Part 2, Audiology

Lottie's audiology appointment was this morning. After rushing out the door and thinking I'd miss the appointment, I happened to make it on time, no thanks to Guam traffic!

The doctor led us into this soundless booth. It was weird and our voices sounded muffled and there was even a slight pressure on my ears. It wasn't really that comfortable at first. Lottie was a champ and allowed the doctor to look in her ears. He confirmed our family doctor's finding that there is indeed fluid one of Lottie's ears and it seemed red, indicating an infection.

He then put some ear buds in her ears and I *think* he was sending sound waves to measure her eardrum's responses. That resulted in him saying that there is quite a bit of fluid in both of her ears. He immediately said that he is going to refer us to the ENT (Ear, Nose, Throat doctor) who will more than likely put Lottie on a round of antibiotics. There is a possiblity that she would also get tubes, but that isn't at all sure yet because we need to actually talk to the ENT first.

The last test he did he went into a different room with a window to us. He put ear buds in Lottie's ears again. This time he sounded a tone in each ear and flashed a lighted toy at the same time. The toy was either to her left, her right or above her. He would sound the tone in her right, left or both ears as he lit the toy up. The point was to create a conditioned response where she would hear the tone and be rewarded for looking for the tone by seeing the lighted toy. Eventually he would sound the tone and then light up the toy rather than doing them together, and then eventually just sound the tone without lighting up the toy.

Anyway, Lottie didn't do so well on that test. She never got to the second step where he would light up the toy as a reward for looking toward the sound. She only sporactically turned toward the sound at all and sometimes she didn't even look at anything but instead started trying to get my attention.

The doctor assumed that she was distracted and thats why she wasn't looking, but I think it was the other way around. She started getting distracted because she wasn't hearing anything. He then reported that she has mild and moderate hearing loss in the high and low tones (I can't remember which tone was mild and which was moderate). He said this is very much a problem when it comes to speech and language development.

So. Bottom line is, she needs to see the ENT. Then we'll go back to get her hearing checked again. It can go either way- the hearing loss can be completely repaired by getting the fluid cleared out of her ears, or the hearing loss could be permanant. But they won't know until we get the fluid cleared up.

Off to the other doctor then! Maybe we'll get that appointment next week and get the antibiotics going before Christmas!

Early Intervention Part 1

Lottie's Early Intervention (EDIS) appointment was this morning. There are problems but we don't know how these problems are going to affect her yet.

Issues:

1. She has low muscle tone in her stomach/back. This results in her having a hard time sitting cross legged or pushing herself up from a sitting position without 'bear crawling' her way up.

2. She has already created a preference for her right hand. While this isn't a huge deal, this does mean her left hand isn't gaining as much strength and she may have issues with coordination when she gets older. The lady seemed to think this could be a result of low muscle tone in her left arm or hand that caused the preference.

3. She has a lack of muscle tone in her mouth. She exhibits this by chewing weird. She also tends to shove her food to the side of her mouth rather than using her tongue to move it around. This results in frequent choking on her food. The lady observing said this could also be because of:

4. She has as texture aversion. Ever since she was little she didn't like putting things in her mouth and would choke easily on food. Not 'mouthing' toys or food well means that she didn't gain the proper muscles strength in her mouth to actually form words.

As we were pulling out all the toys for Lottie to show off her skills, the lady said that Lottie is very smart. She's doing activities that are beyond most 18 month old babies she sees. She seems to think that things could go either direction- Lottie could figure out how to talk and have a verbal explosion or, because sign language is working so well for her, she could decide learning to talk is just too hard.

What I'm supposed to do:

1. Get a vibrating tooth brush for Lottie to play with. This will help desensitize her mouth, if she's willing to put it in!

2. Let Lottie play on playgrounds/jungle gyms even more often. She needs a chance to strengthen her core muscles. Playing is good but she needs to play even more than the normal 18 month old would.

3. Stick our tongue out at Lottie and get her mimicking us as often as we can. This is important for her eventually copying the words we teach her.

4. Stop responding to Lottie when she says "uh". Lottie uses one sound to get attention, express needs, or generally say anything. We need to stop responding when she says 'uh' and only respond when she uses a different sound, regardless of what that sound is. This will encourage her to explore other sounds to get what she wants.

Lottie is a very smart child, I know this. But once she figures something out, she doesn't like to change nor have other people help her. This does not bode well for teaching her how to talk! Ignoring her oft-used 'uh' will mean more temper tantrums. Yay.

At this point, the lady from EDIS will give her report to her boss. She said that Lottie would not fail any of the tests they would give, because sign language is considered communication just as speaking is and since she has a rather large sign vocabulary, she wouldn't qualify for services based on the tests this lady knows about. She is hoping that her boss knows a test for verbal only that will allow them to get her help that she does need. If she doesn't qualify for services now, they'll put her on a monitoring situation where they'll meet with us once a month and she can give us as many tips and tricks as she can until either Lottie starts talking or she hits the 2 year mark where she is supposed to have 30-50 words and she would definately qualify if she hasn't started talking yet.

Audiology appointment next week. Again, hopfully nothing comes up.

Lottie at 18 Months

We took Lottie in for her 18 month check up today. She was poked and prodded and stabbed. Once we got into the car, she fell right asleep.

She is 21.5 pounds and 30 inches!

We filled out two questionaires, one for autism and the other for general age appropriate milestones. I remember doing these through Parents as Teachers for Emmaline and they were great. But the ladies would always come with a bag of toys and do the assessments themselves. But me? I have to fill out the questionaires in the waiting room of the clinic.

One of the questions that was asked was if Lottie could dump a clear bottle over to get a cheerio (or other small object) out either with being shown or without. Well, how am I supposed to know that? I don't go around putting cheerios in water bottles. Now, if they were to ask me if Lottie can easily navigate her stroller through a kitchen full of chairs and people without getting stuck? Sure! But I have no clue about the waterbottle thing. So I had to say no.

They also asked about her communication. Out of 6 questions, I was only able to say yes to one of them- does she make her wants known? Yes, and most of the time loudly with much 'patting'.

The problem is that Lottie just doesn't talk. She says 'uh uh uh' all the time and for a while she'd say 'bip' at everything but otherwise, nada. Oh, she can distinguish animals from other things- when she sees an animal she makes a weird sort of scream/growling noise thats hard to describe.

I'm confident she doesn't have hearing problems because I've whispered behind her back, called her from across the room, talked toward one ear more than another, etc. She really can hear just fine. But...

The doctor still wants us to do an audiology appointment. They'll test her hearing. She'll also get an appointment with an early intervention specialist for a thorough evaluation. He was going to refer us to the ENT because he saw some fluid behind her ears but decided to wait on that until after the hearing test was finished. Also. He is taking himself off her case and transferring us to the pediatrician and we are supposed to get an appointment with her in the next few weeks. So- three more appointments.

My thoughts? I am not sure what to think. Sometimes I'm confident that she's just a late talker and she'll come around to it on her own time and people need to stop worrying. But other times I really do worry that there is something wrong. The normal sound babbles that most babies experiment with don't generally happen with her. I'll hear it occasionally and it makes me take note because it sounds weird/different coming from her. Sometimes I wonder if I just didn't read enough to her, or sing enough with her. Or maybe the fluid buildup in her ears is a lot worse than it looks.

I'm not worried... Even if she does present with some difficulty- be it needing help hearing or speech therapy- I'm not in the slightest worried about helping her take care of it. Luckily Matt has some really good benefits so it won't cost us an arm and a leg. And I know that God loves her more than I'm capable and he may have given her a set of trials that we'll have to work through. But although they may be difficult, I'm still not worried. I trust that she'll still grow into an amazing woman with a lot of talents and an amazing strength.

I'll keep everyone updated as we go to our appointments. Hopefully all the appointments mean that there is nothing wrong. Thats every mother's wish ;)