Candidacy for CI

[Hear Again]

If they are doing speech it is not AVT.

Yes, it is since speech therapy is a component of AVT.

Let's agree to disagree faire_jour, shall we?

 

[Cheri]

We're talking about covering a mouth for minutes a day, if even that.

I can't speak for everyone, but I assume most everyone who wears a HA or CI in this forum wears these devices so we can hear words and sounds (why else would we wear our aids or CIs? For the sheer experience of wearing something in our ears and getting no benefit from it?)

And, for many of us, we get additional benefit out of our HAs and/or CIs when we've "worked" to learn to distinguish between sounds and words -- look at all the word and sentence discrimination posts in AllDeaf. Covering a mouth for minutes in therapy helps train a child's ears, so they'll understand even better, even with lipreading.

Yeah exactly. You've said it better than I did.

 

[faire_jour]

So did I.

I don't know anyone who walks around with their hand covering their mouth, but they do talk from the other room, behind the child and far away, in ways that the child can't lipread, instead of coming close and letting the child lipread. That is another difference between AV and Auditory Oral. In AO you would make sure you are face to face with the child to communicate.

 

[Hear Again]

I don't know anyone who walks around with their hand covering their mouth, but they do talk from the other room, behind the child and far away, in ways that the child can't lipread, instead of coming close and letting the child lipread.

Alot of people talk with their hand covering their mouth. Just ask ADers here. I'm sure many of them could share experiences where this has happened to them. I know it has certainly happened to me. (I can tell this by the muffled sound of their voice.)

 

[faire_jour]

Alot of people talk with their hand covering their mouth. Just ask ADers here. I'm sure many of them could share experiences where this has happened to them. I know it has certainly happened to me. (I can tell this by the muffled sound of their voice.)

I mean AV parents, walking around with their hands covering their mouths to prevent lipreading. I have never met one who does that. And in our therapy sessions we use an "acoustic hoop" so thst the sound isn't effected but the mouth is still covered.

 

[Hear Again]

I mean AV parents, walking around with their hands covering their mouths to prevent lipreading. I have never met one who does that. And in our therapy sessions we use an "acoustic hoop" so thst the sound isn't effected but the mouth is still covered.

In AVT sessions, it's typical to use a hoop, so that isn't unusual at all.

How do you know parents who have their children in AVT don't walk around covering their mouths? I'm sure some of them do.

Besides, isn't that the whole point of AVT?

 

[faire_jour]

In AVT sessions, it's typical to use a hoop, so that isn't unusual at all.

How do you know parents who have their children in AVT don't walk around covering their mouths? I'm sure some of them do.

Besides, isn't that the whole point of AVT?

I know them, my child plays with them, I am involves in organazations with them. I see them interacting with their children. I would say I had 100 families at my last Hands and Voices activity and at least half of them do AVT and I didn't see the hand cue once.

 

[Hear Again]

I know them, my child plays with them, I am involves in organazations with them. I see them interacting with their children. I would say I had 100 families at my last Hands and Voices activity and at least half of them do AVT and I didn't see the hand cue once.

You literally were able to observe 50 families and how they communicated with their children? Wow. You have amazing eyesight.

Having said that, just because 50 families did not use hand cues doesn't mean other families don't.

Besides, how do you know what the majority of AVT parents do or don't do?
Are you in their homes 24 hours a day?

 

[faire_jour]

You literally were able to observe 50 families and how they communicated with their children? Wow. You have amazing eyesight.

Having said that, just because 50 families did not use hand cues doesn't mean other families don't.

Besides, how do you know what the majority of AVT parents do or don't do?
Are you in their homes 24 hours a day?

My job is to greet and interact with them, so I try to spend time with each family. I can only speak to my experieces, and I don't know anyone who does.

 

[Hear Again]

My job is to greet and interact with them, so I try to spend time with each family. I can only speak to my experieces, and I don't know anyone who does.

That's fine, but your experience doesn't mirror the majority.

 

[deafdude1]

Bringing hearing to normal or near normal levels does not solve the problem of distortion and lack of clarity.

My audiologist will program them and enable features that minimize distortion and boost clarity. I will find out when I get those HAs back. You did great with HAs before you lost so much hearing that you had NR at 1000Hz and above. No HA can amplify a cochlear dead region and most of your cochlea had no residual hearing left.

All the AVT in the world won't help a person who cannot discriminate speech due to lack of clarity.

I can discriminate about 80% of what my dad says in a noisy car without lip reading.

As for trying out hearing aids, how far do you want people to go? Do you really expect someone to try every single high powered hearing aid on the market before receiving a CI?

Trying two or three of the best HAs is enough. If those don't help people such as you, no HA in the world will ever help. You had much worse unaided/aided hearing than I did. Those with similar or better unaided hearing than me will benefit, especially from an experienced audiologist.

I find it ironic how the 2 people who suggest this (deafdude and DD) are happy with hearing environmental sounds and have decent enough hearing with hearing aids to understand most speech.

Me and my audiologist can't understand why some are doing so poorly or don't make the effort to train their ears to understand speech. Everyone is different but as long as they have some residual hearing, my audiologist can program the best HAs to give that person amazing results. He of course needs to spend some time training his ears(it's no different with HA or CI, both are tools to aid deaf people)

Really? You can hear the "th" sound? How about "f"? Those are at about 15 db at 4000 hz. I dare you to find a hearing aid that can bring a profound loss at 4000 hz up to 15 db. If you are happy with enviromental sounds, Hurray for you! I wasn't ok with that for my kid. Why stick with something VASTLY inferior when there is a BETTER option? CI's bring better high frequency hearing, improved clarity (so improved that my daughter didn't even realize it hearing, she didn't label it as hearing right away), and speech understanding, not just recognition for many who couldn't get it with hearing aids. WHY NOT?? I just don't get the reason to cling to a technology that isn't helping.

My dad has a high frequency loss above 2000Hz, his HL is moderate. Yet he has no problem understanding speech. He told me as long as you can properly hear 1000Hz to 2000Hz(mid frequencies) your speech should be decently good. No HA will bring profound losses to 15db at any frequency, im looking at 25db to 35db aided after my HAs are reprogrammed.

I can't understand why Miss Kat heard so badly despite having 15+ db more residual hearing than me. Do any of the doctors/audiologists have any explanations? My audiologist said if I had "only" 100db hearing loss above 500Hz(which ironically used to be the case) id hear speech perfectly with those HAs after he reprograms them. I was born with 70db loss at 250Hz, 90db at 500Hz, 100db at 1000Hz to 6000Hz straight across on the audiogram and I did well with analog HAs. I did even better when I upgraded to digitals.

It seems that nowday people are too quick to get CI without trying the best HAs and the best programs and taking a few months to train their brain to get used to their new HAs. Before CI technology was widespread, people made the effort with HAs and most did fantanstic and hear so much environmental sounds and understand a high % of speech.

My audiologist will beg to differ that my HAs are inferior, he doesn't recommend I get CI because he feels he can program my HAs to give me excellent, clear hearing and says if I give it 6 months of AVT training, ill understand almost all speech. He did tell me that my 120+db high frequency loss can't be touched/aided by any HA in the world but that transposition will bring the high frequencies down to where ill hear. What if he could have given Miss Kat excellent, crisp hearing and great speech comphrension?

 

[Hear Again]

You did great with HAs before you lost so much hearing that you had NR at 1000Hz and above. No HA can amplify a cochlear dead region and most of your cochlea had no residual hearing left.

That's true. I was able to use my residual hearing until 1995 when my loss became profound in my left ear and severe-profound in my right.

However, even then I continued using a Comtek FM system with DAI so that I could hear my voice and environmental sounds better.

 

[Hear Again]

Me and my audiologist can't understand why some are doing so poorly or don't make the effort to train their ears to understand speech. Everyone is different but as long as they have some residual hearing, my audiologist can program the best HAs to give that person amazing results. He of course needs to spend some time training his ears(it's no different with HA or CI, both are tools to aid deaf people)

If your audi can program your aids to give you hearing at 0 dB, let me know. I doubt he can.

No amount of training will help someone understand speech if 1.) they don't have enough residual hearing and 2.) there is too much distortion.

 

[Hear Again]

No HA will bring profound losses to 15db at any frequency, im looking at 25db to 35db aided after my HAs are reprogrammed.

Really? You no longer want to hear at 0 dB? Why is that?

 

[Hear Again]

My audiologist said if I had "only" 100db hearing loss above 500Hz(which ironically used to be the case) id hear speech perfectly with those HAs after he reprograms them.

Apparently your audi doesn't know alot about hearing loss or hearing for that matter. Even people with normal hearing don't hear perfectly.

 

[Hear Again]

My audiologist will beg to differ that my HAs are inferior, he doesn't recommend I get CI because he feels he can program my HAs to give me excellent, clear hearing and says if I give it 6 months of AVT training, ill understand almost all speech.

I think your audi is deceiving you. If he were my audi, I'd fire him right then and there. NO audi can claim that a client of theirs will understand almost all speech. If he is telling you that and you have a profound loss, your audi is sadly mistaken.

 

[Hear Again]

Digital aids do not help everyone. When I wore digital aids, they created more distortion and sounded much weaker than my analogs.

 

[deafdude1]

AVT would be nearly impossible with a severe-profoundly deaf hearing aid user. It would be cruel for a child. How can you learn to listen when you can't hear?

It worked for me and my profound 100db(at 1000Hz+) hearing loss(and that was before digital HAs). My audiologist will make every effort to program the HAs to give each person the absolute best possible aided hearing so they can indeed hear then train their brain to understand speech. They would avoid the risks of surgery and CIs.

I think the reason why AVT is given to CI recipients is because there is more hearing to work with. Since a person is able to hear (generally) between 20 and 30 dB, it makes sense that they would be trained in regards to being able to hear/understand speech, use lipreading cues as well as identify sounds.

Alot of people don't get 20-30db aided with CI. Overthepond hears 35db-40db with CI but then she had 60db aided at 1000Hz and NR above that. Her unaided hearing was almost as little as Hear again's and her aided hearing not much better. But if someone can be aided to 20-30db with HAs, why even worry about CIs unless you lose another 20db of hearing? Yes there will be some distortion with HAs but 20db is 20db! No guarantee youll get that with CI!

[QUOTQUOTE=faire_jour;1289899]Nope. AVT is to teach children to hear, but profoundly deaf kids with aids can't hear. They are not able to hear far enough into the speech banana to learn language without visual cues. That is why they can't (successfully) do AVT.

I can draw a line thru the speech banana graph to show what id hear(best case) when my audiologist is done reprogramming my HAs.

Agreed.
Faire_jour and Hear Again,
I'm aware that there are FDA reccomended guidelines for implantation.
However, that doesn't mean there isn't "off label" implantation going on for folks who are borderline. Matter of fact, with the current state of health care costs in the US, it would surprise me if this wasn't happening! You know.....high insurance premiums PLUS the out of pocket costs for hearing aids. I do know of two boys who could hear in the high 60ish percentages aided getting implanted.
If I recall correctly the mom got them implanted b/c unaided they could only hear 10% unaided.
Yes, hearing in the high sixites isn't perfect, but it's a lot more then the little to no benifit from HA that CI folks claim is needed for implantation.
I mean it wasn't like they were hearing in say the low 30 percents with amplification. Up to or around 45% WITH amplification, I think should be implanted without a huge hassle. That's like a hoh person upgrading from ITE aids to BTEs.
"Off label" use of the CI is being seen. Yes, it prolly would be impossible to get it for a unilateral profound loss or whatever. And I do think that the majority of implantees opt for it after a long hard period of decision.
But there's the fact that some of the marketing practices about CI haven't been exactly kosher. (ie "comissions to audis for referring clients to CIs, stuff like random people IMing potentional CI implantees and telling them they should get a CI)

Excellent post and valid points to agree on.

I know how you feel about CIs and "borderline" candidates DD -- although I agree with faire_jour that either you are a CI candidate or you're not. There are no two ways about it.

Besides, if the mother you mentioned wanted to have her child implanted and the surgeon agreed, what's so wrong about that? He could be hearing at 15-20 dB across all frequencies and have 90% speech discrimination or better.

By the way, did that child you mentioned have a progressive hearing loss? If he did, that probably explains why he was accepted as a CI candidate.

My audiologist can get "borderline" candidates to hear great with HAs. You save the cost and risks of surgery. The mother wants the child to hear the best which is understandable but realize that the average CI result is 40db(such as what Overthepond achieved) also as Shel said, 30% of CI implantees aren't happy with their CIs or don't recieve much benefit from them. Even with a progressive loss, as long as HAs give enough benefits, what's the hurry? There will always be better technology.

Despite what those qualifications say, CI candidacy criteria vary from one CI center to another. I know some CI recipients who had severe-profound hearing loss and were denied candidacy because the CI center they were evaluated at only implants those who have profound hearing loss.

Then those people will just get a 2nd, 3rd, 4th opinion at different centers till one with lax requirements says "yes"

 

[Hear Again]

I can discriminate about 80% of what my dad says in a noisy car without lip reading.

You can? And you have a profound loss?

Wow. When I had moderately-severe loss, I couldn't even do that.

If you are truly able to understand 80% of speech in noise, then you do not need a CI.

 

[Hear Again]

Alot of people don't get 20-30db aided with CI. Overthepond hears 35db-40db with CI but then she had 60db aided at 1000Hz and NR above that. Her unaided hearing was almost as little as Hear again's and her aided hearing not much better.

Charlotte (overthepond) hasn't had her CI as long as I have. It's normal for people to hear at the 35-40 dB range when they are first activated. It will take time for her to improve to 20-30 dB, but it will happen.