Friday, April 8, 2011

Joshua's Hearing Test

Today Joshua had a hearing test.  Forgive me if you have already seen my Facebook status update, I usually try to keep most of the details here and not there, but I was pretty upset this morning!

So, every child has a newborn hearing screening which involves placing earphones on the baby and attaching electrodes to their head.  The earphones play different sounds, and if they are heard, the brain will respond.  This is in turn picked up by the electrodes on the head, and generates a pass or fail result.  Joshua had this test done before he came home from the hospital, and he passed.  The man who did his test informed me that Joshua would require a follow up hearing test at 9 months of age, as he was considered to be in a high risk category for hearing problems due to his HIE/Seizures and having spent more than 48 hours in a Neonatal Intensive Care Unit.  He told me someone would contact me to arrange it.  9 months came and went and I hadn't heard anything, so I started to wonder if maybe I should follow it up, especially given that I was having concerns about his language development.  Thinking about it must have been enough, because finally someone contacted me about it at 10.5 months old!

I'd heard a few things from people who had also taken their (typical) child for a 9 month old hearing test.        I was pretty sure from their description that Joshua would not do what was required.  (Even some of the typical children were less than co-operative!)  So, I was feeling pretty anxious about this hearing test.  Not because I am worried about his hearing...  I'm not.  My opinion is that he hears fine.  But more so that I was concerned about whether or not the type of testing would be developmentally appropriate for Joshua.  The appointment started out with the audiologist having a look at his ears.  Everything looked fine, so she then did a pressure test which is intended to confirm whether or not the ear drums vibrate appropriately.  Again, everything was fine with that, so then it was time to do the hearing test.
She led us to a "booth" where another lady was waiting to assist with the test.  I think this lady must have thought Joshua was younger than he was, because the first lady started to pull out a chair and the second lady said "Oh he might be a bit young for that".  I looked at the chair, and it was basically like a regular chair but with a high chair tray attached to it.  He might have been ok with it, but likely not, so I said "Yeah, he can sit, but not that well."  So, then it was decided that he should sit on my lap.
The idea of test was that they would play a noise, and Joshua should look in the direction of the noise, where he would be rewarded with a puppet that lights up.  The audiologist told me they would spend some time first conditioning him to do this.  I was skeptical from the beginning, but I didn't say so, as he may have surprised me.  So, the first lady went off into her box while the other lady was in the booth with us to judge his responses.  It was also her job to try and teach him to look at the puppets.  Each time the noise played, she would jump up and rush over to the puppet making a big deal about it and trying to encourage Joshua to look at it.  He didn't.  He would look at her, but paid NO attention to the puppets.  A couple of times he jumped in fright at the lady jumping up like a mad woman trying to get his attention on these puppets.  They tried for a quite a while, which I found to be pretty stressful as I knew he wasn't going to do it and it was making me upset.  I was actually holding back tears.  Finally the lady said to the other lady "I don't think this is going to work, he is only looking at me, he is not looking at the puppets at all" to which I said "Yeah, I don't think he will do it", to which the lady said "Mum's usually know best about that kind of thing".  So then they had some discussion and decided on a different approach, which they apparently use for younger children, before they use the "puppet" approach. For this second attempt, the first lady returned to the room with us, and sat behind me, while the second lady stayed in front to judge Joshua's reactions.  This second test involved shaking a variety of "noise makers" to either side, with the intention that Joshua should turn his head to look at the sound or respond in some way to the noise.  Of course...  to do this test, (and the first one) they gave him a toy to "distract him".  So all the while the lady is ringing these bells etc. Joshua is going to town with the toy he had, banging it with his hands and babbling away.  My instinct was to take the toy away so he could pay attention to the sounds, but I restrained myself.  After all, there must be a reason for that kind of stupidity right?

Anyway, the second test was a bit more successful in that Joshua responded sometimes.  The rest of the time, he was too busy playing with his toy or getting annoyed with the situation.   So, overall the results are inconclusive.  They said they got definite responses for sounds at 50 decibels.  They described that as being loud conversation.  Otherwise, nothing certain.  I attempted to provide them with some anecdotal evidence, but they basically shut me down.  For instance, I told him that he can hear it when you whisper to him.  They said it depends on how close you are to him.  I replied that you didn't need to be close to him, he can hear it from quite far away.  To which they replied that he might only look because he sees my mouth move (REALLY?).  For the record, I tested this out again when we got home, and I can be standing across the room and whisper his name while he is facing away from me and he will look.  I also told them that he can easily hear noises from across the room and will turn and look at them.  To which they told me that hearing "noises" is not the same as hearing speech.  (Umm well...  the sounds they were using to do his hearing test weren't speech either!)  So, they told me they want him to come back in a couple of months.  They hope he will be able to do their stupid puppet test then.  I wouldn't put money on it!

I left the hearing test quite exasperated and got into the car and cried on the way home!  It is so frustrating to feel like you are always having to "prove" your child's abilities.  I am frustrated by the fact the tests do not seem to be appropriate for children that are not typically developing.  They were not testing his hearing at all, but testing a behaviour.  When we had our foster children, one of them also needed to have a hearing test.  For his hearing test, they wanted him to place a peg in a pegboard when he heard a sound.  That would be fantastic - if he understood how to put a peg in the peg board!  They tried him with a test geared towards a younger child (which I suspect was probably the puppets) and things were hit and miss with him too!  It just seems to be such a poor way to test hearing when the results are so dependent on the child's ability to behave in a particular way.  It makes me want to scream, and I am really not looking forward to going back again because I don't think it is going to be a roaring success next time either.  I think they need to do it like they did when he was a newborn, though with older children, this generally requires sedation.  In that case, I am not sure I would want to do it, because when I personally don't think he has a hearing problem, in my mind it is hard to justify having him sedated for a test.  But having said that, you do hear about children who DO have hearing problems even though their parents never suspected it.  So I would hate to be in that situation too.

Can nothing be simple?


  1. I am surprised that they treated you like that. I was told before they even started the hearing test on Caitlyn that given her age she may respond or may not respond at all to the looking in the direction of the sound test. The first time I thought she did well, but the lady said it was a flute she was looking in a direction. She also said that they would classify her as having hearing loss (only responding to voice sound, nothing else) but since she was a baby it is appropraite for her age - wouldn't be if she was a child.

    She did fail the ear drum test in her left ear though both times we went, however since she did better with the looking test the 2nd time (maybe was in a better mood because it wasn't after a 2 hour doctor's appt) they deemed that she could hear good enough out of her one ear for speech and rescheduled her for 6 months later so we go back in July.

    As for the nicu - they never told me to have her retested after she passed the newborn screen (she was 5 weeks at the time). I only had her tested after her 9 month doctor's appt because she wasn't making any sounds other than Aaaa.

  2. Karissa,

    Same for Anton, he passed at 1 1/2 month corrected age and they never mentioned that he'd have to take another test. I know he can hear fine because, same as Joshua, he responds to me when I call his name and even when I am whispering across the room. To be honest, my "typical" 3 year old never ever passed the test. Not as a newborn, and not later (around 9-10 months old). I knew he could hear me fine, but they were adamant he probably had some bad hearing loss. They kept wanting for me to come back and try again, and everytime I would end up in tears whilst thinking I knew he could hear! They even called me back 6 months ago to ask me to come back again since he had failed all his hearing tests so far. What a waste of my time! He can speak French, Chinese and some English now!
    I think we know our children better.
    But I completely understand your reaction. I would have cried too. It's hard enough as it is!

  3. Very informative post.Thanks for posting.
    Most of the people just ignore taking hearing tests and they don't know about hearing problems if they suffer.Hence going for hearing test helps to find the problems.Hearing test.