Developmental Assessment

When we returned to Ohio and thus to Help Me Grow (Ohio's early intervention organization), we needed to have a second assessment done to identify how Abigail had progressed over the past six months. An assessment is a meeting between various professionals that will be involved with your child's care and your family. It is a chance for each of the professionals to observe and evaluate Abigail against their respective areas of development. Our assessment included a speech therapist, an early intervention specialist, a hearing therapist and a physical therapist (they're were some minor concerns that she had not started crawling yet.) Each professional evaluated Abigail while we discussed daily routines, Abigail's responses to family members, and any concerns that my husband and I had with her development.

Our EI (early intervention specialist) used the Hawaii Early Learning Program (HELP) charts to monitor Abigail's development, while the hearing and speech therapists used a variety of games to monitor both Abigail's verbal and non-verbal responses. The physical therapist conducted a variety of strength and balance tests to evaluate Abigail's motor skills. Each professional will be responsible for providing a copy of their findings reports at the IFSP. These reports will become part of the IFSP and serve as a baseline for future evaluation and comparison.

Abigail's Second Hearing Test

Yesterday was Abigail's second hearing test in the sound booth. If you haven't ever experienced a pediatric hearing test, I will explain a little bit about how the test is done. The test is conducted in a soundproof room and usually requires the presence of two audiologists. There is one audiologist in the soundproof room with you and a second controlling the sound board (where the various tones and sounds are produced from). The idea behind the test is that if your child hears a tone, sound, etc. he/she will produce one of several reactions--a pause in play, raised eyes, or ideally they will look for the sound that they heard. This is why there is an audiologist that sits across from you--it is her job to monitor your child's reaction. If the child turns toward the side of the room where the sound originated they are rewarded by seeing a toy that was once hidden in darkness move and light up. The more sound booth tests that a child has taken, the more likely they are to search for which one of their friends (toys) made the noise.
Once I understood how these booth tests worked, I immediately questioned how accurate these tests actually were. It seems to me that there is a great deal of subjectivity in these tests--what one audiologist sees as a pause, another might not. In fact, how do we really know that her pause should be attributed to sound and not simply to gas. In this test it seemed like Abby was just searching for her friends (toys) and wasn't really paying attention to any tones at all. Since her first test had indicated that her loss may fall more in the mild to moderate loss range, I was eager for a second round of results to confirm this. Generally both aided and unaided tests are conducted in the sound booth--not only do we want to confirm that her hearing aids are functioning properly for her, but also we want to verify that her hearing hasn't degenerated at all. This test didn't seem to go so well and unfortunately we were only able to test her with her aids on. Our audiologist did not seem concerned and asked for us to come back in three months for a follow-up test.
At first I wasn't really concerned about it either, but the more I thought about it, the more I felt like I needed some sort of confirmation that her hearing loss hadn't gotten any worse. Her hearing aids were being programmed based on the first sound booth test that indicated she only had a mild-moderate loss, but she still wasn't babbling. I decided to call in and ask for a retest just to allay my fears that we might be missing something. I mean we already had wasted so much time because her hearing aid volume wasn't disabled, I didn't want to sit by and just accept something when I had such a bad feeling about it. Once again, it didn't seem to be a concern to my audiologist that she hadn't had an unaided test in six months. She again stated that she thought she would be fine until the October time frame and then we would do the unaided portion of the test first. Maybe it was because she hadn't seen Abigail since the beginning (we had worked with four different audiologists because of employee turnover since Abigail's initial diagnosis in October 2008), or maybe it was because I was too pushy. I am not sure, but for me it was the final straw--I had decided that we would transfer Abby's audiological care to Cincinnati Children's Hospital.