John Tracy Clinic: Week 2, Day 1

It is way past my typical John Tracy bedtime, but I am going to try to fit a post in today. Dennis helped me set up our camera, so I am now able to post pictures with my blog posts. While I'm updating the blog, he is in the exercise room on a treadmill (marathon training waits for no man).

Today's lectures were great, and I was especially interested in the classroom amplification system lecture. Since we are going to have Nolan's IEP meeting when we return to New York, I wanted to get more information on the available systems for children with hearing loss.

The lecture covered soundfield amplification systems and personal FM systems. For Nolan, a personal FM system is a good choice because he is a hearing aid user and his private preschool program will not be able to provide a soundfield system. In addition (and perhaps, most importantly), Nolan has a lot of language. He has a lot of language, and he's not afraid to use it- he tells us if his hearing aids are not functioning properly or are not fitting well. He is a "good reporter," which is the most vital component to using a personal FM system.

There are times a personal (ear level) FM system is not appropriate. For very young children with cochlear implants, there is no way to verify the FM system is working properly with the implant. If there is static, the child must be able to report the malfunction in the system. For this reason, a soundfield may be a more appropriate choice for a young preschooler with a CI.

In any case, children in a classroom situation need some sort of FM system (soundfield or personal FM) to increase the signal to noise ratio. Children with hearing loss require the teacher's voice to be 15dB greater than the ambient noise for audibility. Distance, background noise, and reverberation all affect the signal's clarity, and the FM system helps to reduce these listening problems.

We also had a lecture on oral anatomy, feeding issues, and speech disorders related to oral motor skills. We discussed the detection and treatment of verbal apraxia of speech, and I learned of two speech therapy methods for speech disorders I had never heard of before (the Kaufman and Prompt methods). Apparently, the Prompt method is useful for children with developmental apraxia of speech and for children with low tone.

We concluded with a lecture on sensory integration, which is necessary for being able to make sense of the world (and therefore, necessary for learning). I won't go into detail (because this blog post would be ridiculously long), but I did learn two very interesting things today. The first is that in a recent study including 48 deaf children, ALL of the children demonstrated abnormal vestibular responses. This included children with all levels of hearing loss, so even children with moderate hearing loss levels showed an abnormal vestibular response. This makes sense, since the same hair cells that line the inner ear line the semi-circular canals. Still, I was surprised to learn that 100% of the deaf and hard of hearing children tested had varying degrees of vestibular dysfunction.

The second interesting thing is that the style of children's play has changed over the years. Children are more sedentary, which leads to less exercise of the vestibular system. What surprised me was the statement that deaf or hard of hearing children are more sedentary than their hearing peers. I asked why, and found out that the time in therapy ("sit and listen"), time in the car to appointments, and vestibular issues (balance problems) reduce the active play time of deaf and hard of hearing children. This is very true for Nolan, who has had various medical appointments/procedures, therapy, and long car trips. Fortunately, we are a family that desires natural play opportunities, so Nolan has been provided with lots of free play time and physical experiences despite the amount of time in therapy or in the car. The point being made during the lecture was that parents of deaf/hh children need to make an extra effort to ensure their children are getting the physical/gross motor play needed for healthy development.

Inspired by the lecture, several parents gathered together for a walk to a park on Flower St. A very nice mama from the June session told me about this park, so we headed out to find it. There was quite a bit of construction, and I'm sure several people were staring as we tried to cross a busy street in a construction zone with several strollers. We looked like an out-of-place toddler caravan! Luckily, we ran into a local family, and we followed them into the play area. The playground was truly amazing- there was a water sprinkler we had to keep the kids away from (next time, we'll bring swim suits), soft surfaces, a sound system that was activated when the children ran past sensors, spinning toys, a roller slide, and a million other neat play items.

Nolan and G. race down the slides!

Nolan and Noah play "chase."

Dennis and I returned "home," then took off for El Cholo, a Mexican food restaurant in Los Angeles. We are now thoroughly stuffed, and Nolan was very grateful for the rocket popsicle the restaurant gave to him. After dinner, we ran to Ralph's grocery store to pick up some more lunch items, then Dennis gave Nolan a bath while I ran the laundry. All of this activity explains why I am blogging at nearly 10:00pm in a semi-comatose state. It is definitely time to turn everything off and go to bed!