system have to be on board with this for it to succeed, so we’ll definitely need to weigh our options on schools when Fiona gets to the appropriate age. Fortunately we still have a few years there.

If anyone reading this has firsthand experience on this topic they’d like to share, we’d love to learn more. Especially with school systems in the Atlanta area.

First Speech Therapy Appointment…With More Cowbell!

Auditory Verbal Center

Today was Fiona’s first auditory speech therapy session at the Auditory Verbal Center of Atlanta, the same great center I posted about last month. Now that Fiona has her hearing aids, the plan is to visit the AVC every 2 weeks to help train her to make sense of limited sound, and to train mom and dad on how to grow her skills between sessions.

Since Fiona is just 3 months old, and her hearing aids are of limited benefit, the goal initially is basic “sound awareness”. Training Fiona to respond to limited sounds, and to acclimate her to the therapy routine. After she gets her Cochlear Implants (6-9 months away), the therapy will intensify to a weekly regiment focusing on improved speech recognition and language development, with the ultimate goal of complete integration with hearing children by preschool! Kick ass.

The AVC will be a regular fixture of our lives for the next 3-4 years, so today’s session was primarily informational meet and greet. As we entered the lobby, I chuckled at the “chocolate ears” available for sale. They looked pretty yummy I must say, but in any other context I’m not so sure…

Yummy Treat…or Ritual Cannibalism?

We met our therapist Jennifer, but found out later she will be leaving the center soon, so we’ll be settling in on a new therapist next time. After 40 minutes of extensive Q&A (“does fiona make cooing sounds”, “does she recognize laughing sounds”, “does she mimic your facial impressions”, etc.), we got down to the fun part.

We turned on Fiona’s hearing aids, then Jennifer then took out a series of toys to “clang” behind Fiona’s head, looking for responses.

In this picture you can see her pounding what looked like a pool paddle with a plastic mallet:

Bang Bang Bang!

The good news is that Jennifer detected slight responses to some of the sounds.

I still have trouble myself differentiating an actual response from random “baby faces”, so I asked for tips on how to differentiate. Jennifer recommended focusing on the eyes (look for sharp movement of the pupils), the eyebrows (furrowing), and abrupt movement of the head. Still, at 3 months old there’s no foolproof way, so you need to keep with it.

She then brought out other toys to try different sounds, including the legendary cowbell! While I (barely) resisted the urge to make “More Cowbell!” jokes, we watched for some time, but did not see much of a reaction. Its possible Fiona was getting tired, though.

So we left the center with homework to get some noise making toys and practice testing her awareness of sound. We must be the only parents in America who are actually SEEKING OUT noisy toys for our child. Should be a fun trip to Toys R Us – I see lots of toy drums and cowbells in our future!

And on that note, I leave you with…More Cowbell!

The Future of Hearing Correction

Coming Soon

It’s interesting to think through the parallels between vision and hearing correction over the years. First you had eye glasses, which could correct the shortcomings in vision, but through an outwardly visible prosthesis you wore over your ears and nose. Over time, the glasses got smaller and the corrective powers grew larger.

Then came contact lenses, which were equally effective, but completely invisible to the outside world. No one need ever know.

Finally came LASIK, which could physically correct the shape of your eye. In a sense you are “fixing your body”.

If you think about it, hearing correction is following a similar progression. First you had hearing aids, the “eye glasses” of the hearing world. They amplify sound and are worn in an external prosthesis that sits over the ear. Over time the aids have gotten smaller and more powerful, with recent models even fitting entirely within the ear!

In the Ear Hearing Aid

Then came Cochlear Implants, which could actually bypass damaged hearing nerves to provide a wider range of correction. Not directly analogous to eye glasses since they do more then amplify sound, but from an outward perspective they are still bulky and noticeable:

Cochlear Implants of Today

To me there are 2 logical next steps remaining in this progression: first, an entirely “invisible” corrective hearing mechanism, similar to contact lenses. And finally an actual physical “correction” to the body, similar to LASIK.

In terms of the first, research has already been underway on a “completely internal cochlear implant” for some time. As far back as 2000, a company called Epic Biosonics was working on a device that would be

“fully implanted into the middle ear….a microphone is implanted under the skin in the ear canal. This picks up sound and sends it to a speech-processing device which is similarly implanted under the skin behind the ear. “

(Totally Implantable Cochlear Implant History). In other words, an implant that is outwardly completely invisible!

This sounds fantastic until you read down further that “Epic ran into a particularly difficult technical hurdle and had to shelve the development of this exciting implant.” Epic was later acquired by Med-El (first discussed in my post on Big Business), which to my knowledge offers no such device currently.

In 2011 another company called Otologics was attempting the same feat, but then was later acquired by another CI vendor called Cochlear in what looks to be a bargain basement bankruptcy offering. Clearly there are some challenges still remaining with this technology, but the optimist in me feels it is only a matter of time before we figure those out.

Of course the true correction, the “LASIK” of the hearing world is further out still. There are really two aspects to this: better amplification of sound (glasses/contacts/lasik), and providing sound where there was none before (Cochlear Implants). In terms for the former, hearing loss is trailing vision loss, but in terms of the latter, hearing loss seems further ahead.

As little as I know about hearing loss, I know even less about blindness, despite being extremely nearsighted myself. I pray I do not need to become an expert on that topic, but nevertheless remain a constant technology optimist.

Progress marches on…

Hearing Aids…1 Week Later

Tomorrow we come upon our 1 week hearing aid anniversary. So far the results can best be described as … meh.

To date, we’ve seen virtually no change in Fiona’s response to sound, but then again we weren’t expecting much either. Still, there’s always hope.

Eliza did notice a response from Fiona when using the dustbuster the other day (are they still called dustbusters?). Ironically, Fiona’s hearing aids were not actually “on” when the response occurred, which is perversely amusing. This response is not altogether unexpected, though, since the sounds of a vacuum cleaner occupy the lower-left quadrant of the audio spectrum I discussed in my earlier post.

Probably our biggest annoyance is that the aids are constantly entering feedback loops. Same concept as putting a microphone in front of a speaker – the loud shriek drives you crazy. We were told by the audiologist this is quite common for infants since their heads are constantly wedged into small spaces…car seats, swings, etc. In other words, there’s nothing wrong with the aids. Fortunately Fiona is blissfully unaware of the feedback, which is a sad blessing. The dog, however, is not.

So while managing the hearing aids is an extra annoyance, it’s nevertheless an important step on our journey to Cochlear Implants. And the good news is Fiona is getting acclimated to devices hanging off her ears which will surely help us in the months to come.

But as an aside, here’s where it gets fun. In the last week or so Fiona has started regularly smiling! For those who remember the first few months of raising an infant, this is a HUGE development. Finally all the crazy monkey faces, diaper changes and sleep deprivation is starting to pay back with…an actual reaction! WOOHOO!

So here’s the obligatory smiling picture from earlier this morning.

You Funny!

Check out the stylin’ baby jeans, it begins!

First Hearing Aids

Earlier today Fiona Kate Isham, at the age of 11 weeks, received her first hearing aids.

I Be Stylin’!

As promised, here is the video from the activation. The first few minutes show Eliza and I practicing putting her aids on her head, so if you want to skip to 4 min 30 sec you can see when we first turn on the aids.

To set expectations, we do not expect her to discern a wide range of sounds with the aids (my earlier post on the Frequencies of Familiar Sounds is a good reference), nor is she old enough to really process what she’s hearing. After all, she IS only 11 weeks old.

Nevertheless, we DO expect her to detect the presence of SOME sound, especially loud, low frequency ones. It’s a little hard to tell in this video, but there are some instances where it really looked like she responded to audible stimuli. Maybe wishful thinking so we’ll let you be the judge.

Hearing Aids are just a stepping stone towards the cochlear implants, but nevertheless its important for her development to have stimulation of her auditory nerve.

In 2 weeks she has her first therapy session at AVC where she will get more practice getting used to the presence of sound. We can’t wait.

Big Week Next Week

So after a period of relative quiet, next week is a big week for Fiona. Monday she is having an MRI and Wednesday she will receive her first hearing aids.

MRI

I think most everyone knows what an MRI is: it provides a more detailed picture inside the body then is otherwise possible through X-Rays alone. For example:

Sample MRI Image

Many of us may have even had one, myself included. What I didn’t know, however, was exactly how they work – it’s pretty amazing.

There’s a good article on one of my favorite sites HowStuffWorks about this, but its pretty long and technical. Here’s my vastly oversimplified explanation:

The body is made up mostly of water, water contains hydrogen, hydrogen has protons.
Magnetic fields from the machine align those protons in the direction of the field. A small number of those protons do not align.
Those protons that do not align are hit with a specific radio frequency wave that causes them to absorb energy.
When the wave is turned off, those protons emit that energy. That energy is then absorbed by “coils” in the machine that feed data into a computer.
The computer runs complex math to map that data into a picture like you see above.

Pretty magical stuff. Go Science!

Here’s a good infographic from the How Stuff Works article:

Steps of an MRI

If you’ve ever seen a MRI machine, its pretty intimidating and claustrophobic:

Because Fiona is an infant, she will need to be sedated with general anesthesia for the procedure. As a parent, this will doubtless be tough to watch, but is surely better than a baby screaming her head off inside a big scary machine.

From this procedure we are hoping to get our first insight into the cause of her hearing loss, and more importantly her candidacy for Cochlear Implants (see my earlier post about Auditory Brainstem Implants). While it is not guaranteed we will have all the answers on Monday, we do expect to learn more of the puzzle.

Hearing Aids

On Wednesday Fiona gets fitted with her hearing aids. While we are not expecting any significant response from the aids, the audiologist advised us to bring a camcorder “just in case”.

Personally we don’t expect to see a response like we’ve seen from the CI and ABI videos in earlier posts, but it is possible Fiona will hear SOME new sounds for the first time. We’re keeping our expectations in check, but nevertheless I will keep the camera rolling “just in case”.

Stay tuned.

Video Diary of First Year of Hearing

Another good find by Eliza. This video shows the running diary of a baby girl born with profound hearing loss. Over the 8 minutes you can see her progress from birth, through hearing aids, to the CI surgery and finally to integration into the hearing world. An eerily similar parallel to our upcoming journey.

The progression is really interesting to watch:

To frame the context: Fiona is now 10 weeks old and will be getting her hearing aids next Wednesday.

The Hearing Test

If you’re like me, you probably have no clue how you could possibly test hearing on an infant who can’t even speak. What’s even more fascinating is that they can test infants a DAY AFTER they are born! Incredible.

How does it work?

Well actually there are 2 different kinds of tests. The first test, conducted 1 day after Fiona’s birth and again a week later as a retest was called the Otoacoustic Emission (OAE) Test. In my layman’s non-medical understanding, what they basically did was insert a small probe into her ear that generates sounds and captures the “echo” back from that sound. They can then measure if that echo looks normal or not. Its pretty quick and non-invasive, provided the baby can stay quiet for 15 minutes.

All new infants receive this test today, but it is not uncommon to fail due to ear blockage from the birth. This is why we were not too concerned when Fiona failed her first (and even second) tests.

So after failing the first 2 tests, they pulled out the big guns 1 month after her birth. This was a test called the Auditory Brainstem Response (ABR) test. Basically it measures how sound introduced into the baby’s ear translates into electrical responses received by the brain. Here’s a great explanation from MedicineNet.com.

The test is performed by placing four to five electrodes on the infant’s head, after which a variety of sounds is presented to the infant through small earphones. As the hearing nerve fires, the sound stimulus travels up to the brain. This electrical activity generated by the nerve can be recorded by the electrodes and is represented as waveforms on a computer screen. The audiologist can then present different loudness levels of each sound and determine the softest levels at which the infant can hear. For infant-screening purposes, only one sound is used to test the hearing, commonly referred to as a “click.” The click is a grouping of several sounds to test a wider area of the hearing organ at one time. The click is typically presented at a loud level and a soft one. If a healthy response is recorded, then the infant has “passed” the hearing screen.

Here’s what the equipment looks like (stock picture, not Fiona). As you can guess, “Fiona was not impressed” with this setup:

ABR Response Test Equipment

Sitting through this test was not pleasant – it took about 3 hours to run, while you’re sitting there in darkness and silence watching the audiologist fidgeting with various graphs on a screen, all the while having little clue if the graphs are “good” or “bad”. In addition, the baby needs to remain quiet and still, which is an immensely taxing chore, especially for mom.

The screen the audiologist is looking at looks something like this:

I don’t pretend to understand 1/100th of how this works, but I’ll tell you what I learned: they test each ear individually, measuring responses to different frequencies at different volumes (dB levels). Low frequencies (like the booming of a subwoofer) are easier to hear while higher frequencies (breaking of glass) are harder. This is why you can hear the ground booming when walking up to a concert well before you hear the singer, especially annoying teeny-boppers like Bieber…

During this test they are basically measuring 3 different variables:

The frequency: can the infant hear some frequencies (base drums) better then others (glass breaking)?
The volume (dBs): are some frequencies just “quieter” then others and can be amplified?
The ear: is the left different then the right?

Each different graph captures a different combination of the above 3. I don’t know how to read those graphs beyond saying “the bigger the peaks and drops the better”. If the line is essentially flat, that means no response at all.

Most infants have various responses at various frequencies and volume levels. Some may look just fine, while others can be corrected by “turning up the volume”, which is basically what hearing aids do.

Fiona was flat at all frequencies and all volumes, in both ears. This means “profound” hearing loss, and something that is likely not correctable by hearing aids. (to be fair there was one low frequency in one ear that got a small result at very high volume level, but that could be an artifact of the testing precision. We’ll know more in a later retest).

The good news is there are now options (beyond sign language, which is also awesome) for profound hearing loss in the form of cochlear implants. I’ll talk more about that in a future post, but we’re very excited there.

Hearing loss is the most common birth defect today. I had no clue. Apparently 3 out of 100 babies have some level of hearing deficiency. This is why they test so early now – and it is true wisdom. Babies begin learning language within their first 6 months. As you can imagine, hearing is a huge component of this, and the earlier you are aware of the problem, the sooner you can act on it to help speech develop normally.

In this regard we feel truly fortunate. Knowing for sure within 1 month (1 month!) after birth has set us on a course NOW that we’d likely not have otherwise started until 1-2 years old, well past the start of language learning. This makes me much more optimistic in our ability to educate her well in these early stages.

Profoundly Strong – Fiona's Journey

Join us as our daughter Fiona grows up to overcome profound infant hearing loss.