The Coppit Family Daily News

The semester’s over, finally. It seemed long because I was teaching a new class in formal software engineering methods. The kids did pretty well, despite the difficulty of the class. Unfortunately the prep work for the class ate up a good chunk of my time.

Now I have to turn my attention back to research. We have a paper due in a couple of days, and a proposal due in January. I’m also trying to get some software development done over the break, and prepare for my class next semester.

Yesterday we drove to Charlottesville to get Christopher’s hearing aids, and to talk to a speech therapist. Christopher doesn’t seem to mind the aids, but then he doesn’t seem to notice them either. Hopefully after wearing them for a month or so he’ll begin to notice more sounds…

We spent a long time talking to a speech therapist about therapy options. Dorothy and I feel that we should get Christopher into “auditory-verbal” therapy. We had already decided that we wanted him to have every opportunity in a primarily hearing world, but our discussions with the therapist reinforced this decision.

First, kids who do “total communication”–i.e. sign language plus lip reading plus auditory plus speech–actually don’t do all of them equally well. Instead they do worse in all categories than if they focused on learning one communication method. Second, kids who do only auditory-verbal actually end up learning to lip read on their own anyway, so they are better off than kids who focus on lip reading at the cost of learning to use sounds.

This webpage described A/V therapy, describing a study in Missouri that the speech therapist told us about. It also describes the qualifications necessary to become certified in A/V therapy. The therapist told us that there are only about 300 certified therapists in the world. This means that we’ll be driving once a week to Charlottesville, Richmond, or Norfolk. We’re hoping to find someone in Newport News who can help Christopher, so that we don’t have to drive 1-2 hours each way every week.

This plugin allows the blog administrator to set an explicit ordering, spacing, and indentation of categories in the category list that appears in the sidebar. The administrator specifies the ordering in the new “Category Order” management page. There is also an option for placing the category post count inside the link.

A screenshot shows the management page.

The plugin overrides any ordering or indentation of categories created by the list_cats() Wordpress function. It works by dissecting the normal <ul> or <br /> formatted list that Wordpress creates, then reconstructing a custom </ul><ul> or <br /> formatted list based on the new custom ordering and indentation. Since the plugin modifies the display only, you can revert to the default ordering by simply disabling the plugin.

The plugin handles subcategories (by overriding the parent-child relationship), and the post count on categories. If the plugin fails for you, it is likelythat your category list HTML is somewhat different than what the plugin expects. In this case, please email the HTML snippet to the me and I’ll try to fix it.

Download it here: Category Order 1.8.0

Apparently there are some deaf folks out there that feel like being deaf isn’t a disability. As a result, there was and still continues to be some backlash against cochlear implants for children. They say that putting an implant in a child is committing “cultural genocide”. Emotionally charged terms aside, I guess I can see how the “deaf culture” might dwindle as more and more people get usable hearing at an early age. But given the choice, I’d rather have my child participate in the 99% culture than the 1% culture.

Let’s face it: 90% of deaf children are born to hearing parents. This means that these children start off at a severe communication disadvantage. Overcoming that disadvantage is hugely difficult, and has lasting lifelong impact. I got eye surgery to correct my vision, and wouldn’t hesitate to get an implant to correct my hearing. Why wouldn’t I want every advantage for my child?

I wonder how many proponents of “deaf culture” actually know what they’re missing. Perhaps if they did, they wouldn’t be so adamant that others support their “culture”.

The next day Christopher was really tired–too tired. Once we finally got him to sleep, the audiologist hooked him up to the ASSR test. The basic setup was the same as the ABR, except that the equipment plays tones instead of clicks. This meant that it can test specific frequencies. Also, the equipment could go up to 120 dB. This is like a jet engine.

It was a bit unnerving to see Christopher sleeping soundly as this loud tone was being blasted into his ear. Even though it was sent through an earpiece, it was still pretty darn loud to us.

The test results confirmed the results from the previous day. There was some good news though. At 90 dB there was some response at 500 hz. At 115 dB there was also some response at 1000 hz. He’s not totally deaf, but it looks like he’s “profoundly” deaf. Unfortunately this is too deaf for hearing aids to help.

On the other hand, the tests suggest that the hearing hairs in Christopher’s cochlea are not working correctly, but that his auditory nerve is working. This means that he’s a good candidate for a cochlear implant. This is basically an array of electrodes that threads into the cochlea, stimulating the auditory nerve directly. The other end of the wire is connected to a coil seated in the patient’s skull behind the ear. Finally, there’s an external unit that interprets sound and converts it into electrical signals. These signals are sent through the skin using induction to the implant.
Wikipedia has a good entry on cochlear implants.

All the research says that the sooner we get an implant into him, the better his language development will be. If we miss this “window of opportunity”, he’ll have a really hard time later. So we’re pushing as hard as we can for getting an implant at 10 months. Right now the FDA only approves 12 months, so we’re fighting a bit with the insurance company on the timing.

In the meantime we need to get him into hearing aids. There are two reasons for this. First, if he can hear even a little bit that would be good. Second, it’s one of the FDA requirements that we at least try.

Dr. Stonebreaker said that we should use the “team approach” that UVa has from here on out. She couldn’t have been more right. The same day that we got the results of the ASSR, we were lucky enough to be able to get a mold of Christopher’s ears for the hearing aids. Later that day we saw the doctor, Dr. Hashasaki and his colleagues, who signed a form to get hearing aids from the Virginia hearing aid loan bank. In a couple of weeks we’ll go to get him fitted.

By the way, the hearing aid loan bank is a great idea. It was designed to help people like us who can’t really pay thousands of dollars for good hearing aids that we expect to only use for a few months. It also happens to be located at UVa, another good reason to work with those guys.

Overall, it was a very productive trip. We now have a definitive diagnosis for Christopher, and we’re on track to get him an implant at 10 or 12 months.

First, a little background on Christopher’s hearing tests…

In the past, Christopher’s hearing tests have had various problems. The first time we actually woke him up for a test for which he should have been asleep. Once we finally did get him back to sleep, it turned out that he breathes abnormally loudly. We tried a second time a couple of months later, but the audiologist still couldn’t get a clear reading due to his heavy breathing.

The next step was to head to Richmond for another audiologist to try, and to also try another type of test. Originally we did an OAE test, which sends sounds at the cochlea and then listens for reflections from the hairs. This time we tried that test again, but didn’t get any good results due to his breathing. The audiologist also tried a second test, called an ABR. This test checks his brainwaves for a response using electrodes behind his ear. The software is better as well, and can take measurements in between his breaths. This time, the results were negative, not just inconclusive.

At this point we went to our local ENT (ear-nose-throat) doctor for a consultation. I really have to give Dr. Stonebreaker credit–she very quickly realized that Christopher’s situation was beyond what they could handle, and immediately referred us to UVa.

Last Tuesday and Wednesday we went to Charlottesville to consult with the specialists there. We were happy to see instructions ahead of time telling us to make sure that he was sleepy when he arrived–this meant they had their act together. When we got there, we found out that our audiologist was a PhD, which made us feel more confident. Her knowledgability and professionalism also went a long way.

This time we did another ABR. The test sends clicks at different loudnesses and measures the brain’s response. She pushed the machine as far as it could go, up to 90 dB. 90 dB is as loud as a lawnmower. She also had another audiologist place a transducer against his head behind his ear in order to make sure that he couldn’t hear anything using direct conduction through the bone.

Both of these tests showed no response. This indicates that it’s probably not an outer or middle ear problem, but probably a problem inside his cochlea or nerve. At this point Christopher woke up, so we couldn’t switch to another test. The audiologist was kind enough to schedule a time for us the next afternoon to try again.