Friday, October 22, 2010

Where Have All the Esses Gone?

If you are sitting right next to Nolan in a quiet environment and say the "S" sound in isolation, he can detect and reproduce it. The "S" sound within a word, however, is completely masked by the louder vowel sounds- and he can't hear the "S" sound if you are more than 3 feet away.

Why is "S" so important?

  • It denotes plurality: duck vs. ducks
  • It shows ownership: Bobby's toy
  • It stands in for a full word in contractions: She's going to the store.

To check how well Nolan is hearing across the speech frequency spectrum, we do daily "Ling Checks." If he can detect and discriminate these sounds, then we know he is hearing across the full speech spectrum for the English language. Here is an example of Nolan responding to the Ling sounds with his hearing aids on, from a distance of three feet.

He can't hear the "S" sound, even with his aids on. This is the problem of under-amplification. We are in the process of getting a "third site" hearing evaluation performed for Nolan, but I doubt they'll get an aided audiogram done at Buffalo Children's (I'm certainly asking for one).

One way to address the situation is the use of the FM System, which adds about 15dB to the sounds Nolan is receiving. It helps solve our "disappearing S" problem. Here is the same Ling test, using the FM System:

Using the FM System, Nolan can hear the "S" sound. This is not a perfect solution to his problem of under-amplification, but it will help him learn to detect and discriminate the sound within words. Once I can get the FM System set to the recommended 50/50 mix, he will be able to wear the FM system on a more regular basis and will (hopefully) begin spontaneously adding the "s" sound into his speech.


Herding Grasshoppers said...

Oh you're bringing back memories of Tate as a toddler...

"Look, Mama, 'now!" (snow)
"It 'nowin' Mama, let make a 'nowman."


"Look what in my hand, Mama... 'lug!"
(yes, it was a slug... ewwww).

Though the S is important, I kind of miss those days :D


Melanie said...

Still not understanding why he is this an issue of equipment limitations??

rouchi said...

His voice is really sweet! Why is he under amplified. We are getting Prisha her new aids with all the frequencies in the speech banana and even without that she was able to do ling sounds.

tammy said...

What a wonderful device!! I love how he's raring to go play and knows when he's done with those lings! Too cute. Are you still trying to get his amplification on track from all the info. you learned at John Tracy? I know you all have had so much going on since then.

It's funny how with CIs, /s/ is typically one of the earlier sounds a child uses. Aiden's /s/ are superb, including a lot of /s/ blends and at the end of words. Yet, in the same breath, we struggle with a lot of the lower frequency sounds such as the b's and n's especially in the beginning of words.

PinkLAM said...

He is SUCH a cutie! The absence of the /s/ who seems to be pretty common among kids who wear hearing aids, I guess since the high frequency losses tend to be more severe.

I had the same problem, spoke well and could hear most sounds without a problem but those tricky /s/'s! It took me years to say my name correctly (it has an s smack dab in the middle), and I absolutely hated it when people asked me what my birthday was: September sixth. It was remarkable how much easier it became once I got CI's. I think that's one of the first thing I noticed, how clear the /s/ sounds were. Now I don't have any problem saying them either!

Kristen@nosmallthing said...

The FM is a lifesaver, especially in school. I'll bet it helps Nolan a lot.

Ericka said...

Miles pronounces his "s" as "th".
I couldn't hear the "s" in your video either. It's really hard to hear outside for my kids too even with their hearing aids on. Even though our kids wear hearing aids, they still have hearing loss. They will never hear normally.

Joey @ Big Teeth and Clouds said...

That's really tough. You have to hear it to say it. Julia had trouble discriminating /f/ and /th/ with her hearing teacher recently. I have to discuss this with the audiologist.

Thank goodness for the FM even if it is kind of a stop gap type thing. With any luck they'll figure out a way to get the aids to handle it all on their own for Nolan.

And if you're ever taking a super long field trip to the area slightly north of Pittsburgh we'd be glad to adopt you into our play group!

leah said...

The "underamplification" is from testing at The John Tracy Clinic- his aided audiogram is abysmal. He only has a moderately severe/moderate hearing loss, so his aids are more than capable of handling his level of loss. Conductive losses require more power than the standard DSL settings, though (they are set for sensorineural losses), so if Nolan's loss has a conductive component, he needs aided audiograms to get proper amplification settings. Our local audiology clinic doesn't believe the JTC results- but we can tell he's not hearing the /s/ sound. We're getting a third opinion from Buffalo Children's on November 10.

leah said...

Joey, maybe one of these days we'll stop by! :-) Nolan's on the young end (he's just three), but it would still be cool. Magic ears rock!