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.
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