Welcome to the All About Audiology Podcast- episode 16- another All About You episode because one of the main reasons I’m doing this show, is so you feel less alone, more educated, and empowered to be the very best advocate for yourself and your loved ones wherever you are on this hearing journey. I’m Dr. Lilach Saperstein, educational audiologist.

The last episode titled “All About Sign Language” in which I interviewed Kimberly Sanzo was well-received by so many of you. And I really appreciate the comments on Instagram and on allaboutaudiology.com where the post is, as well as full transcripts of each episode.

Next week’s episode, we are going to be talking “All About Cochlear Implants” and I’m going to explain how they work, a little bit about the process and I’m also going to include an interview with a mother who has two children who are implanted and hearing more about her journey. First I’m going to share with you some of the comments that came in about last week’s sign language episode. And for today, I also wanted to bridge the two episodes together, sign language and cochlear implants and really show that the either/or doesn’t have to be there.

So I invited my friend who really exemplifies this. Her name is Toby Coleman. She is an implant user and you’ll hear all about her story and she says that she has one foot in the hearing world and one foot in the deaf world. So I hope you’ll listen to last week’s episode if you missed it, all about sign language and that you’ll stick around again for next week’s episode, all about cochlear implants, and that we can really learn from Toby about how in her life she’s been able to integrate both of these parts into her identity and her life. And before we jump into that I will first share a couple of comments. Thank you to everyone who sent in comments and being part of the #AllAboutAudiology community.

Alicia commented on Instagram: “This episode was fantastic! It makes me so sad that NO ONE from our medical team mentioned the option of ASL. In fact, we were discouraged from using it for our son. Thankfully, we did our own research and decided that learning ASL was the right choice for our family. It was so refreshing to hear this point of view discussed on a medical podcast. Thank you for being open and judgement-free!”

Alicia, thank you so much for your comment. THIS is the reason I do the podcast. It’s because I saw so many parents in your position who wished they had been better informed just to have been given the options and then being allowed to do your own research and coming to your own conclusions to do what works for you and your family like you said. I always believe, Knowledge is power!

Ariella commented on the blog: “I think it’s crucial for Kimberly to think about how she uses shaming words like “tiger mom.” Not only is she furthering the divide between groups whose ultimate goal is a deaf child’s well-being, but it is also that same “tiger mom” dedication that gives a person strength to fight for her child to have access to sign language and to go against the COUNTLESS professionals who say not to.”

Thank you Ariella for sending in this comment. I really appreciate that you are able to voice your opinion here. Whatever it is that you would like to say, you will be heard around here. I think it’s always tricky when we are passionate...

Read the full transcript here:

On this week’s episode of All About Audiology, I’m joined by Kimberly Sanzo, a speech language pathologist at a residential school for the deaf, and founder of Language First. Together, we delve into the sometimes-difficult but ever-important topics of sign language and deaf education, language deprivation and brain development. 

Kimberly received her masters from Gallaudet University, one of only 2 universities in the U.S.  that is exclusively for deaf and hard of hearing students. The majority of her current work is with deaf children who have experienced language deprivation, which is the primary subject of this episode. 

This week on All About Audiology:

* 2:13 – I welcome my guest, Kimberly Sanzo, an expert in language deprivation for children who are deaf or hard of hearing. We speak about how Kimberly has witnessed first hand what can happen when children aren’t given early access to sign language. 

* 5:56 – ASL is a fully fledged language, not a gestural system, with grammar and sentence structure. If children are given this language early, their brain develops just as it would with any other language. 

* 8:31 – Parents can often feel as if they have only two options, either a cochlear implant or to learn ASL to communicate with their child. It would actually be more beneficial if the child had the opportunity for both so they can choose which one works best for them as they grow.

* 17:26 – Language First – Kimberly created this project to focus on raising awareness on language deprivation. When someone is not given a usable naturally occuring language in the first 5 years of life, it can cause irreversible damage. A signed language would solve this problem because they would be receiving the information through their eyes instead of ears. 

* 27:14 – A 2010 Study by Niparko Et Al tested language abilities in children with cochlear implants with results that varied immensely. It would be more beneficial for children if they were implanted before 18 months while also receiving language in another way – through their eyes. 

* 32:54 – Deafness as a cultural identity – Kids who are given the opportunity to be a part of this culture and community early in their life, develop better social and emotional skills and benefit from having role models who are also deaf.

* 35:19 – The Ling 6 sounds were created by Dr Ling, who chose 6 sounds that spanned all of the frequencies. He hypothesized that if a child could hear all of these 6 sounds, then they could hear all the sounds of the English language. Unfortunately, this doesn’t translate to the realistic situations in which kids would be hearing these sounds.

For more resources and research, please visit:

* All About Audiology Website

www.allaboutaudiology.com

* All About Audiology Facebook group 

https://www.facebook.com/groups/470583160143167/about

* AllAbout Audiology Instagram

allaboutaudiologypodcast

* Language First Lab Website

Transcript:

Hey! I’m Dr. Lilach Saprestein and this is episode 14 of the All About Audiology Podcast- the All About YOU episode.

In this episode, I’ll share some of the responses that came in from last week’s episode which was all about ear infections and tubes. Our conversation with Dr. Hadassah Kupfer was really well-received and I’m so honored by the comments and responses you all sent in.

A friend of mine posted about the episode on a facebook community of moms and dads who seek evidence-based parenting advice. She said about the episode that it was a

“great episode about the SCIENTIFIC EVIDENCE surrounding something that effects so many of our kids – ear infections.”She say, “I thought this was a balanced approach that explains what the doctors don’t have time to tell you.”

I so appreciate your support and sharing the podcast with other parents who could benefit from it. Thanks for being a friend to the show and a friend to me.

Sara said “Thank you for sharing this! This is a great source of information based on what I’ve heard from my audiologist and the many ENTs I’ve taken my daughter to. My daughter had tube surgery a month ago at 16 months old and the difference in her speech is already amazing! We were dealing with constant ear infections including a ruptured ear drum and so far, so good.”

Wow Sara, thanks for sharing your experience with us. For so many parents, the experience of a child’s behavior, hearing ability, and speech development show significant progress soon after getting tubes since they are no longer hearing underwater, through all that muck!

“This is Chava. My son Dovid had tubes put into his ears when he was 2 years old. He had several ear infections when he was young and he didn’t really start speaking until very late, or making any sounds. We kept going back and forth to the doctor, eventually to the ENT, who suggested we put tubes in his ears, after testing his hearing and seeing that he wasn’t hearing well. He had some hearing loss after all the ear infections and from constantly having fluid in his ears. And it was affecting his ability to speak and his ability to sleep at night. So we had the surgery. I was a little nervous about it before, but we had a great ENT surgeon and he really put us at ease, explained everything to us, and worked. He was really good with my son as well, put him at ease, easily distracted him- he just had great bedside manner, which helped a lot. In addition to that, in case this is of interest, a few months after he had the surgery, and he was still not sleeping well at night I was desperate (I had also a baby) and I was desperate to get some sleep at night and I actually went to see a sleep coach. Before starting the consultation, she asked me a whole bunch of questions, routine questions that she asks everybody and then she asked me about ear infections, and sleeping habits and if my son woke up often at night… She asked if we ever checked whether he had sleep apnea. It had never occurred to me, but sure enough, we started paying attention to his breathing at night. Actually, my husband sat next to him one whole night and recorded his breathing, just with a simple voice recording on his phone, and he really heard that his breathing stopped at one point, so he had a second surgery to remove his adenoids and that really helped. After that he slept well,

Welcome back to the All About Audiology podcast. I’m your host Dr. Lilach Saperstein and this is a very special episode; it’s going to be our first interview episode. I’d like to introduce more voices and bring in more professionals who are in the field or who are related to audiology in some way. And also to hear some of your stories like we did in the last All About You episode. It’s really important for me that your voice is heard and for you to know that what you’re going through is helpful for other people for what they’re going through and this way we can all connect and help each other.

So I have a few things to tell you before we jump into the interview. If you haven’t gotten it already or heard about the free checklist that I created for you guys, be sure to check it out. It’s a morning and evening routine checklist for caring for a hearing aid. It’s available for free! All you have to do is go to the podcast show notes or check on my Instagram @allaboutaudiology podcast or go to allaboutaudiology.com, or any way that you would reach me, you can get to this PDF file. It has information about caring for hearing aids and how to clean them. And also I made it that if you put it into a plastic sleeve or have it laminated, you can use a dry erase marker to check off what you’ve done. Hang it near the bed or have it in the bathroom, wherever you get ready in the morning with your hearing aids.

So right before we jump into the interview, let me tell you about Dr. Hadassah Kupfer, a private practice audiologist in the Mill Basin area in Brooklyn, New York. Dr. Kupfer and I went to school together; she was a few years ahead of me in school. I knew her when I was doing my undergraduate degree at Brooklyn College and we both attended the CUNY graduate center in New York for the audiology doctoral program. We had an excellent conversation that I’m going to play for you now all about ear infections, tubes, etc. The reason I reached out to my friend and colleague was because I know that she did a research capstone, kind of like a dissertation in the doctoral program, on this topic of childhood ear infections and fluid in the ears and has a lot of information and guidance for parents of young children dealing with this issue.

www.doctorkupfer.com

https://www.instagram.com/drkupfer/

www.facebook.com/lifelonghearing

Tweets by KupferDr

Dr. Kupfer has a patient-first approach and her passion for audiology and for her patients comes through in our interview. We’ll have Dr. Hadassa Kupfer’s information and links in the show notes and in the post at allaboutaudiolgy.com and if you want to visit her website, it’s www.doctorkupfer.com.

So before we start, I’m just going to make an apology. The sound quality is good but I wish it can be better.

Transcript:

Welcome to the All About Audiology Podcast -episode 12, that’s all about you! I’m your host Dr. Lilach Saperstein and in this episode I’m featuring some of your voices, my listeners.

Ever since I launched the podcast about two months ago I really wanted to get your voices and your experiences involved with the show. So today, I have some voice recordings that were sent to me by listeners,

and a special interview with my sister.

Before I jump into those recordings, I do want to let you know that if you haven’t downloaded the hearing aid checklist yet, head on over to the website allaboutaudiology.com or find me on instagram @allaboutaudiologypodcast to get your hands on the checklist. It’s a one page pdf printable that has on it a morning routine checklist and an evening routine checklist for caring for your child’s hearing aids. (Click).

You can also join the facebook group to be the first one to know when I have more free printables available. And that’s All About Audiology podcast on facebook.

We’re going to jump right in to hear two responses that were sent in as voice memos. You can do that through the contact page at allaboutaudiology.com or dm me on instagram or facebook to send your voice memo responses and they might be included in a future episode.

“Hey Dr. Saperstein, This is Riki from Florida.I recently had my fourth child and this was the first time that I got to experience the newborn hearing screening in the hospital. It was very easy, very quick, and painless. The baby didn’t feel a thing. The only problem that we ran into was that the babies around in the nursery were all crying. So the machine was reading incorrect results. But, I was very happy to see that the nurse knew what she was doing, waited for them to calm down and tried again. I’m happy to see that the hospitals are doing what they’re supposed to do and doing a really great job at it. “

“Hi, my name is Peri and I’m from Israel. My son was born at 36 weeks and was considered a late term premie. His first hearing test, he failed. His second hearing test at the hospital, he failed. And then they took him for a special test the last day we were in the hospital and he did pass. It was very reassuring being able to have those tests done given that I’m hearing impaired. So it was nice to know that at least he did have hearing at the end. And if he didn’t at least we knew what direction to head in.”

“Hi, This is Bat-Chen. I am Dr. Lilach’s sister.”

LS: My big sister, let’s not forget.

B: I am the big sister. I’m also the coolest one.

LS: Wait wait wait. Ok, so in case you get confused by our voices-

B: Which is so expected, because everybody says we sound alike-

LS: -then you just have to listen to the gravitas in my voice [laugh] and then you’ll know it’s me. [both laugh] Ok, so Bat-Chen, you have a number of children and you had most of them in hospitals- not all of them though- so tell us about your experience,

Welcome to the All About Audiology podcast. I’m your host Dr. Lilach Saperstein and in this episode we are going to be talking about the newborn hearing screening (NBHS) (as I have discussed in this article I wrote).

Now, one of the many hospital screenings that occur within the first day or two days of birth is the newborn hearing screening. The keyword is “screening” which means it’s a pass or fail kind of test. You either pass the screening or you don’t pass. It’s not a diagnostic test. A diagnostic test means that we are determining the specific type or degree or configuration of hearing loss and really getting a lot of information. The screening is just choosing a cutoff and saying anyone who passes this, we are calling it a “pass” and if they don’t we call it “fail”. They won’t tell you if there is a little bit of hearing loss, a lot of hearing loss, what kind of hearing loss… In other words just because the baby will fail the hearing screening, it doesn’t mean they have hearing loss. There can be other things going on and we will discuss it throughout this episode.

Also, even if the fail is accurate and there is a hearing loss, we still need to get more information about the type, degree and configuration. And if you have been listening to the podcast, we have discussed in previous episodes how important it is to understand the type, degree and configuration of a hearing loss in order to know which devices would be appropriate or what’s the best way to approach the rehabilitation process for the specific kind of hearing loss.

About the universal newborn hearing screening:

The universal newborn hearing screening is a means of identifying hearing loss as early as possible and it has been a very positive initiative throughout the world because early identification and intervention lead to better outcomes for deaf and hard-of-hearing children.

In the olden days before this universal newborn hearing screening was instituted, what would happen is that the first time a hearing loss or even deafness would be identified would be later on in the child’s life, maybe when they were two years old and weren’t speaking, or later on in their development when parents noticed they don’t always respond or hear softer sounds. So it would be identified through their behaviors and through noticing that a child wasn’t listening or wasn’t able to hear, but not at infancy. The reason that the universal newborn hearing screening is so valuable is because it can identify children who are deaf or hard-of-hearing much earlier on, right at the beginning of their life and get a full diagnosis and then implement interventions as early as possible to give the children language input.

Another thing that I have talked about on this show before, and it’s something that I’m very passionate about, is the problem of language deprivation. Now when I say language deprivation, I don’t necessarily mean spoken language, as speech, I am referring to other languages which can also include sign language.

One of the biggest detriments to deaf and hard-of-hearing children is language deprivation in the first 2-3 years of life which are the critical periods of language acquisition. If we identify a baby to have a hearing loss and that baby then gets a hearing aid or cochlear implant or other devices that will try to maximize their auditory potential,

Transcript

Welcome back to the All About Audiology podcast. I’m your host Dr. Lilach Saperstein and this is the All About YOU mini episode. In the last full episode, episode 9, we talked all about your child’s hearing test and the different ways we test children of varying ages, some tips for preparing for your appointment.

On my instagram @allaboutaudiologypodcast I posted some photos and videos about the VRA equipment that we talked about- the toys in light up boxes we use for younger toddlers. I love connecting with you listeners on instagram. I connected with a fellow audiologist from Ireland -Hi Rhea! Great connecting with you. We chatted about the ways audiology services are delivered in different countries. For example, hearing aids are covered for free up to age 18 in Ireland. Rhea works with adults in the private sector now, but told me she is interested in educational audiology because one of her lecturers was a teacher of the Deaf for many years before joining the university and shared a lot about that amazing work.

That’s very interesting to me because I worked as an educational audiologist in a school for the Deaf in New York and I learned so much during that time. Working with children of all abilities, and programming and maintaining the school equipment which included hearing aids and classroom FM systems. I also did troubleshooting for students’ cochlear implants, ordered parts and was in touch with their clinical audiologist.

My favorite part of working in that school was the implementation of an interdisciplinary approach, meaning all the different professionals were always in touch with each other, the different therapists, school administrators, medical professionals and of course the family- all with the child at the center.

Being part of the team is one of the things I love about being an audiologist. And this goes for when I’m working with children, but also when I work with adults; I interact with their family member who came with them to the appointment, sometimes a health aide, or their primary care physician or ENT. Seeing the patient as a person with a life, and communication needs- and various people and professionals who are there for them.

You can take a look at an article I wrote on this topic in the Blue Umbrella Magazine. You can find the link in the show notes or at the transcript on allaboutaudiology.com . It’s important for all of us to remember that when you have a child with a hearing loss, you are the leader of the team, you create the system. The ecosystem of support and services with your child at the center.

I’ve also created a free handout where you can have all the different people on your team with their contact information and their role. Again, check that out on the website.

We also have a facebook listener group– so feel...

Welcome back to All About Audiology, the podcast that’s, well, all about audiology; with resources and information to empower you wherever you are on your hearing journey or the hearing journey of your child, family member or someone you love. I’m your host Dr. Lilach Saperstein and in today’s episode we are going to be talking about your child’s audiology appointment. What can you expect for their appointment and how can you help prepare them for an audiology appointment or hearing test.

In last week’s episode we spoke about adults hearing test and different tips for preparing for that as an adult but for children the testing is very different and preparing for the appointment will be different as well.

The first important thing to understand is that we have different kinds of tests in audiology in order to test hearing. Some tests are automatic and help us get an understanding of the health of the ear and the functioning of the ear without a person having to be involved. The second kind of tests are subjective and do require your child’s participation. When children are very, very young infants then we can only test them with the automatic tests, either an “OAE” or an “ABR”.

There are a lot of acronyms in audiology and I’ll just take a minute to explain what they mean. OAE stands for Otoacoustic Emissions Test and this is a very brief test where a little earphone is placed in the baby’s ear, sounds go in the ear and the healthy ear will take in those sounds and will actually produce a kind of an echo or a result that can be detected by the microphones in the OAE device. So we can have a very quick screening that can take just a few seconds in each ear that can tell us if that ear is functioning properly and if the outer hair cells respond to sound.

The second type of test we use on babies is the ABR, Auditory Brainstem Response and it’s sometimes called the BAER, Brainstem Auditory Evoked Response. This test includes putting electrodes on the babies forehead and behind their ears and then presenting sounds in through an earphone. This actually is measuring the electrical activity of their eighth nerve, of their auditory nerve and to see if there is activity at the level of the eighth nerve and the brain stem, meaning they can hear the sounds. The OAE and ABR are often used as screenings for newborns hearing screening in the first 24 to 48 hours of life and any babies that do not pass these screenings are passed on for further testing.

Now I’d like to talk to you more about how we do the behavioral testing for toddlers and young children. There are two basic ways of testing young children that are split into the younger category and a little bit of an older category. This is not a hard definition and it depends on the child’s age; not just their age of how old they are, but really on their developmental abilities. The first method called, Visual Reinforcement Audiometry, is used for children ranging from 6 months to two years of age. The second method called, Conditioned Play Audiometry is used for children from the age of 2 to about the age of 5, but really these two methods can be used whenever appropriate for the patient.

Now testing young children’s hearing can be an exciting challenge for an audiologist because each child requires a unique approach. The goal is for them to feel like it’s a game and not a test and to get the child motivated to focus, attend, listen and perform the task you are asking them to do. The task, for example, can be filling a peg board with pegs or throwing sand bags into a bucket or building a tower of blo...

Transcript

Welcome back to the All About Audiology podcast. I’m your host Dr. Lilach Saperstein and this is the All About YOU mini episode. In the last full episode, episode 7 we discussed what happens at an audiology appointment and what you can expect for your hearing test.

George from St. Paul, Minnesota commented,

“Very informative. I wish I had known this before my appointment.”

and Raj from Queens, New York wrote to me saying,

“When I took my mom for her appointment, I was totally lost. It was a long and harrowing experience for both of us. She has dementia and has good days and bad days. I think your advice about making a morning appointment would have been a good idea for her. I’ll keep that in mind for future appointments.”

Grace commented,

“It totally calmed me down. Your podcast walked me through step by step what will happen. Listening to your podcast not only made me realize that the results of the test are partially affected by my anxiety and the time of day, I now know that I have the power to help myself succeed in making the results more accurate when I get my hearing tested.”

Thank you so much George, Raj and Grace for listening to the podcast and for sending me your responses.

Molly from Florida asked,

I have claustrophobia and I’m really scared to go because I don’t want to be in that small dark room. What do you suggest I do? I’m putting off the appointment because of this fear.

Great question Molly. There’s a few things I can say here.

1. Some booths are bigger than others. Look up online and see if there’s a few locations near you and give them a call to ask them about their set up. Some hospitals have bigger booths relatively than private practices, and also pediatric offices usually have more room in their booths to accommodate the children and their caregivers.

2. Meditation and grounding are amazing tools that I’ve personally used to deal with anxiety and high stress situations. It can be very helpful to focus on your breath, to remind yourself that you’re safe, to have some sort of anchor thought to carry you through the appointment. Of course, I don’t mean to minimize at all the debilitating sense of being claustrophobic but sometimes working on re-framing the experience can really help. Being in the room and the quiet and the solitude can actually be very soothing for some people. If you’re interested in this, I can share meditations with you, or even create a guided recording for you- I’ve done that before and it’s a tool that can be very powerful in a lot of different situations. Feel free to email me about this Molly, or anyone else who might be interested in this.

3. Advocate for yourself- tell the audiologist how you’re feeling and many times you can be accommodated. The door of the booth can be left open, and it will affect the low frequency results, where in some cases that’s not so crucial, especially if the office is not so busy or depending on the layout where the booth is and depends what kind of noise is around. You can absolutely ask for the lights to be turned on if they are dimmed. This is an excellent opportunity for you to become more assertive and advocate for yourself which is not easy but is really important.

Now,

Welcome back to the All About Audiology podcast, the podcast that’s well, all about audiology. I’m your host, Dr. Lilach Saperstein. I’m an audiologist who’s passionate about this field because it makes a difference in people’s lives. Understanding how our hearing works, what kind of hearing loss people have and how that effects their communication is the reason I am making this podcast. It’s important to understand what your needs are so that those needs can be met. And it’s especially important if that person is your child or your spouse or your parent, and that’s why I make these episodes.

In the last episode we talked all about hearing loss and it got a bit technical for some of you. But I hope that the information was useful in understanding that if there is damage to the different parts of the ear, it corresponds with different kinds of hearing loss which means that treatments are going to be different. We also talked a little bit about of how there are different levels of hearing loss and that means that different people have different experiences with hearing loss.

Today’s topic is all about, “What to expect at your audiology appointment”. In this episode we are going to be talking about adults and in the next episode we’ll talk about how this appointment is very different for children. So today I’m going to walk you through the different parts of a typical audiology appointment when you’re coming in for your hearing test. There are also different kinds of appointments and we’ll talk about those at the end but in general if you are coming in to an audiologist it’s going to be for a comprehensive, audiological evaluation or a full hearing test.

First and foremost, the audiologist is going to ask you many questions. Sometimes, these questions come in a form when you first come in, an intake form on paper or they’ll ask you the questions in person. What the audiologist is doing is getting a medical history, and specifically a history of your hearing issues or communication trouble, any specific history that’s affecting the head and neck, ear, nose and throat, and talking about your current symptoms.

After a thorough history the audiologist is going to look into your ears with a light, the otoscope, checking the health of the outer ear, the ear canal and looking at the ear drum. Now, for the rest of the testing there is going to be two different kinds of testing. Some are automatic tests that you don’t need to do anything for, just different measurements of your ear and different ways that we can test your hearing without your participation. The second kind is the kind where your participation is required, where you are asked to raise your hand when you hear a sound, a beep or a tone. This kind of testing is done in a sound proof booth and we make sure no other sounds are interfering with the tests from the environment. We do have both of the different kinds of tests because we are getting a full picture and everything needs to match. The audiologist is putting all the different pieces together, like a puzzle and seeing where the breakdown is that needs to be consistent across the different kinds of tests.

As discussed in another podcast, in regards to raising your hand during the test, you absolutely will not be able to hear every single beep that’s presented. That’s actually the point of the test. It’s supposed to be softer than what you are able to hear. We are trying to find your threshold, what’s the softest sound that you can hear. So when you are in there, try to relax and do your best.