Daughter just diagnosed with severe-profound hearing loss - please help!

[Beach girl]

That would be the hard part, I'm sure.

 

[jillio]

I have a question: parents of babies implanted with CIs say it's because they want to maximise the use of the auditory nerve. Hearing aids don't stimulate the auditory nerve?

Sure they do. They just don't bypass the cochlea.

 

[jillio]

Ok, I am wondering why parents feel it's so urgent to implant their babies if hearing aids can do the same job of stimulating the auditory nerve. I mean, why not use hearing aids and wait till the kid is older before doing CI?

I do understand that hearing aids don't work for all deaf people. I am just speaking about parents whose babies CAN get sound from hearing aids but opt for the CI anyway.

It is a connundrum. Worried about processing language? Use ASL with your child. Worried about auditory stimulation at some level? Use and HA with your child. CI is no quarantee the child will be able to perceive sound at the speech levels.

 

[DeafCaroline]

Sure they do. They just don't bypass the cochlea.

ok...which brings me back to my original question: if parents use the argument that CIs implantation in babies is crucial for stimulating the auditory nerve, why aren't they're satisfied that hearing aids do the same?

Again, i am referring to babies who can get sound from hearing aids.

 

[jillio]

but a baby can't speak so how can they determine it's not able to process language?

That is just it. It can't be determined exactly how much sound in the speech thresholds a child perceives and/or discriminates without responsive testing. And discrimination is the key factor in it all.

 

[AlleyCat]

I can only imagine that it's a very tough decision. If babies get sound from HAs but not enough to process language, the parents probably want to move to CIs more rapidly.

Too many of us prelingually deafened who don't benefit well from HAs still have great spoken and written language. Im one of them. It's not a valid argument for a CI.

 

[Beach girl]

OK. I'm not arguing for it or against it; just trying to guess what those parents might be thinking and feeling.

 

[shel90]

OK. I'm not arguing for it or against it; just trying to guess what those parents might be thinking and feeling.

That is the view that needs to be eliminated becuase it is a dangerous one...assuming that the CI will allow children have access to language only to find out later on that it didnt happen. ASL guarantees access to language for all deaf/hoh children.

 

[jillio]

ok...which brings me back to my original question: if parents use the argument that CIs implantation in babies is crucial for stimulating the auditory nerve, why aren't they're satisfied that hearing aids do the same?

Again, i am referring to babies who can get sound from hearing aids.

Because the medical community convinces them that newer is better. It is all about unrealistic expectations in most cases. And, the parents, seeing their child's deafness from a medical perspective, somehow hold on to the hope that the best in medical treatment will correct everything.

 

[GrendelQ]

I have a question: parents of babies implanted with CIs say it's because they want to maximise the use of the auditory nerve. Hearing aids don't stimulate the auditory nerve?

CIs are only available to those for whom HAs can't provide sufficient sound. Hearing aids amplify sound so any remaining hair cells you have working in the cochlea can work harder to transmit sound signals to the auditory nerve. If you don't have a sufficient amount of working hair cells in the cochlea, even the most sophisticated and powerful hearing aids can't stimulate the auditory nerve.

Cochlear implants don't utilize the hair cells within the cochlea at all. They can be used to bypass the function of the hair cells within the cochlea.

You can think of your hearing like a piano keyboard: if your working hair cells are pretty evenly distributed that's like having a fair representation of working keys on the keyboard, so if you have enough of these, you can bang on them really hard you can get a pretty faithful representation of sound. Some hearing aids are really sophisticated in how they can amplify residual hearing and put your working hair cells to good use.

But if your piano is missing whole sections of keys, or all but every seventh key, you can bang as hard as you like on that piano keyboard, but you won't be able to play songs, if there is no key to lift the hammer and send vibrations along the strings, no sound is produced. A hearing aid can't send a signal past non-working hair cells. A CI can bypass non-working hair cells in the cochlea as if you reached past the missing keys into the piano and manually raised the hammer to strike the strings.

 

[GrendelQ]

Ok, I am wondering why parents feel it's so urgent to implant their babies if hearing aids can do the same job of stimulating the auditory nerve. I mean, why not use hearing aids and wait till the kid is older before doing CI?

I do understand that hearing aids don't work for all deaf people. I am just speaking about parents whose babies CAN get sound from hearing aids but opt for the CI anyway.

For many with profound hearing loss, a hearing aid can't stimulate the auditory nerve.

Children with mild, moderate, and most with severe hearing loss are not eligible for CIs because they can get adequate sound from HAs.

 

[jillio]

"Sufficient" is extremely subjective. Who determines what is "sufficient" sound reception? There are those who are profoundly deaf who hear nothing in the speech ranges on their audiograms, or maybe a minimal, and yet, they are able to discriminate and produce speech very well. In reverse, there are those with severe losses that have quite a bit of residual hearing in the speech ranges and can discriminate or produce almost no speech.

We also need to keep in mind that those guidelines are just that. A guideline. Age requirements and aided requirements are bypassed on a constant basis.

 

[deafskeptic]

"Sufficient" is extremely subjective. Who determines what is "sufficient" sound reception? There are those who are profoundly deaf who hear nothing in the speech ranges on their audiograms, or maybe a minimal, and yet, they are able to discriminate and produce speech very well. In reverse, there are those with severe losses that have quite a bit of residual hearing in the speech ranges and can discriminate or produce almost no speech.

We also need to keep in mind that those guidelines are just that. A guideline. Age requirements and aided requirements are bypassed on a constant basis.

When I was little, I was dx'd with a severe to profound loss but I have never been able to do a good job of discrimating speech sounds though I did learn to speak well.

My loss is in the profound range now. I don't know what caused my hearing to go down - only that I started having problems with bad ringing in my ear when I was 19.

 

[DeafCaroline]

Yeah. I hear absolutely nothing without my hearing aids. Zilch. But with them, I can discern speech, tone, influctuation, accents, etc. But obviously it takes time before one is able to do that so how can one determine a baby will not be able to discern speech at all even with hearing aids?

 

[jillio]

When I was little, I was dx'd with a severe to profound loss but I have never been able to do a good job of discrimating speech sounds though I did learn to speak well.

My loss is in the profound range now. I don't know what caused my hearing to go down - only that I started having problems with bad ringing in my ear when I was 19.

Exactly. Discrimination depends on so many things and is a very individual ability.

 

[GrendelQ]

Yeah. I hear absolutely nothing without my hearing aids. Zilch. But with them, I can discern speech, tone, influctuation, accents, etc. But obviously it takes time before one is able to do that so how can one determine a baby will not be able to discern speech at all even with hearing aids?

There is a combination of tests that can be conducted -- including a non-behavioral test on a sleeping or sedated child that measures brainstem response to auditory stimulation -- which can determine if the hearing loss is such that signals at the level of sounds that comprise spoken language sounds don't even reach the processing center. Regardless of whether a child's brain has the processing capability to discriminate and recognize tone, inflection, etc., if the sounds can't be accessed to begin with, no processing can happen.

 

[DeafCaroline]

Thank you GrendelQ,

 

[jillio]

Yeah. I hear absolutely nothing without my hearing aids. Zilch. But with them, I can discern speech, tone, influctuation, accents, etc. But obviously it takes time before one is able to do that so how can one determine a baby will not be able to discern speech at all even with hearing aids?

They can't.

 

[jillio]

There is a combination of tests that can be conducted -- including a non-behavioral test on a sleeping or sedated child that measures brainstem response to auditory stimulation -- which can determine if the hearing loss is such that signals at the level of sounds that comprise spoken language sounds don't even reach the processing center. Regardless of whether a child's brain has the processing capability to discriminate and recognize tone, inflection, etc., if the sounds can't be accessed to begin with, no processing can happen.

Many people who do not access all sounds in the speech threshold are able to discriminate speech.

 

[dogmom]

one of the things I just started wondering about as I was reading in here was - who determines/how was it determined about the things that are "key indicators" on the the types of EI and other diagnostic tests regarding audiological hearing loss? What bodies/agencies/people? And what are those beings <agencies, etc> connected to in terms of boards, foundations, societies.....