Life is Bliss - Lily's Cochlear Implant Journey

Holiday Listening and Language Activities

We have done loads of holiday activities with Lily's teachers to learn about Christmas and all its parts. Here are a few that Lily loved:

1)  Two sets of foam stocking ornaments and all the parts.  Lily had to tell her teacher what she wanted on her stocking, like a cuff, buttons and a wreath, and then her teacher told Lily what she wanted on her stocking.  A language and listening activity.

2)  Clifford's First Christmas Book - A new favorite!

3)  Building a candy cane out of beads and a pipe cleaner, which became an ornament.

4)  A listening activity where we had foam tags and wrote activities on them.  Then Lily would either pull them off or put them on the tree and do the corresponding activity.  Of course the string that was supposed to hook the ornaments on the tree suddenly became a jump rope.   Lily loved jumping over (at 2-3 inches) and crawling under the rope.

5)  A small tree with hundreds of mini ornaments, garland, stars, etc. which we sorted through and discussed.  

6)  Fisher Price Christmas scene with Santa and his sleigh, a hot chocolate stand and an ice skating rink.

7)  Matching cards of kids doing things with the objects they wanted for Christmas and putting them in the mailbox for Santa Claus.  

Upcoming Moog Center Workshops

As you may remember we had a fantastic experience this summer attending the "Helping Your Children Learn to Talk" workshop in St. Louis. It was without a doubt one of the best couple days you can spend and well worth the investment. Well, the Moog Center is taking applications for this summer's training and offering a variety of other programs for parents and educators alike. Here's a listing. Check it out and don't forget to tell your educational professionals as well.

January 21-22, 2010 - $300 

Pediatric Cochlear Implant Programming 

A workshop for cochlear implant audiologists who work with infants and children. This workshop will focus on cochlear implant programming techniques for optimizing access to sound for infants and young children.  Protocols for monitoring progress in children at various developmental levels will be discussed.  Instruction will include live demonstrations, videos, and presentation of relevant case studies.  Seating for this interactive workshop is limited. CEU’s available.  Contact:  Connie Ciavirella at 314-692-7172 or cciavirella@moogcenter.org 

 

February 18-20, 2010 - $350 

The Earlier They Get Started, The Faster They Learn To Talk. 

For teachers and SLPs providing early intervention services to children with hearing loss. This workshop will focus on techniques for helping parents work with their own children and strategies for professionals working with very young children to develop spoken language skills.  Instruction will include live demonstrations, videos and hands-on opportunities.  Seating is limited. CEU’s available.  Contact:  Betsy Moog Brooks at 314-692-7172 or bbrooks@moogcenter.org 

 

July 7-11, 2010 - $150 

Helping Your Child Learn To Talk 

A Workshop for Parents of Children who are Deaf or Hard of Hearing, ages 2 to 5 

This four-day workshop will provide parents with opportunities to learn strategies to help their children learn to talk while their children receive daily individualized instruction by a staff member of the Moog Center.  Each day is packed full of activities for the children and information for the parents.  Children over age 3 may receive speech and language evaluations, for an additional fee.  Contact:  Betsy Moog Brooks at 314-692-7172 or bbrooks@moogcenter.org 

 

September 2010 – Date to be determined. $150 

Strategies for Professionals of Mainstreamed Students with Hearing Loss 

For SLPs and teachers who have a student with hearing loss in their classroom. Learn effective strategies that work with students with hearing loss who are mainstreamed into your school setting.  Topics to be 

discussed include:  hearing loss and effects on language, academic difficulties, assistive listening devices, and support services. Contact:  Connie Ciavirella at 314-692-7172 or cciavirella@moogcenter.org 

 

October 2010 – Date to be determined. $300 

From Assessment to Practice:  Developing Spoken Language Skills in Children with Hearing Loss For SLPs and Teachers of the Deaf 

This workshop will focus on accurately assessing language levels, identifying areas for language instruction, selecting appropriate goals and objectives, and planning lessons for children with hearing loss.  Topics include:  Using norm-referenced language evaluation tools to diagnose strengths and weaknesses, using criterion-referenced language rating forms to select goals and mark progress, and implementing targets into a variety of language lessons. CEUs available. Contact:  Connie Ciavirella at 314-692-7172 or cciavirella@moogcenter.org 

 

November 2010 – Date to be determined. $300 

Conversational Language Activities for Deaf Children For SLPs and Teachers of the Deaf 

This workshop will focus on implementing language goals into a variety of conversational language activities for children with hearing loss.  Topics include:  Modeling and imitation techniques for correction and expansion of language, selecting appropriate language goals, planning conversational language activities to meet language goals and a variety of ideas for many different kinds of conversational activities.  This workshop will also include classroom observations and some hands-on practice. CEUs available.  Contact:  Connie Ciavirella at 314-692-7172 or cciavirella@moogcenter.org 

 

For your convenience, the Moog Center offers onsite workshops for larger groups.  If your staff or district is interested in scheduling one of the above workshops onsite, please contact Connie Ciavirella at 314-692-7172 or cciavirella@moogcenter.org 

 

Visit the website at www.moogcenter.org for complete workshop listings and information about the Moog Center’s publications.

Online Music Therapy Courses and other CI Experts

Last week, I watched a free online session with Chris Barton, board certified music therapist, hosted by Advanced Bionics. Chris  is an award-winning composer, performer and music therapy guru.  I think I've raved about her before, but this online session reminded me of how well she understands kids with CIs and how music therapy/music training is a must for kids who are learning to listen and talk.

The session I attended was primarily a Q and A, but there are at least seven other free online courses with Chris Barton in Advanced Bionics's Listening Room. 

There are also lots of other sessions in their eLearning Library by some of my favorite CI experts like Dave Sindrey, Mary Koch and Amy Robbins. Specially look at Amy Robbin's intervention Activities for ITSIs (Infants and Toddlers with Cochlear Implants).  Check it out!

Daddy, I Want Play Baby Lab

Last night Lily rushed into the house saying "Daddy, I want play Baby Lab." She asked me to put on her "vest" and get her babies. At the baby lab in Boys Town Lily wears a vest that has microphones built into it so that Mary Pat and gang can hear and record her utterances during the lab. We found a vest and went to our play room. She then told me I was "pretend Mary Pat" and we had a grand time playing games and practicing saying words. Who knew speech therapy could be so fun ;-) 

Communicating Her Needs Or Stalling Tactics

Lily is quite the communicator. She's using her new skills to try and convince us to let her stay up later at night. Last night we came home from dinner at Grandma's and before Lily headed upstairs to put on her pajamas she ran over to the kitchen table, jumped into her booster seat, buckled herself in, and said, "I play cards now Mommy". She was referring to activity cards that she played with Mommy earlier in the day from Advanced Bionics Listening Room. She knew that it would be hard for us to say no to just a little more language learning. Clever girl. Here's a photo.

Tonight was a little different. We've been reading the book "Baby Can't Sleep." In it the daddy tries to get baby to fall asleep by counting sheep to her (One sheep chasing fireflies, two sheep playing guitar, three sheep staring at stars, etc.). Lily was a little restless and reached for me to pick her up and said "I count sheep, I count sheep, I count sheep," which sounds remarkably like "I can't sleep." Once I made the connection we counted a few sheep and she promptly relaxed and fell asleep. Ahh the power of language.

Moog Center's Parent Workshop - We're in Love! Part 1

We spent the last few days at the Moog Center's Parent Workshop.   We are in love with this place.  The workshop had about 15 families with children from one to five years old who had hearing loss.  Some kids wore hearing aids, many wore Cochlear Implants and a few wore both.   

The families were from all over the country and seriously committed to helping their kids learn to talk and listen.  The last question of the seminar from the parents was when can we come back?

The workshop lasted four days and covered topics such as Modeling and Imitation, Simulated Language Learning, Audiology, Benchmarks, Capitalizing on Routine Activities, Mapping, IEPs, Teaching Family and Friends about Communicating with your Child, Parents Share and a Kids Panel made up of first and second graders and their Moms.  Betsy Moog Brooks delivered most of the sessions and seemed to have an answer for every question that the parents asked.   She meant business and was clearly there to make an impact on kids with hearing impairments.   

Bestsy’s mother, Jean Sachar Moog was also there and presented research on Early Educational Placement and Later Language Outcomes.  She highlighted the significant impact two-year-old classes for D/HOH kids can make in later language outcomes.  These two women are leading the way in helping children learn to talk and listen.  What a thrill to be a little a part of their lives.

The research they gave us about the Moog Center says that at three years old 81% of their kids were at or above their age level in receptive vocabulary and 86% were at or above their age level in expressive vocabulary.  At age five, 94% were at or above their age level in receptive vocabulary, 97% in expressive vocabulary, 91% in receptive language and 77% in expressive language.

It seemed nothing at the Center happened by accident.  Everything was recorded, strategic and intentional.  We would move to St Louis in a minute if Lily was not thriving from the services in our area.   Lily had an hour of speech therapy everyday with Laurie, a Moog SLP, and spent the rest of the time talking with Moog teachers in the toddler room.  At the end of the workshop, we knew everything Lily worked on and where they believed we should put our “language and speech” energy.  

They said we should focus on requiring Lily to use two and three word sentences every time she talks.   Lily has a huge receptive and expressive vocabulary, but just needs to move towards more complex sentences.   If Lily doesn’t attempt a two or three word sentence after we model it, they said we shouldn’t give her what she wants.  

This is their model of modeling and imitation.   It seems to already be working.  Lily is talking non-stop and we don’t know where she is coming up with some of the words and sentences she is putting together.  Some of that started before we got to St Louis, but the "strategy" seems to definitely be accelerating her language.  

The facility itself was beautiful, incredibly quiet for the best learning environment and run with an eye for detail.   We are re-energized!!!

Here are some photos of the Moog Center.

(Note the metal slide and static-free play structure)

Hearing Journey Posters, A New Book and Listening Tests

Faye, our Hearing Resource Teacher, has brought a couple of great posters from AB's Hearing Journey website including the Sleepy Time Poster and the "I Heard That" Farm Poster that Lily has loved to explore and talk about. 

She also brought a book from Eric Carle called Papa, Please Get the Moon for Me.  It involved a father climbing up a ladder, on top of a mountain, to get the Moon for his daughter -- something Lily's Dad would definitely do.  Lily soaked the book up as we read it, but didn't react too much.   Then later that same day, as her Dad was holding her, she tried to reach and grab the moon herself.   She's already an independent woman and definitely understood and could apply what she had read.

Lily's languauge continues to grow everyday.  She repeats everything and many of her words and sounds are getting clearer.  Today our SLP Staci was doing a listening test where she would ask Lily to point to the box with the Baby, Ball and Star or Book, Blocks and Heart, etc.  After the exercise was completed, our SLP said Lily had done fabulously and that she usually waits until kids are three to do these exercises, but that Lily was definitely ready for them.  Too fun!

WASP activity (Word Associations for Syllable Perception)

Lily has been "playing" with listening and sound production through the use of sound/object toys for the past few months and has been doing very well. 

Last week we started using the Level 1 WASP (Word Associations for Syllable Perception) pictures for the same purpose, to help Lily discover the connection between what she hears and what she is able to say.  These pictures represent the full range of the English language, vary by pitch, duration and intonation patterns and by number of syllables. 

The program progressively becomes more complex as a child develops stronger listening and sound/word production skills.  We'll be able to use this tool for both strengthening of auditory perception and speech production skills as well as for assessment. 

Our SLP Carole uses the WASP sound cards by covering her mouth and then saying the sound or word.  Lily repeats the word and then gets to see and hold the card.  Sometimes the card goes on Lily's head, on the floor, walks across her tray or jumps right into the card box.  Amazingly, Lily got nearly every sound right.  We're so proud.

Here are some technical stats for our SLP readers of the words or sounds she missed:

• Lily substituted d/g, n/l, s/f:  all developmental errors  (kids do d/g often, also w/l or p/f.  RE:  n/l and s/f:   Lily knew the type of sound to make (/n/ and /l/ are both glides, /s/ and /f/ both airy sounds.....so she was really getting good information about how the sounds were made or should sound. 
• Also sounded like ts/ch one time, again very typical.  For /ch/, children often move from /t/ to /ts/ to the /ch/.  /g/ is a sound that develops during the 3rd year, /f/ during the 4th year, /l/ and /ch/ more like 5-6 years.  
• Lily also said "boo" for "oo," then changed it.   I actually think she was just anticipating that it was "boo" since I made the sound with the same inflection we say "boo."  She changed to "oo" as soon as she saw my mouth. 

So far, Lily is off to a fantastic start.  We're amazed at how attentive she is to the activities and how she is able to use her listening skills to discriminate what she hears and then say it back.   Really awesome performance. (Thanks for your help writing this post Carole.)

Perfect Morning

Lily was on her game this morning. Carole brought over a board game to play with her. On the board were nine pictures of everyday items like apple, dog, sheep, telephone, umbrella, fish, etc. Along with the board came matching cards that Lily could place overtop of the pictures. Carole would ask Lily where each item was and hand Lily the matching card when she pointed to the right item. Not only did she get every item matched properly she spoke every word as well. She's also adding a ton of "expressive" words to her list, including, go, shoe, socks, roll, heart, flower, and cheese to name a few. Ahh, progress!

Speech Therapy - The "Wh"

Today's focus at speech therapy was the Wh sound, as in Where, What, Wait, Watch, Owie, etc.   We said things like what's that, where is.., mama watch, wait, weee, does baby want water, etc.  We rolled cars down the ramp, fed a giant baby on the front of a box paper food, and played with a puzzle that had vehicles for its pieces.   The ambulance of course went woo woo. The other goal for the day was focusing on the second syllable of words.  Lily now says O-pen, instead of ooooh. I noticed she is also saying Ba-by instead of ba-ba.    Homework includes putting band aids all over a baby and talking about her owies. We're sure to have the Wh and the second syllable of words down in no time. 

Ling Sounds Song

I found a "Ling Sounds Song" off the www.auditoryoptions.com website.   It is sung to the tune of the Wheels on the Bus.  I thought it was creative to incorporate the Ling Sounds into natural song.  Here are the first two verses.  This website also lists some interesting research summaries and lesson content.

The horn on the car goes beep beep beep                       
Beep beep beep, beep beep beep
The horn on the car goes beep beep beep all through the town.

The people in the car eat mmm, mmm, mmm
Mmm, mmm, mmm, mmm, mmm, mmm
The people in the car eat mmm, mmm, mmm all through the town.

Repeating the Ling Sounds

Lily has finally mastered the Ling Sounds (Ah, Ooo, Eee, Mmm, Ssss, Shhhh).  We don't practice these as a separate skill too often, but primarily work them into everyday language.  The Ooo seemed the most evasive, but the repetition of the Choo Choo at Disney helped her achieve this sound. 

Last week our SLP Carole used a hoop (like you would use for needle point) to cover her own mouth and then began to say each Ling sound to Lily.   To encourage Lily to repeat the sounds, Carole has had Lily drop blocks in a box before, but this time she just handed Lily the hoop.  It worked.  Lily repeated all the Ling sounds. 

This is one way to demonstrate that Lily is hearing across the entire sound spectrum and is a good test when Lily first puts her CIs on to make sure everything is working.  Now we will focus on repeating the Ling sounds from a distance and in noise. 

This is a picture of Carole and Lily working/playing.  Toys are always more exciting when they come in a box.

Unofficial Language Results - 16.5 months

At our last weekly speech session, I asked the SLP how she thought Lily was doing compared with normally hearing kids.  She said, "Well," and then paused.  I thought Oh No, what is she going to say.  Are we not doing enough, are we taking the wrong approached, am I failing her and not maximizing the capability of the CIs and this critical window of language development?  Maybe I shouldn't have asked the question. 

Since Lily was two months old, we have been receiving developmental milestones from someone.  Almost weekly.  And not only for her hearing and language but for every possible thing that could develop in a baby.  This has been wonderful in one sense because we knew very little about child development and have had experts guiding us all the way.  But in the other sense it has been extremely stressful.  EG - It is 3 months and Lily is not rolling over.  It is 6 months and she is almost sitting.   It is 9 months and she only turns to clapping and Ba Ba Ba.  Is she stacking her blocks. Is she tracking objects with her eyes. Can she pass one object from hand to hand.   Does she have three words by one year.  So we worked very hard (maybe obsessively) on everything (motor skills, social emotion, cognitive and now language) to make sure all the milestones were met or exceeded.  Fortunately they have been. 

The SLP continued, "I think she is ahead of her hearing peers in receptive language and two months behind in expressive language."  Ahhhh I'll take it. 

Language Extremes

Today we all went for Lily's weekly visit to our private SLP.  Our language goals were Big, Little, Stop, Go and Help.   Our SLP started by showing Lily a big and little ball and then asking, "Where is the Big Ball? Where is the little ball?"  Amazingly Lily picked the right ball each time.  So the SLP said, "Bounce the ball, roll the ball and throw the ball."  Lily pick up on these very quickly as well. 

Stop and Go were a little harder.  The SLP used a vibrating ball. We have been using this ball for off and on, but today we were saying stop and go.   Lily likes how the ball shakes her whole body and prefers it to be ON.  Later in the evening she started saying OP (Stop), as in Op Tango (our dog).  We will work more on Help this week.    

Other language toys we played with today included the classic Melissa and Doug sound animal puzzle and a page with pictures of "B" items like boat, boot, ball, baby, bee, etc.  Lily was supposed to match the corresponding picture square on top of the existing picture and then stick them together with the Velcro. This is the first time we have done the activity and the SLP said she did pretty well.  It takes patience to just observe first and let her figure out the matching picture or how to put in the wooden puzzle piece.  Observe, Wait, Listen - OWL is a great acronym used by the Hanen Centre.  I'd add Talk Talk Talk somewhere in there too.

LENA - Every Word Counts

Last week during Karen's visit she mentioned that the Omaha Hearing School had just purchased a new speech language measurement system called LENA. It's a new technology that measures and analyzes the amount of language a child receives in their everyday environment. Basically the baby wears a tiny speech listening device that measures sound and then connects to a computer to analyze the conversations that take place throughout the day.

We're excited to check it out. In the meantime, for more info about it, check out LENA's website that offers links to research about language development, sample videos and activities, and some parent testimonials.

Speech Sounds - The Basics

Cochlear has a great resource that provides a rich overview of all the speech sounds, along with activities and examples that can be used everyday. Well worth checking out - Speech Sounds for Parents and Professionals.

Snoring Pig

Lily has a snoring pig that she received from James, our neighbor, for her birthday.  The pig snores for a while and then says, "A nice bucket of slop would taste so good right now."  Weird, I know.  Carole, our fabulous LPS Speech Pathologist, who may be leaving us because LPS has not figured out their hiring yet, has been showing Lily how to cover a little baby up with a very small blanket and then say "shhhh the baby is sleeping."  Brian and I knew this was a stretch because Lily doesn't use a blanket and she doesn't like to go to sleep.  A few weeks ago, as I was trying to convince Lily that her crib is her friend, I showed her how to cover up the snoring pig with the blanket.  Then yesterday I turned the pig on (snoring) and suddenly Lily ran to get her favorite pink blanket (given to her from Grammy) and covered up the pig.  She is learning fast.