Silence...of another kind!

Wow, it's been a while since i've written anything - mostly cos we haven't actually had an appointment for quite some time! A bit of an achievement for us...

Anyway, I thought i'd just write a few things that have been happening lately...

I had an interesting discussion with our Aus Hearing audiologist in January about Jarrah, who i had noticed was hearing ok but still not alway listening well, and certainly unable to answer any sort of questions. I noticed it particularly back in December when we went to visit the Kindy Jarrah is now going to - they offered him milk or water and he just looked at them as if they had spoken to him in Chinese. I observed him more closely over the following weeks, and noticed that requests requiring an action were ok, but anything requiring a verbal answer was not. It seemed he didn't understand that there was such a thing. Anyway, while discussing something quite different with the audiologist, i had a bit of a revelation about why there might be this problem with questions. It seems that Jarrah has a very good auditory memory, so has been learning words & phrases as distinct items, but not necessarily understanding that all words have meaning, and absorbing the meaning from sentences - he tends to latch onto one word that he knows and makes an assumption about how that word was used, rather than listening to the rest of the sentence and processing that.

I had wondered if his comprehension was really as good as i should have expected it to be by this stage (1 full year of hearing aids & speech lessons), and i was finding myself often frustrated by his apparent total lack of understanding of what seemed quite basic language. When we returned to speech lessons in Feb i asked our teacher about all this, wondering how i was sposed to teach J to process language, not just learn distinct sounds, and she decided that questions and turn-taking with language was something we should work on. By now J had taken to copying back the question instead of ignoring it altogether, so at least he was hearing it, but there was still no understanding (a) of what the question meant, and (b) that he was required to give a response. We've ended up doing lots of role-playing and lots of pointing at the person whose turn it is to speak, and he's beginning to get the idea. Now I at least get a "no thankyou" when i ask if he needs to go to the potty! :-)

Yes, in the middle of all this I decided it was time to go nuts with the potty. We'd been sitting J on it sometimes regularly (sometimes irregularly!) for months, and a couple of times he'd even woken in the middle of the night to use it! I figured that meant he was really able to train at least in the day time...and when i discovered that we had a clear calendar for a week or so, i thought we'd have a shot and see what happened. So, here we are 2 weeks later in undies :-) and today we had our first accident-free day; we managed to finish the day in the same pair of undies we started in - yay Jarrah!

Kindy began in January - i really felt it would be good for Jarrah to begin to learn to function in a fully hearing environment, without a lot of the help that he gets at home, and to learn to socialise more with kidlets his age, so i enrolled him in a local Kindy just one day a week. At first i wasn't sure how he would go in terms of language, i thought everyone might struggle (teachers included!) but he seems to have done fine...well, more than fine really, his language has come ahead in leaps and bounds, many of the songs he sings are now much clearer and actually have the right number of words in each phrase :-) Each Friday when he comes home he seems to use words more than just noise, which is wonderful - lots of little speaking people obviously helps! Hopefully this will continue, but at this point Kindy was the best thing we've done this year!

Kaelen is now comfortably sitting up and responding really well to sounds, both speech & general noises. At the moment we're trying to encourage him to attempt to copy some animal noises (moo, baa, etc.), mostly looking for different vowel sounds, and you know i reckon he's trying to say moo. It sounds like aahhhh, but it's the same aahhh each time, and has a very similar rise and fall to my moo...he did it a few times today, see if he'll do it again tomorrow...

My son's first word: moo :-)

Next appt: Wed 11th March, Aus Hearing checkup for Kaelen; first VROA (puppet test)

January appointments - ENT & chiro

Sorry, forgot to blog about these ones, they were reasonably inconsequential...

Tuesday 6th January - ENT checkup for Kaelen. Kaelen first saw our ENT when he was about 10wks old, and was far too tiny at that point for the ENT to see anything much in his ears, so we were advised to come back when he was about 6 months old. Since that happened on New Years Day, we duly went back and apparently the view was much easier, and there's no sign of any fluid behind his eardrums at all! This is very good, and it will now be interesting to see the results of Kaelen's first VROA (puppet test), due to be done in early March.

ENT had a look in Jarrah's ears too, while we were there, and they appear to be clear atm as well. They have been discharging in an alternating fashion over Christmas, but that appeared to be co-incidental with the arrival of certain 2-yr-old molars. Since the teeth have arrived, the ears appear to have righted themselves. We did purchase a small otoscope so we could keep an eye on things more closely ourselves, but hopefully we're over the worst of it, and if we can keep Kaelen well this winter, we may be able to avoid the middle-ear issues we've had with Jarrah. I believe his middle ear troubles really began in about May 2007 when he got a bad cold which lasted about 8wks...that was pretty much the beginning of the end!

We had a fun trip in and out of town on the train - it's the first time i've not had Jarrah in the stroller, so it was going to be interesting to see how well he coped with all the walking. We stopped at our local park for a quick play on the way to the train station (so Kaelen could go to sleep) and then walked the rest of the way. Unfortunately J fell during that walk, and something made walking uncomfortable for him, so he didn't walk much at all that day, he mostly perched on the front of the pram! He was very good and didn't wiggle about or cause any difficulty, and walked well when i needed him to. We boarded the train (which was unexpectedly packed!) and he found himself a seat right away, just near the door where we always sit atm. No help from me, he knew what to do...

Wednesday 7th Jan - Chiropractic check-ups for both boys. Dr checked them all over and said they're doing great. Just a few small adjustments, but generally fine. The advice is to go back every 3 or 4 months, but i must confess that Sandgate is quite a drive with 2 small kids, so we're just doing twice a year atm, especially since they seem to be doing fine and not needing major adjustments each time.

Next appt: Mon 19th Jan, K Paediatrician

Kaelen - Aus Hearing checkup

Fri 5th Dec - This must have been the shortest Aus Hearing appt we've ever had! Still nearly 1hr, but they were even running close to time at the end of the day, so we were done a lot earlier than i expected.

I wasn't sure what to expect from this appt - every time we go to Aus Hearing with J they do testing of some sort, so i wasn't sure if they would do the same with Kaelen, but it turns out this was just to check the settings of his aids and take new impressions for ear moulds. Because the babies grow so fast, they go through moulds like they're going out of style (i think this will be Kaelen's 3rd or 4th set, in 10 weeks!) and the size of their ear canal changes, which affects the levels at which the hearing aids are set, so they need to be tweaked regularly, it seems. This is all a bit new, cos Jarrah didn't have hearing aids as a baby, so he's only just got his first new set of moulds and had his first tweak. So, a rather uneventful appt!

A quick update on Kaelen's general progress though - we had our last speech lesson for the year yesterday, and he's really beginning to respond well to voices, and locating sounds around him (turning to them when he hears them). His speech teacher was very pleased with what she saw yesterday, he was listening really well and turning to her right away when he heard her voice, which is very age-appropriate. His current favourite sound is "Sh-sh-sh-sh-sh" - this is pretty much guaranteed to produce some giggles! Which is also great, cos that's quite a soft sound, and shows that he's hearing well in the high frequencies.

Next appt: Tues 6th January 2009, K @ ENT

Strike, how can a kid grow so much?!?

Well i thought Kaelen was looking bigger (especially longer), and some of the mums at MOPS yesterday commented that he looked bigger, but this morning we went to child health and found out just How MUCH! :-)

It seems that in the last 4 weeks Kaelen has put on nearly 1 whole kilogram (!) and grown about 5cm in length!! My goodness boy, are you thinking NBA already?!? Perhaps he was just doing some catching up (and stashing a bit away for Ron...), but to me that seems an astronomical amount to grow in 4 weeks. At least we know what he's been doing with all the milk he's been drinking...

Thinking of starting solids next week, really only so we can offer him a wide variety of tastes and flavours before he gets too set in his ways at the ripe old age of 6 months, as i've heard of happening. Perhaps he'll actually have some need for them by then too...

On the hearing front, Kaelen has begun to respond very clearly to voices in the last 7-10 days. He has always responded well to noise-makers such as rattles & cymbals & cellophane (a favourite!), but about 10 days ago at his speech lesson he decided that he liked "meow" very much, and would grin from ear to ear upon every repetition. During last week this reaction gradually spread to other sounds, "moo", "quack quack" (especially from Daddy!), "woof woof" & other animal sounds. This is a great sign, cos it shows he's really beginning to tune in to voices, which is critical for developing speech. He even responded to a few things without his hearing aids, so there's obviously enough residual hearing there that he still gets some input without his technology. According to his speech teacher, we should expect him to develop age-appropriately; because he got his aids so early, he really hasn't missed much at all.

Which comes first - the chicken or the egg?

Or, in this case, the teeth or the ears?

Since my last entry, Jarrah's ears have continued to discharge, alternating sides of course - and then i discovered he had a new tooth! His first 2-yr-old molar! That was prob about 2 weeks ago, and followed a few days of runny nose in addition to ear discharge. Then, last week, about when the discharge swapped sides, i discovered a second 2-yr-old molar.

So, which comes first - the teeth or the ears?

Now i'm not sure if the ear discharge is related to or even caused by the teeth, or if the timing was just unhappy co-incidence. I also don't know if the runny nose was caused by either the teeth or the ears, or how about both...it's all a mystery. What i do know is that he's hearing spectacularly at the moment, so any discharge that is there doesn't appear to be bothering him too much...

Children are complicated sometimes... :-)

Easier said than done...

Did i say something last post like, "if we can just keep Jarrah's ears healthy..."?

Well, it seems this is easier said than done.

Tomorrow is 7 days since that last test. Tomorrow will be day 3 of our next round of drops due to discharge from his right ear. And, i must confess, we didn't get on the drops right away, we waited a day or two for things to present themselves clearly.

How can this be?

How can a child go from having clear, apparently healthy ears on day 1, to having lots of odourous discharge (thus preventing the wearing of a certain hearing aid) in less than 7 days, probably closer to 3 days? With no obvious catalyst or other illness? This is verging on ridiculous.

Despite all this, Jarrah did very well at speech today with only one ear in - detected all 7 Ling sounds and listened very well to instructions...you could see his little brain processing the contents of the sentence backwards, it was fascinating! Apparently kids who are cochlear candidates don't detect all 7 Ling sounds, so that's encouraging that he can do that with only 1 hearing aid and who-knows-how-little-hearing in the other ear - and it confirms the opinions and decisions that have been offered and made so far.

*Sigh*, off to make my chemist richer than he already was...

Jarrah - Aus Hearing checkup

Tues, 4th Nov - Well, the good news keeps on coming! It's been a long time coming, but at least it's coming! Grab it, with both hands, and don't ever, ever let go!

Today was another routine check-up at Australian Hearing for Jarrah. They've been happening every 3 months because his levels have been fluctuating so much, so he's starting to get a little bored of the puppet game. The VROA (Visual Reinforcement Orientation Audiometry) is where they put little pipes in his ears, play sounds at various frequencies and levels through the pipes, and when he responds by turning to the sound he's "rewarded" by something visual, usually a puppet lit up in a box, hence my term "puppet test". The plan for today was to try a different method of testing, designed for slightly older children, but because of the work he's been doing at Yeerongpilly it was considered that he should cope fine. Unfortunately our regular audiologist was not at today's appointment, so that different method of testing was not used, even though i mentioned that it had been discussed and approved at our last appointment.

Nevermind, we had another go with the puppets. Ears were checked and clear, grommets were in place and open, and Jarrah had slept reasonably well last night so he was in a very good frame of mind for testing, thankfully! The priority was to get clear results on the right ear, since we hadn't had any decent results from that ear since January, so they began with that side. I can usually hear some of the tones as the test goes by, but today i heard very little...which made me wonder whether they were testing much, or if Jarrah was hearing well. But then, i could see when it was a response because they showed the puppet!

Jarrah lost interest part-way through testing the left ear, but the results they did get were not different from the previous test, so they were deemed accurate. What we did get was this:

Right ear:

250Hz - 75db (previously 70db, so within margin of error)

500Hz - 70db (previously 70 or 75db, so within margin of error)

1kHz - 60db (previously 85-90db, so significantly improved!!)

2kHz - 70db (previously 65db, so within margin of error)

4kHz - 60db (previously 105db, so significantly improved!!)

Left ear:

1kHz - 75db (previously 70-75db, so within margin of error)

4kHz - 80-85db (previously 90-105db, so some improvement)

These are virtually the same results as Jarrah returned at the test immediately after he was fitted with hearing aids nearly 12 months ago, in fact the left ear 4kHz result is actually slightly better.

HOORAY!!

This for me confirms the decision of the Mater Implant audiologist who was of the opinion that Jarrah was not in need of cochlear implants, and tells me that most of the fluctuations we've seen throughout 2008 have been due to middle ear conditions. Therefore, if we can keep J's middle ears healthy (ie. infection-free), then with his hearing aids he should do just fine.

By the way, he's trying to say lots of words like "eggshell" and "truck" and "clock" these days, and his favourite song atm is "Bananas In Pajamas", which kind of sounds like "naa ni ni, naa ni ni, aaaaah naa ni ni, naa ni ni..." I must confess it took me a few days to figure out which song that was... :-)

Next appt: Fri 5th Dec, Kaelen's Aus Hearing check-up