Hearing Tests for Babies

i'm gonna explain a bit about the audio tests that Afif had taken from birth until now. Please note that this post is from my understanding, my experience and my point of view. i'm no doctor nor audiologist so i could be wrong.

1)Automated Otoacoustic Emission (AOAE)

Also known as newborn hearing test, it was conducted on Afif when he was about 3 days old. He failed it but the audiologist assured us it could mean nothing as c-sect babies tend to fail this test as fluid tend to retain in the baby's ears and nose. Afif took the test again at 1month old and still failed the test. 

How is it done?

"They place a small soft tipped earpiece in the outer part of your baby's ear which sends clicking sounds down the ear. When an ear receives sound, the inner part, known as the cochlea, usually produces an echo. The screening equipment can pick up a response." -source

2) Tympanometry

After failing his first AOAE, the audiologist conducted tympanometry on Afif. 

"Tympanometry is an examination used to test the condition of themiddle ear^[1] and mobility of the eardrum (tympanic membrane) and the conduction bones by creating variations of air pressure in the ear canal." -source 

In short, the audiologist wanted to check if Afif's unfavorable AOAE result is caused by fluid in his middle ear (which means a temporary hearing loss) or not. Afif's tympanometry suggests normal middle ear function - no fluid and the eardrums are functioning okay.

How is it done:

By inserting a thin, long probe into the ears. It took around 5 minutes. 

3)Auditory Brainstem Response (ABR) and Auditory Steady State Response (ASSR)

When it is certain that he doesn't have middle ear problem, ABR and ASSR were conducted. Afif took these tests at the age of 2 month. 

For Afif, these tests confirm that he has bilateral hearing loss (HL) especially in the higher frequency. Moderate to severe reverse slope HL in the left ear and severe to profound reverse slope HL in the right ear.

How is it done?

It is done by placing a soft headphone on baby's ears, and 3 electrodes on his forehead and sides of the head. The headphone produces sound (picked up by the ears, send to the brain) and the electrodes will pick up how the brain processes the sound. A graph (called audiogram) will then chart his brain response at a particular frequency and volume. For details on the similarity and difference between ABR and ASSR, click here

To conduct these tests, the baby has to be very still, quiet or better yet, asleep. It was a challenge with Afif as he is quite a talker (he started to coo A LOT at 2 months.. which is why i found it hard to believe that he's deaf). For the first ABR and ASSR (he was 2 month old) we did the test while i was breastfeeding him as that was the most comfortable position for him. At 7 months, we looked for second opinion at a different hospital. He had to be sedated for the test to be conducted.

ABR test when Afif was 2 months young. 

So tiny in my arms.

Afif's various test report on at 2 month young.

4) Audio Test Using Audiometer

Once his hearing loss has been determined, Afif went for countless sessions of audio tests. Without hearing aids, to test his actual hearing threshold and also with hearing aids to see how effective the hearing aids are.

How is it done?

Purpose of this test is to see his hearing behavior - can he hear and respond to it?

The audiologists uses audiometer to produce sounds at different volume (decibel) and frequency (Hz). This time, the tests are conducted while he's wide awake and alert. Unlike ABR which charts brain response, Afif's physical reaction to those sounds are recorded. Did he turn to the source of sound or did he not hear the sound? His reaction is then charted into the audiogram. 

For me, these sessions are the most exhausting. To make it work, the child has to sit still and be distracted with toys/books but at the same time not too distracted that he ignore the sounds. Afif was a 14 months old toddler who is so eager to explore everything. Who won't sit still. Who has a short attention span to toys/books. Not to mention the times he's cranky/unwell. It took us around 5 sessions to complete the tests, covering all frequencies and decibels for both ears. Phew.

*  *  *  *  *  *

Writing this post took me down the memory lane.
How with every tests, confirming that our son is deaf, are like stabs in our hearts.
How speechless we were when the audiologists and doctors explain that he can't hear well.
How my heart cried, not knowing more, not knowing what to do.
How in every audio tests i silently shouted in my head at Afif "You can hear that. Turn your head to the speaker." hoping that against all odds, he is actually hearing.

i'm sure he'll have to go through more tests. we'll take it one step at a time.

First Music Class - A Disaster

i have been reading Rhianna's Cochlear Implant journey and i'm amazed at Yanti's (her mom) effort to get Rhianna to hear better. After Rhianna was diagnosed with her hearing loss, she got he cochlear implant. Yanti took a long time off work to intensively care for Rhianna. She signed her up for music and reading class, and actively went for playgroups/seminars.

i decided to enroll Afif into a music class for toddler too.

We initially went for a trial class. Us being us, we got there half an hour late. Afif being Afif, he was so amazed at a new place and busy exploring. Instead of joining in with the teacher and other kids dancing and singing, he went to bang on the wall, tried to open drawers, and busy pushing buttons at power outlet.

Totally not what i expected.

The teacher assured us that it's common for newcomers to be like that. Busy exploring and not joining in. i felt a bit better. So we signed up for the class.

Last  Saturday we went for the first class. Got there half an hour early, at the teacher's advice. Afif, as usual, busy running in the mall, went up and down the escalators (my brother and i took turn to watch him). 

At 3pm, the class started and Afif has gotten a little cranky. i guess he was tired from all the running and climbing. Again, he refused to cooperate and join the crowd. He followed instruction when he feels like it but most of the time he'd just do his own stuff. 

The teacher gave a pair of bells. He just played with it for a while and then threw it on the floor. When i picked it up, he'd cry and want it back and then proceeded to throw it on the floor. The same with plastic mirror. More throwing and crying. A couple of times, he laid on the floor and bang his head on the floor. That's the first time he did that!

It was chaotic. Music playing, 5 toddlers with parents dancing around and there i was, desperately trying to calm my child and getting him to join the fun. 

i was so depressed. What happened to my fun loving boy? My singing and dancing boy? The other parents looked at us like we're aliens. i could feel them judging me- a bad parent.

At the end of the class, the teacher told me to sign Afif up for a sign language class. She said that he can't tell me what he wants, that's why he's so angry. i felt so humiliated, especially as she done that in front of other parents. 

YES, my child is deaf. i want him to hear and speak that's why i sent him to a music class. If i want him to sign, i would've taught him sign language without you telling me to. Besides, i know he wanted milk but would you like it if i breasfeed right then and there in the class with fathers watching? Instead of saying that to her face, i kept quiet and left.

Sigh.

If it's up to me, i would never want to go back. But we paid for a semester of music class and the money would've gone to waste. We'll see how it goes next week.

Ee-Aii-Ee-Aii-Ohh

Afif will be 19 month tomorrow.

His hearing age is around 9 months.

As usual he babbles a lot. Lately he always say eyaiyaiyaii. At first i did not know what he's saying. One day, we were watching some nursery rhyme videos on YouTube and Old Macdonald song came up. He sang along and say eyaiieyaiiyaiii..

He was singing ee-aii-ee-aii-ohh all along!

Obviously without the ohh part.

Nevertheless i am so happy. That's a progress!

He also sings along a few other songs. He sings in tune which is great but no clear words yet.

He loves singing Twinkle Little Star, Itsy Bitsy Spider, Wheels on The Bus, Old Macdonald, and Head, Shoulders, knees and Toes to name a few. How do i know he's singing these? Because he made different movements with different songs. Spinning wheels, starry fingers, spidey fingers and touching his knees and toes. 

Can't wait to hear the next words that will come out from his mouth ;)

 9 hours road trip to Kota Bharu, Kelantan.

Distracted him with drawing blocks, toys and the iPad.

Took off his hearing aids as the car seat causes feedback and whistling.

Playing with his lil Aunty Delisha

Pregnancy and Labor

Just like any other couple, Idzwan and i are two people in love. 5 years in relationship and we decided to get married.

Two months into marriage, we found out that i'm pregnant. As new parents, the usual mix of emotions were there. Happy, confused, ecstatic, anxious, excited.. All at the same time. i went through rounds of morning day and night sickness. Nothing i can't handle.

Viral Fever

At 8 weeks of pregnancy, i got a high fever with rashes all over my body and was hospitalized for 4 days. Turned out it was viral fever. The entire time, all i can think of was my baby. Please let my baby be okay. Please let my baby live. Please let my baby survive. Please, no harm on my baby. Ultrasound shows that my baby is very much alive and kicking. The obstretician assured me that the baby is okay. Not to worry. It was a relief.

Thankfully the rest of 7 months of pregnancy went smoothly. Monthly ultrasound scan and bloodworks show that my baby is thriving and healthy.

Labor Story

Week 36 of pregnancy, i was bleeding. Was taken to the labor room and it is found that i'm having irregular contraction. i truly thought i was going to deliver my baby boy on that day. i was given two steroid shots to mature the baby's lungs as the baby is not full term. After 3 days of hospitalization and being observed, i was sent home. Baby is not ready to come out yet.

At 37 weeks, my water broke at 3am. At 10am, i am still 2cm dialated and baby's heart beat began to decrease. Doctor decided we can not wait any longer and i had an emergency c-section. It turned out that the umbilical cord was short, making the baby unable to descend.

Afif Haiqal was born on 11 October 2012. Truly one of the happiest moments in our life.

Now, the reason i share Afif's birth story is to see if there's a connection between my pragnancy/labor with his hearing loss. 

The doctors suspect that the  viral fever that i had at 2 months pregnancy is the culprit. At 2 months, baby's organs are developing. An infection at that time could interrupt the process. If that's the case, we're thankful it's only his ears that are not properly developed. It could've been something more serious like his brain or heart.

Or it could've been during birth itself. As i mentioned, the umbilical cord was so short that it almost broke. The lack of oxygen supply could've been another reason to his deafness. 

Anyway these are just my theories.

Introduction

Assalammua'laikum and Hello!

This blog is dedicated to our firstborn son, Afif Haiqal.

Afif was born on a bright Wednesday morning (on 11th October 2012 to be exact) via Ceasarean section after a dramatic false alarm. He entered this world screaming and ready to pounce.

On his third day on Earth, he failed his newborn hearing test. We were told not to worry as it is normal for C-sect babies to fail his/her newborn hearing test as the amniotic fluid tend to still be in his/her ears and nose long after birth. The ears will be ok after a few months, they said. So we did not think much about it.

At around one month old, he failed the test again.

And again.

And again..

We came back for a few more test. ABR, sedated ABR, tympanometry..

All tests and check-ups bore the same result; our son has moderate to severe hearing loss.

As parents with normal hearing with no family history of anyone being born deaf, we were taken aback.
Puzzled.
Confused.
Sad.
Mad.

Why is this happening to our perfect baby?

Why our baby?

We were in denial.

He babbles and coo a lot. He talked back when we talk to him. He CAN NOT be deaf.

We went months trying to prove the test results wrong.

We went to seek second opinion at another hospital.

Still the same result. Afif has moderate-severe hearing loss.

And we can't prove the test results wrong either.

He would not respond to me calling him from behind. He would not flinch at the sound of thunder.

Though hard, we finally accepted that our son is hearing impaired.

Not deaf, just hard of hearing.

At 9 months, he got his hearing aids.

And thankfully (Alhamdulillah) he began to show hearing behavior.

That's why this blog exist.

This blog is dedicated to Afif Haiqal. So that one day he'll be able to re-live the journey, know the effort, the path we chose, the things that we do for him, with him.

So that he knows, he is perfect in his imperfection.

i also hope this blog will be a companion for parents of deaf or hard of hearing children. All the wikis and medical websites can give you information, but i find that reading other parents' experience more of a help. i hope this blog is good enough to be a reference for you.

Please know that you're not alone.

Our children will be okay.