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JustMe
06-01-2012, 12:04 AM
Different things have been recommended by different people to help dd be successful in class. The regular sound-dulling headphones have been recommended to help when other children become noisy, but ETY.plugs have also been recommended. When I first heard about these, I misunderstood and thought they drowned out all sounds other than the teacher but in reading more it seems they only drown out hums of lights, machines, etc.

Dd heard me talking about these things to someone and when I said something about earplugs that drown out all sounds except the teacher, she got very excited and said she needed those, they would help her tremendously in class. She is now begging me to get them asap...but now I don't think such things exist.

On the other hand, a friend mentioned that her dd uses some kind of earplug and the teacher speaks into a microphone?

Is anyone knowledgeable about the different options out there?

Thanks!

niccig
06-01-2012, 01:45 AM
Is your friend talking about an assistive listening device like a FM system? I know they are used for children with hearing impairments - the teacher talks into a mic and it's delivered via FM to the receiver that is plugged into a child's hearing aid. I think they're also used for children with other learning disabilities. They present the teacher's voice to the child as if the teacher was right by the child, so the voice isn't dampened by distance or other background noise.

There are several other assistive listening devices as well.

JustMe
06-01-2012, 11:42 PM
Yes, that's it. Are there any other types you know of that are relevant for auditory processing issues?

thanks!

niccig
06-02-2012, 12:17 PM
I think you can use the FM system for auditory processing. It might be best to talk with an audiologist. I only know what I was taught in a class on auditory rehabilitation by an audiologist.

Just a side note. My audiology professor is an expert in Hearing in Noise, he is involved in designing the main test the Hearing in Noise Test (HINT), there is one available for kids. In his opinion, auditory processing disorders often present as difficulty with hearing in noise and he thinks they should have a hearing in noise test to rule that out. People with difficult hearing in noise have normal audiograms with the pure-tone tests, so often told their hearing is fine. It's not until they do a specific hearing in noise test (HINT) that you see any deficits. And as regular hearing always occurs in noise, a pure tone test in a sound booth doesn't represent normal hearing conditions. It's just now that there's more awareness of all the people that have normal audiograms but can't hear at all in normal speaking situations.

JustMe
06-02-2012, 04:21 PM
Thanks! Can you tell me more about hearing in noise!

My dd does not have an auditory processing diagnosis (my friend's dd does), but she does have executive functioning issues. Ever since she heard there were headphones that could somehow help her to focus on the teacher, she has been going crazy begging me to get her some.

niccig
06-02-2012, 11:35 PM
Quick synopsis of what I learned about hearing in noise in an audiology class.

Since WWII it's been documented that some people have normal hearing (ie. normal audiogram for pure tone tests - press button if you hear the beep test) but complain of not being able to hear in noise. During WWII they were said to be malingering to get out of the army and it was called psychogenic deafness ie. it's all in your mind and go see a psychiatrist. In the last 10 years or so, there's been more research and it is a hearing disorder caused by damage to the outer hair cells but the damage is such that it can't yet be detected on the pure tone tests. The Hearing in Noise Test (HINT) is a hearing test where you get speech in quiet and then noise from front, right and left and the speech is from in front of you. The noise matches the long term spectrum of the speech sentences. It's a binaural test, so both ears tested at same time. There are also tests for testing the functionality of the Outer Hair Cells - testing otoacoustic emissions, again pure tone tests are normal but otoacoustic emissions testing shows decreased functionality.

We don't hear in listening environments that are sound booths with pure tones, we're in listening environments where there is constant noise. An audiogram from pure-tone testing tells you nothing about a person's ability for speech recognition in noise.

So that's hearing in noise. APD may be related to that or it might not be.

My professor explained that Auditory Processing Disorder is controversial as there is no agreed definition or testing for it. He argues that if you can't agree on what it is, then how can you test for it. He's not saying it doesn't exist, just that we don't know enough to say for sure someone has it or not, as there's no agreement on what it is. He's also had kids through the clinic that have a diagnosis of APD that have not had full work up of audiological tests.

He told us that if we get a child that has APD diagnosis to ask a lot of questions about who diagnosed and what their definition was and what criteria they used to indicate presence of disorder. We're also to see if the child had any speech recognition in noise testing (like the HINT test) and dichotic listening tests (test if what hear in right ear is same as what heard in left ear) as these are common themes in the research literature of people with APD. He wonders if APD is being over diagnosed and it is a hearing in noise or dichotic listening disorder.

Basically, he's saying we don't know enough about APD and not everyone is getting all tests to make sure it's not something else. He is a hearing in noise expert, so he's coming at it from that direction - hearing in noise is a common symptom for APD so he feels people should have those tests to rule out hearing in noise disorder. He also wants more research in APD so there's accepted definition and testing. We got one quote from one famous researcher in audiology who said "there seems to be more descriptions of APD than there are children who have it." Hopefully, in the next 10 years that will change and they'll know more about APD.

He's also had kids diagnosed with ADD who have undiagnosed hearing disorder - of course they have attention problems when they can't hear the teacher! The screening tests at school and Dr's office don't catch all hearing disorders. Proper testing in audiologists office is when it was caught. Again, not all kids with ADD have hearing disorder, but for many kids it's not ruled out.

I'm getting my hearing tested through this professor's research project as I have difficulty hearing in noise - it'll be interesting to see if I do have do damage to my outer hair cells or not. Prior to this class, I wouldn't have thought anything about it.

JustMe
06-02-2012, 11:55 PM
Thanks, very interesting!

niccig
06-03-2012, 12:03 AM
Thanks, very interesting!

It was a very interesting class. He did tell us that after his classes we would know more about Hearing in Noise than many other professionals - it's barely in the textbooks as most research is only in the last 5 years. This is his area of research, so that's why we got so much on it. Of course, not everything can be traced back to hearing in noise.

I have trouble when the TV is on, DH says it's just him I'm not listening to, but it's DS I have trouble with too. They need more research subjects, so I'm volunteering and I'll get a complete audiological work up. A classmate found that he has high frequency hearing loss, something he didn't know about it, though he did say he had trouble sitting at back of classroom. He now makes sure he sits in front of class right by the professors and if it gets worse, he'll need to consider a hearing aid.

JustMe
06-03-2012, 12:09 AM
Hmmn, dd gets really upset saying she can't hear the teacher when other kids are being noisy. I had borrowed a pair of regular noise-reducing headphones from a friend (I knew this wouldn't address the whole issue, but wondered if they would help at all during independent work times) and turns out dd told me that they have these in the classroom already, that she tried them, and that she knows this sounds weird but she felt like it made the noises louder! Any ideas of what that could mean?

We do have a place locally that specializes in speech and hearing. However, I doubt we could get insurance to pay for that at this point as dd was evaluated by a speech pathologist as part of an interdisciplinary evalutation, who found no issues. I was there during the testing, though, and they did nothing like this...everything was done one-on-one without any noise or other distractions.

niccig
06-03-2012, 01:41 AM
We do have a place locally that specializes in speech and hearing. However, I doubt we could get insurance to pay for that at this point as dd was evaluated by a speech pathologist as part of an interdisciplinary evalutation, who found no issues. I was there during the testing, though, and they did nothing like this...everything was done one-on-one without any noise or other distractions.

SLPs may do a screening test where they just run through a few tones (I've seen the grad. students do it at our clinic), it's not in a sound proof booth, nor is it a full pure tone testing like what an audiologist does let alone more detailed testing like hearing in noise etc.

I don't know if you should do more, especially if you have to pay for it, and I don't want you to be out more $$. But if she's complaining of not being able to hear the teacher, maybe the screening wasn't enough? I don't know. I know there's a couple of audiologists here on the boards, they would know more than me.

JustMe
06-03-2012, 11:48 AM
Do you know what the intervention/device is if it is found to be a hearing in noise issue? Just thinking that the other possibility is to just try the intervention and see if it works. I know a lot of these devices are expensive, but it the school district already has one we can try out, that might work.

niccig
06-03-2012, 12:34 PM
Do you know what the intervention/device is if it is found to be a hearing in noise issue? Just thinking that the other possibility is to just try the intervention and see if it works. I know a lot of these devices are expensive, but it the school district already has one we can try out, that might work.

Assistive listening devices like a FM systems. There are other set-ups too. Part of rehabilitation is to also teach people to control the listening environment eg. if it's too noisy ask the person to move to another part of the room where it's quieter etc.