Hearing tests

[Guest guest]

I need advice on audiology testing.

As you all know, my son passed his newborn hearing screen. The

hospital uses the oto-accoustic emissions test. After seeing an ENT,

we were told that the validity of this test was totally wrong because

has bilateral atresia. SO, we went for formal audiology

testing at MCV (Richmond, VA). There, air conduction tests (they

called this an ABR) were done using probes that were inserted into

what little canal/hole is present. With this test, he " passed " with

hearing in the 30-40 dB range. They felt that with normal air

conduction, bone conduction testing was not necessary. We were told

by the audiologist that he didn't need hearing aids. We then

followed up with a different ENT who felt that had " fibrous

atresia " and that with the reassuring audiology testing, the only

thing we needed to do now was get behavioral testing via audiology

NOW (my son at the time was 14 weeks old). The temporal bone CT was

then done which seemingly showed atresia.

Last week, we went to see Dr. Jahrsdoerfer at UVA. He feels that

has significant stenosis on the right but atresia on the

left. UVA audiologists did bone and air conduction testing (ABR)

which revealed good hearing on the right (25dB) and conduction loss

on the left (70dB)...

I feel like I am running around in circles. Dr. J recommends BCHA

now - but we can't find a decent audiologist in Richmond. And with

all of these differing test results, I am simply very weary of the

entire process. I trust Dr. J; the problem is that I don't trust

anyone nearby. Has anyone out there got hearing aids from one

institution and then had maintenance/follow up testing done by

another group/audiologist? And has anyone had similar experiences?

Please advise. Any help would be greatly appreciated.

Thanks,

Lili ('s mom - bilateral microtia and stenosis/atresia??)

lili_linz@...

[Guest guest]

> Last week, we went to see Dr. Jahrsdoerfer at UVA. He feels that

> has significant stenosis on the right but atresia on the

> left. UVA audiologists did bone and air conduction testing (ABR)

> which revealed good hearing on the right (25dB) and conduction loss

> on the left (70dB)...

It sounds to me like Dr. J did the right tests, and from everyone I have

heard from he is great. He also has extensive experience in _exactly_ what

has. I would take his results over everyone else's.

Another note...be careful when you say " good hearing " on the right. 25dB is

classified as a " SLIGHT " hearing loss (15dB-25dB), and borderlines on a

" MILD " hearing loss (26dB-40dB). Children with a MILD hearing loss will

usually get a hearing aid, with a slight hearing loss, some do and some

don't.

> I feel like I am running around in circles. Dr. J recommends BCHA

> now -

Sounds like good advice to me. A BCHA won't hurt, but it can help a lot.

> but we can't find a decent audiologist in Richmond. And with

> all of these differing test results, I am simply very weary of the

> entire process. I trust Dr. J; the problem is that I don't trust

> anyone nearby. Has anyone out there got hearing aids from one

> institution and then had maintenance/follow up testing done by

> another group/audiologist? And has anyone had similar experiences?

> Please advise. Any help would be greatly appreciated.

We originally got our BCHA from an audiologist who had " fitted " only one

previously. They were fantastic. We now go to a different audiologist, and

they are dealing with it fine, no problems.

But really, there isn't a lot to do with a BCHA. It is actually much

simpler to " fit " a BCHA than it is an air conduction aid. All you need from

the audiologist, is to order the aid. When it comes in, you adjust the

metal band, turn it on, and adjust the volume. That's it. (With air

conduction aids, they need to make ear molds etc.) From then, the

audiologists usually will do hearing tests every few months, with and

without the aid. Form these results, they will be able to determine if

is getting good benefit from the aid.

The only other " fitting " you may want to do, you can do yourself. We never

used the metal band, but made a stretchy headband to hold it instead (Check

out my web page, http://www.pde.com/~kazemir for a description, and

pictures). There is also commercial head bands available as well. Does

anyone remember the name of this headband? Do you have a web page?

Steve

[Guest guest]

Thanks for your advice, Steve. I'll look at your website again for tips on

the head bands.

Lili

RE: Hearing tests

> > Last week, we went to see Dr. Jahrsdoerfer at UVA. He feels that

> > has significant stenosis on the right but atresia on the

> > left. UVA audiologists did bone and air conduction testing (ABR)

> > which revealed good hearing on the right (25dB) and conduction loss

> > on the left (70dB)...

>

> It sounds to me like Dr. J did the right tests, and from everyone I have

> heard from he is great. He also has extensive experience in _exactly_

what

> has. I would take his results over everyone else's.

>

> Another note...be careful when you say " good hearing " on the right. 25dB

is

> classified as a " SLIGHT " hearing loss (15dB-25dB), and borderlines on a

> " MILD " hearing loss (26dB-40dB). Children with a MILD hearing loss will

> usually get a hearing aid, with a slight hearing loss, some do and some

> don't.

>

> > I feel like I am running around in circles. Dr. J recommends BCHA

> > now -

>

> Sounds like good advice to me. A BCHA won't hurt, but it can help a lot.

>

> > but we can't find a decent audiologist in Richmond. And with

> > all of these differing test results, I am simply very weary of the

> > entire process. I trust Dr. J; the problem is that I don't trust

> > anyone nearby. Has anyone out there got hearing aids from one

> > institution and then had maintenance/follow up testing done by

> > another group/audiologist? And has anyone had similar experiences?

> > Please advise. Any help would be greatly appreciated.

>

> We originally got our BCHA from an audiologist who had " fitted " only one

> previously. They were fantastic. We now go to a different audiologist,

and

> they are dealing with it fine, no problems.

>

> But really, there isn't a lot to do with a BCHA. It is actually much

> simpler to " fit " a BCHA than it is an air conduction aid. All you need

from

> the audiologist, is to order the aid. When it comes in, you adjust the

> metal band, turn it on, and adjust the volume. That's it. (With air

> conduction aids, they need to make ear molds etc.) From then, the

> audiologists usually will do hearing tests every few months, with and

> without the aid. Form these results, they will be able to determine if

> is getting good benefit from the aid.

>

> The only other " fitting " you may want to do, you can do yourself. We

never

> used the metal band, but made a stretchy headband to hold it instead

(Check

> out my web page, http://www.pde.com/~kazemir for a description, and

> pictures). There is also commercial head bands available as well. Does

> anyone remember the name of this headband? Do you have a web page?

>

> Steve

>

>

>

>

[Guest guest]

I'm still very skeptical on the ABR since I know SO

many people who've recieved weird results on it.

I know right off the top of my head there was an

article a year or so ago that said that even with an

ABR a lot of losses were being missed.(I'll go and see

if I can find it in my files) Even today it's not that

unusual for a clinically significent hearing loss to

be missed. If you read the professional journals very

often they'll say something like " So-and_so was dx

with a PROFOUND hearing loss at age 3 " ) I think the

ABR can indicate that there is a loss but I still

think it is too difficult to accurately tell what a

baby hears. Even hearing babies play " Now I hear you

now I don't " I would not reccomend at ALL for a little

kid to get an aid based on the results of one ABR. I

know parents are concerned about language and speech

delays but, I got aided pretty late (at three, so have

been wearing aids for about twenty years) and my

speech and language is fine. (and bear in mind that I

have a syndrome that causes varing degrees of

developmental delays) As a matter of fact I taught

myself to read when I was three! (always been a

bookworm. Here at college you'll usually see me in the

lounge curled up in a chair reading and I have been

thinking of late that I want to get a Ph.D) Definitly

get the BCHA. Don't make your son wear it 24/7. Maybe

you could have him wear it for a few hours and then

have him take it off and see how he functions without

it.

Torrie (bilateral atresia/stenoisis, absent eardrums

and fused inner ear bones resulting in a mild-moderate

loss)

=====

Let there be peace on earth, and let it begin with me.

" Deaf people can do anything except hear! " Dr. I.King Jordan

" I'd found myself becoming more immobile, when I'd think a little girl in the

world can't do anything. A distant nation my community, a street person my

responsbilty. If I have a care in the world, I have a gift to bring " - " Hammer & a

Nail " Indigo Girls

Waste some time looking at my webpage!:

http://www.angelfire.com/grrl/deafgrrl/indextwo.html

__________________________________________________

[Guest guest]

> I'm still very skeptical on the ABR since I know SO

> many people who've recieved weird results on it.

> I know right off the top of my head there was an

> article a year or so ago that said that even with an

> ABR a lot of losses were being missed.(I'll go and see

> if I can find it in my files)

I would be interested in seeing this article.

And I have to say, I am confused by the problems with the ABR. Being an

engineer, when we had tested, I was very interested in HOW the ABR

worked, so I asked the technician a bunch of questions. I think I have a

fairly good idea of how it works. From what I know, as long as the

technician does the test properly, they cannot get a false positive reading

(i.e. the ABR can't show hearing when there isn't any). I could see the

case where the ABR shows no hearing when there actually is some (loose

connections etc).

I think one thing to note: an ABR only tests the conductivity of the sound

from the ear to the brain. It cannot tell if the signal going to the brain

is right, or if the brain interprets this signal properly. i.e. It cannot

tell if there is certain types of sensory-neural hearing loss.

I suppose too, the state of the baby at the time of the test could be a big

factor. Is the baby totally asleep, is the baby dreaming, was there

sedative used etc. etc.

> with a PROFOUND hearing loss at age 3 " ) I think the

> ABR can indicate that there is a loss but I still

> think it is too difficult to accurately tell what a

> baby hears.

Good point. With 's ABR, the technician said he could tell he was

hearing to ~30dB or so. He said that may be able to hear even quieter

sounds, but the ABR doesn't have that resolution. On the screen, I could

see " bumps " in the response from the electrodes. As the sound got quieter,

the bumps got smaller, and eventually it gets so small you can't definitely

say it is present.

Steve (Father of - Bilateral Atresia/Microtia)

[Guest guest]

Steve, I'll try to find that article for you. My

thinking is that the ABR measures what the BRAIN

itself hears. I know that there was an article a while

back that said that Deaf/HOH people have differently

wired brains. Their brains compensate for the loss by

rewiring itself to use vison/touch more effencently.

I know even though I am only HOH, I am VERY visual. I

don't even process what sound I DO hear, as sound.

Rather it's like I have a closed captioned system in

my head. I just think that most people should not rely

on the results of a single ABR but should have

extensive testing(eg behavoiral, soundbooth AND ABR)

to confirm the loss.

Am I making any sense? I am TIRED! (glad I can sleep

late tomorrow!

Torrie (bilateral atresia, absent eardrums, and fused

inner ear bones, resulting in mild-moderate loss)

__________________________________________________

[Guest guest]

> Steve, I'll try to find that article for you.

Great, thanks.

> My

> thinking is that the ABR measures what the BRAIN

> itself hears.

I think this is right. How the brain interprets this, or IF the brain

interprets this is another issue (and I think this falls under a

Sensory-neural hearing loss).

> I just think that most people should not rely

> on the results of a single ABR but should have

> extensive testing(eg behavioral, soundbooth AND ABR)

> to confirm the loss.

I agree 100%. had a single ABR (and behavioral testing) early on, but

then he had more behavioral testing every 3 months after that. These follow

up tests help confirm the ABR results, and help to keep tabs on any possible

changes in his hearing.

> Am I making any sense? I am TIRED! (glad I can sleep

> late tomorrow!

Makes sense to me...thanks.

> Torrie (bilateral atresia, absent eardrums, and fused

> inner ear bones, resulting in mild-moderate loss)

BTW: Love your name (Our two month old girl is named Tori ).

[Guest guest]

Thanks Steve! Glad I made some sense! I've read up

on auditory neureopathy/central auditory processing

disorder and I think most deaf/HOH people (especially

those who were born with the loss) have some form of

that disorder, b/c our brains have never been able to

process pure sound, the way a hearing person's brain

can. That could very well account for the varibilty of

sucess seen in coachlea implants and hearing aids. I

mean even people who went deaf when they were

around one or two may have some " infant memory " of

what sound/speech sounds like.

I can listen without speechreading to an extent, but

usually the person either has a really loud high

pitched voice (I have low frequncy loss) or is a

professional speaker-type (eg, actor, singer,

professor, audiologist etc.)

Got to run........homework already and I've been here

less then a week

Torrie (bilateral atresia, absent eardrums, and fused

inner ear bones resulting in a mild-moderate low

frequncy loss)

=====

Let there be peace on earth, and let it begin with me.

" Deaf people can do anything except hear! " Dr. I.King Jordan

" I'd found myself becoming more immobile, when I'd think a little girl in the

world can't do anything. A distant nation my community, a street person my

responsbilty. If I have a care in the world, I have a gift to bring " - " Hammer & a

Nail " Indigo Girls

Waste some time looking at my webpage!:

http://www.angelfire.com/grrl/deafgrrl/indextwo.html

__________________________________________________