Life is Bliss - Lily's Cochlear Implant Journey

AB Harmony vs Nucleus 5

Advanced Bionics has posted a new comparison chart versus Cochlear's latest Nucleus 5. Click on the link for more insights.

Music and the Cochlear Implant

Hearing Health Magazine recently released a variety of articles on Music and the Cochlear Implant. 

In the first article, Ward Drennan, PH.D. writes, "The primary weakness of CIs is their inability to deliver pitch information. There has been a long-standing controversy regarding what acoustic information normally hearing people use to allow them to perceive pitch." 

He continues later in the article, "The CI encodes frequencies according to place. Unfortunately, however, most of the fine timing information that could contribute to pitch is lost. The implant divides incoming acoustic information into 12, 16 or 22 channels, whereas normal hearing gleans information from 30 to 40 channels. Even in the best scenario, place information is already degraded relative to normal hearing. The degenerated condition of the auditory nerves of implant recipients further limits the end result to eight or nine functional channels. Additionally, CI-users lack information that hair cells normally “gather.” Groups of hair cells and their associated nerves, working in tandem, have the ability to capture the detailed pitch timing of each wax and wane of the acoustic wave up to 3,000 to 4,000 hertz. This ability is almost completely lost in the implant-user, who rarely gets such information greater than 300 hertz. Thus, the refined pitch, chords and melodies in music that normally hearing people enjoy often become a garbled, blurred mess when heard via a CI. For the CI-user then, the ability to perceive both place and timing information about pitch is marginalized.  Despite these unfortunate limitations, rhythm perception, an essential element of music, is nearly normal in CI-users. "

He goes on to say, "The brain is the CI-user’s greatest asset. With training and effort, the CI-user can utilize the garbled mess they hear, perhaps finding cues in the implant stimuli, and make the best use of music based on memory. Also, in the vein of Charles Ives, in which any sound might be considered music, the CI-user can learn to find aesthetic value in the “new” sound. Perceiving art, and art in sound, is primarily a state of mind." 

Finally he discusses Cochlear Implant company strategies to improve music listening including those of Advanced Bionics and Cochlear.

Great articles!!!

3-D Scanner May Lead to Better Hearing Aids

Ran into an interesting article in the latest issue of Fast Company that looks at MIT's latest 3-D digital ear canal scanner. The technology will enable a better reading of the shapes and shifts in the ear canal than the traditional silicone ear molds. While the technology isn't likely to effect Lily and other cochlear implant users, it could be a big advance for those requiring hearing aids. MIT hopes to commercialize the technology by 2011.

Claudin-9 Gene Linked to Hearing Loss

Dozens and dozens of genes have been linked to hearing loss, but there are numerous others that are yet to be discovered.   University of Iowa researchers have recently identified claudin-9 as having a connection.  Seems like a "Genes connected to the ear" class is in my future.  Road trip to Iowa City?

"Using a deaf mouse model, the researchers identified the deafness-causing defect in the claudin-9 gene. That mutated gene fails to produce normal claudin-9 protein, which, the University of Iowa team showed, is needed to maintain the proper distribution of potassium in the inner ear."  MORE

Internet Capability in Cochlear Implants

When we spoke at the Advanced Bionics headquarters, we envisioned the future for people with CIs. We thought they'd be the lucky ones with "CIA style" hearing.  Maybe listening to someone whisper across a huge field?

Here's a new take by Google.  "Vint Cerf, vice-president and "chief internet evangelist" of tech giant Google, foresees the introduction of internet capability to existing neural interface technology such as cochlear implants, allowing, as an example, web radio played direct from computer to brain." So cool.  More

Let Our Children Hear — And Learn To Speak - South Africa Editorial

A very interesting editorial in South Africa's The Time's called Let our children hear — and learn to speak

Research on the Importance of Adult-Child Conversations to Language Development

In the latest LENA Newsletter, the featured expert was Dr. Frederick Zimmerman, chair of the Department of Health Services in the School of Public Health at the University of California, Los Angeles.  As the lead researcher, he discussed "Teaching by Listening: The Importance of Adult-Child Conversations to Language Development," which was published in the July issue of Pediatrics.  The following summarizes the findings of the study.

The results supported our hypothesis that parent-child interaction is best when it's a two-way street. We found that each additional 1,000 adult words a child was exposed to led to a .44 increase in the child's PLS-normed score, whereas for every additional 100 conversational turns there was a 1.92 increase in the PLS-normed score. For both stimuli, these changes were approximately one standard deviation from the norm. Therefore, in that standardized sense, adult-child conversations were approximately six times as powerful at aiding language development as adult speech input independent of conversational exchanges.

Our Trip to Advanced Bionics - Part 2

One of the things that was so fascinating about Advanced Bionics was that much of the production work was done by hand.  We watched each person as they created the internal pieces and slowly took each wire under microscopes and soldered them down.  

As the internal pieces moved down the line, each person's work was check by the person after them to ensure the highest quality standards.  They told us that their rate of production without errors (there was a technical term for this) was amazingly high for hand work, even rivaling automated production. 

The AB Director of Manufacturing, went through every step of the production process with us.  You could tell this guy had a lot of passion for the manufacturing process, for his employees and for the end-user.   He even told us a story about another customer and got a little weepy.   It was clear he was in the business for the right reasons and really wanted to make the best product that was absolutely possible.  He was so excited about all the new innovations they were working on. 

We now also finally understand what the manufacturing issue was with their Vendor B problem and saw the steps they have taken to both remedy the issue (they don't use Vendor B anymore and Vendor A manufactures their product differently) and then emerge as a better company with more risk assessment at every level.  This discussion was very reassuring. 

Lily did receive AB's new Melody the Monkey.   She is so cute and has bilateral cochlear implants, something Lily instantly related to.   Melody is just Lily's size and comes with a pink summer outfit. 

When we left AB in our rental car, Lily insisted that we put on Melody's seatbelt.   The traffic in and around LA was overwhelming.  Made me thankful we live in Nebraska where the streets are wide and the traffic is only heavy in our rush 30 minutes. 

Advanced Bionics - Making The Magic Happen

Here are just a few of the great people who played a part in creating Lily's cochlear implants. The folks at Advanced Bionics were so gracious with their time and spoke candidly about the importance of their work on helping people hear better. They were as excited to meet Lily as we were to have her meet them. We can't thank them enough.

Our Trip to Advanced Bionics - Part 1

We have always wanted to visit Advanced Bionics since the moment we chose the company's Cochlear Implant for Lily.  In fact if we knew it was so easy to visit, we might have journeyed to California much earlier to take a tour, meet the people and  see where the magic happens.

We were in the area for Lily's Dad's work, so added a few days on to trek to Advanced Bionics which is located just North of Los Angeles.  AB has two locations, a factory and a headquarters building, which is soon to become one in a beautiful new facility down the street from their current headquarters. 

While we only requested a tour, we were invited to speak to the entire company about Lily's hearing journey.  AB feels it is important for every member of their company from factory workers to the CEO to hear the CI stories of their customers, both good and those who have had challenges.  With this aim, AB invites about 30 customers a year to speak and requires their staff to attend.

We were one of those customers to speak to the entire  staff in both locations.   It was truly an honor, and yet quite intimidating to talk to those inventing, improving and producing products that have allowed or will allow Lily to hear better. 

We saw it as a rare opportunity to directly impact those who will shape Lily's hearing journey through improved hardware and software.  We saw it as a opportunity to directly thank those who made Lily's implants.  (They pulled a half dozen people off the floor to meet with us, who in part made Lily's implants.)  We also saw it as a time to motivate and inspire the company by demonstrating Lily's success with acquiring listening and spoken language. 

I'd say we left our visit as "believers."  While we definitely identified things we thought they could do better, we drank the Kool-Aid and are so happy we chose AB for our partner in this hearing journey. They even told us and showed us some of the secret stuff they are working on and boy are we excited.

There is so much to report about our visit and vacation, we'll have to break it up in a number of blog posts.  As they say on TV.....Stay Tuned.   

AB On The Brain

So as we're going back over notes and resources from the past two years in preparation for our presentation at Advanced Bionics, Lily's Mom stumbled upon another great blog by a recent AB user and a post about why she chose AB. Good reading and a great summary of AB benefits.

Lily's Been Twittered or is it Tweeted

We were playing around with Twitter last night and discovered that Lily's Blog has been Tweeted by the Clarke School of New York.  Clarke School provides deaf and hard-of-hearing children with listening and spoken language skills and has five locations primarily on the east coast. Basically Twitter allows people to post in a mini mini blog about what they are doing.  For the Clarke School, it is an interesting use of technology to connect families and fans. 

Vivosonic - ABRs Without Sedation Or Anesthesia

One of the Google ads running on our site attracted my attention. It was an ad for the company Vivosonic that has developed a new ABR procedure that "enables recording clear responses without the risk or additional cost of sedation." It also allows the test to be administered in a variety of settings like schools, rather than a doctor's office. Here's a link to the product and a pretty good video outlining how it works.

When we took Lily in to the audiologist after her newborn hearing screening, we were told that she would need to be totally quiet and still to get accurate results. Because she was so young, we were able to test her by timing the doctor's appointment with her nursing and sleeping schedule so she slept through both ABRs without needing sedation. However, if she was any older or any more active that would not have been an option. Looks like now, parents may now have a better option. I'm not sure how prevalent this new technology is, but it's nice to see it becoming available. It's hard enough as a parent having to go through MRIs, CAT scans and CI surgery itself without having one more medical sedation.

Is anybody familiar with this product?

New Research on Cochlear Implant Failures

I came across this research abstract at COMD News website. The post highlighted new research published in the ORL - Journal for Oto-Rhino-Laryngolgy. The research looked to "present a failure analysis after cochlear implant revision surgery in a large series of children and adults and to assess the outcome and audiologic performance." 

The researchers looked at 56 device failures in a variety of children and adults, looking at multiple brands of devices as well. Here's how the failures were categorized; "The most frequent causes for revision were hard failures (58.9%), most commonly caused by traumatic impact (37.5%), especially in the pediatric population. Soft failures were less frequent (21.4%)." 

The good news:

"Surgical reimplantations, although challenging in some cases, were performed without complications and with an electrode insertion depth comparable to that at the time of the initial implantation in all patients. The average audiologic performance improved by 2.4 dB in pure-tone perception levels after reimplantation. Conclusion: The cochlear implant failure rates vary between children and adults as well as between different implant manufactures. However, cochlear reimplantation is safe with excellent and predictable results in audiologic performance."

Here's a link to the Research Abstract.

New Stem Cell Therapy May Lead To Treatment For Deafness

Interesting new article on Stem Cell Research from Science Daily (Mar. 23, 2009) and its future potential to treat hearing loss.  The following is a brief excerpt:

Deafness affects more than 250 million people worldwide. It typically involves the loss of sensory receptors, called hair cells, for their "tufts" of hair-like protrusions, and their associated neurons. The transplantation of stem cells that are capable of producing functional cell types might be a promising treatment for hearing impairment, but no human candidate cell type has been available to develop this technology.  A new study led by Dr. Marcelo N. Rivolta of the University of Sheffield has successfully isolated human auditory stem cells from fetal cochleae (the auditory portion of the inner ear) and found they had the capacity to differentiate into sensory hair cells and neurons.

LENA Developmental Snapshot

We found an interesting new Developmental Snapshot for children 2 to 36 months.  The LENA Foundation, maker of the digital recorder that counted our words and interactions, has now developed a 52-question parent survey that assesses both expressive and receptive language skills and provides an estimate of a child’s developmental age. 

In their promotion piece, LENA said, "In the summer of 2007, when the LENA Foundation first offered the assessment, more than 13,000 people used the service in a single two-month period."   Not sure what the fee was at that time, but now it is $19.95.  LENA is also now a not-for-profit, instead of a private company, and is dedicated to developing advanced technology for the early screening, diagnosis, research, and treatment of language delays and disorders in children and adults.

We haven't tried the Developmental Snapshot yet, but it certainly sounds like a useful tool.  Of course  how many developmental snapshots does one baby really need? 

Smart Guy Making CIs Better

Here is a link to a retired HP Engineer's page - citheory.com.  Mike Marzalek has a CI and has been using it to work on a next generation CI speech processing strategy. 

Specifically, he is looking at music and provides a Virtual Piano so people can determine which frequency regions are too loud or too soft and a different way to optimize CI performance. 

This innovation is fantastic to see and needs to be supported.  We need more of the world's best and brightest engineers, doctors and audiologists thinking about how to make CIs better.  I can't provide much help in this area, but I'm happy to blog about it.  Go Mike Go!!!

Coming To A Cochlear Implant Center Near You

We're always on the lookout for up and coming technologies that will make Lily's life easier with her cochlear implants. This often times means looking to Europe or Canada for the latest offerings from the cochlear implant manufacturers. Because of FDA regulations in the US, it often takes longer for these new offerings to make there way through the approval process and to the market. This can sometimes be frustrating - especially for some of these accessory offerings like new battery options or harness options that don't really impact the actual cochlear implant device or the sound processor. However, its nice to know they are looking out for our kids. 

One of the new devices we'll be interested in taking a look at is Advanced Bionics new off-the-ear battery options that will allow Lily to use a behind-the-ear Harmony processor, but not have the bulk of a big battery on each ear (see picture below). We've heard that the behind-the-ear Harmony offers a lot of advantages (like t-mic options, better positioning to take advantage of one's ear anatomy, and digital sound processing). For now, the body worn processor with the single magnet and microphone combo is really ideal for an active toddler, but we'll keep looking for better.

An Interesting Idea? Nutritional Supplements

As parents of kids with hearing impairments become "experts" in the field of speech pathology, they learn about various speech disorders like Apraxia.  I don't think Lily has Apraxia or any oral motor issues, but I stumbled across a new website offering nutritional supplements, when one mom introduced the idea as something to help with language development.  

I have no idea in the validity of the website NourishLifespeak, and frankly it seems like they could be  "Selling Snake Oil" (in this case fish oil), but it is a very interesting idea.  They present some initial research studies, but again, I don't know anything about this or if these studies are credible.  Check with your Doctor before taking anything.  Their idea is that certain nutrients play a key role in reducing inflammation and oxidation which appears to be a formidable issue in individuals with verbal, oral and motor Apraxia.  This is commonly seen in children on the Autism spectrum.

Food processing has changed so much in recent years.  I can't help but think certain disorders, in both adults and children, are linked to what we put in our body or don't put in our body.  Just something to think about.  Now I must go plant my organic garden. 

Always Check The Equipment

When Lily was running around getting ready for bed tonight, we noticed that her left ear processor unit would occasionally beep. This warning beep typically happens when the headpiece comes off or the battery on the speech processor gets unseated, but tonight it was intermittent and didn't appear to be a battery issue. 

Well after 10+ months of heavy usage from an active toddler we discovered that one of her headpiece cords finally gave out. It started to fray at the base where you plug the unit into the speech processor. Luckily we are very diligent about checking all of the equipment each night (and during the day for that matter). For a more detailed test you can check the cord by plugging headphones into the unit and seeing if there is any static when the cord moves. We could tell right away that the cord was fried and quickly found the place of the problem. Luckily, we have a couple of spare cords which we swapped out and got Lily back on the air. 

We've heard that the milage varies for how often people need to replace cords (I'd image it would be similar to wearing your iPod headphones continuously for months - not sure how long they'd last either). Since replacement cords are $39.95 we treat them as gingerly as possible and Lily's good in that she doesn't pull or play with the cords. We've heard stories about parents needing to replace equipment monthly because the kid chews, pulls, or damages the cord on a regular basis. 

In the end it was a good reminder to check the equipment and keep some spares handy. Crisis averted.

OtoChip - Advances in Genetic Testing

For families of kids with a hearing loss, the "why" seems to be a common question.  Why did this happen?  What did I do?  Why is the why so hard to figure out?   I've heard many stories about Moms blaming themselves for "doing something" when they were pregnant to cause it.  Most often these worries are totally unfounded and just come with the guilt that Moms and Dads feel about having/causing a child to have a special need.  

Research shows that cause of hearing loss, for around 50 percent of children, is genetically linked.  For many families, genetic testing has been expensive and difficult to obtain.   It is often not covered by insurance, because a genetic test doesn't "do anything" for the person's health.  This of course doesn't take into account the piece of mind of knowing the "why" question or understanding if there are any other issues that are genetically linked to the disability or the implications/chances of having more children with this disability, etc.  For example, for children with Usher's syndrome, vision loss is connected with hearing loss.  By detecting the vision loss early, families can plan, understand and implement any new sciences that prevent the vision loss. 

One of the more common genetic tests for hearing loss tests the gene defect in GJB2/Connexin 26/30.  About 50 percent of hearing loss is linked to this gene. 

Genetic testing is also not right for everyone.  There are all kinds of issues to consider like what do you do with the information and how can your child be discriminated against with a known genetic issue.  There is a new federal law preventing discrimination from happening, but who can predict the future?  Typically genetic results are provided to you by a Doctor or genetic counselor and these very important issues are reviewed. 

But now for the really exciting news.  Harvard University, is coming out with a genechip that is able to test 8 genes, at the same time, that are all related to hearing loss.  It is called the OtoChip.  This, in theory, is supposed to bring down the cost considerably and speed up the time it takes to process the test.  It will also be testing for gene mutations that are less common and might not be ordered by your doctor. 

Watch the Harvard website for more information. The clinical test will be able to be ordered by a physician.

The Social Well-being of Children with CIs

Interesting new research study titled Factors that affect the social well-being of children with Cochlear Implants. 

Summary:  The aim of the study was to identify factors associated with the level of social well-being for cochlear implanted children and to estimate effect-related odds ratios for the children's well-being.  Another aim was to analyze associations between speech and language level and the level of social well-being.  Data relate to 167 children with cochlear implants.  The analyzes showed that the communication mode at home was the most highly associated factor.  A statistically significant association was found between the level of social well-being and speech understanding, speech production and vocabulary. Children who were exposed to a spoken language had considerably better odds of having a high level of social well-being compared to children with a mixture of spoken language and sign support of sign language. 

The study is posted on Cochlearimplantonline.com, a blog run by Rachel, a 20-something college student who was one of the first 200 children to have a CI nearly 18 years ago.  She now has bilateral CIs, travels the world, speaks English and French, and is an artist in college studying photography.  She and her Mom are advocates for the Auditory Verbal (AV) approach to learning language for kids with a hearing impairment. 

Quality of LIfe for Children with CIs

Interesting new article discussing Quality of Life for Children With Cochlear Implants: Perceived Benefits and Problems and the Perception of Single Words and Emotional Sounds which appeared in the Journal of Speech, Language, and Hearing Research, February 2009

A few excerpts:

Study results reported that the children studied reported significant improvement in quality of life because of their cochlear implants, and they also reported low levels of concern about typical problems associated with wearing an implant.

The children's perceived quality of life did not significantly predict speech perception performance at the single word level. In contrast, increased quality of life predicted better performance on the emotion identification task. Age at first use of amplification predicted perceived quality of life.

The findings regarding age reinforce the importance of early detection and intervention for children's positive quality of life with cochlear implants later in childhood.

Watch a CI Surgery Online

Here is an unbelievable opportunity to Watch a CI surgery online. 

On Tuesday, February 24th at 3pm CST, watch a Sequential Bilateral Cochlear Implant performed from University Hospitals Case Medical Center Rainbow Babies & Children's Hospital in Cleveland.  Cliff Megerian, MD, The Richard and Patricia Pogue Chair in Auditory Surgery and Hearing Sciences at University Hospitals Case Medical Center Implants will perform the procedure and provide a detailed narration. Audiologist Gail Murray PhD., Clinical Director of the Cochlear Implant Program, will supply additional commentary. The physicians will be available during the webcast to answer any email questions from viewers

CIs Help Deaf Cat Brains Unscramble

Interesting new article from the New Scientist about Cochlear Implants and cats.

Researchers found that brain activity that is "scrambled" in deaf cats develops normally if they are fitted with a cochlear implant shortly after birth. The finding may explain how deaf children given implants as babies can learn to speak almost as well as hearing children.

The Future Is Bright - Light May Help Future Cochlear Implants

In other research news, The Times of India published a story today about Northwestern researchers utilizing infrared light to stimulate neurons in the inner ear as precisely as sound waves. The discovery could lead to better cochlear implants in the future. 

Using guinea pigs as, well, guinea pigs, they have been able to precisely stimulate cells in a manner not possible using electrical stimulation methods used in today's cochlear implants. Here's an excerpt from the article:

"Richter said that electrical stimulation of the inner ear by a cochlear implant produces blurred maps, but the light stimulation produced maps that were as sharp as those produced by sound in hearing guinea pigs. 

While it's a mystery how light stimulates the neurons, as they do not contain light-sensitive proteins, Richter hypothesizes the heat that accompanies the light may play a role, and his team is now investigating the long-term effects of heating neurons.

The findings were presented at the Medical Bionics conference in Lorne, in the Australian state of Victoria, earlier this week."

While these advances are likely years away from being implemented, it's encouraging to know that hard work continues and that Lily may have even more options when she gets older.

Glad We Got A Stokke

Unlike our current stock market investments, the investment in our Stokke stroller is looking better and better. Today's CNN points to a new study published by the Dundee University's School of Psychology, which states that babies in strollers should face their parents or risk long-term development problems in their children. The study found that "children not facing the person pushing them were significantly less likely to talk, laugh and interact with their parents." By turning the buggy around, parents' rates of talking doubled. While I'd take the findings with a big grain of salt, it does validate our experiences with our "parent-facing" contraption.

Live Online Mapping

Today Lily had her six month mapping appointment.  She was hearing between 25-30 dbs and preferred listening for voices instead of what we would call "white noise" sounds.  Our Audiologist Jeff said the ideal listening range is between 20-30 dbs.  Lower than that can introduce a lot of noise which may interfere with speech perception. 

With Advanced Bionics, Lily has a dynamic range of 80 dbs so she hears sounds from 20-100 dbs.  Her maps were turned up just a little bit in the high frequencies, but our Audiologist believes they are close to ideal.

Lily's appointment was also broadcast online so friends and family could watch, with a password of course.  Boystown is experimenting with online distance mapping, which will be a great service for those people living in rural areas. 

The photo is of Lily on camera/online in the sound booth, identifying which way a soft sound is coming from.  Our Audiologist says things like, "Lily Lily, ba ba ba ba, Uh-oh Hi Lily, Over here," while Lily is being distracted with toys by another Audiologist. 

The Meaning Of Tech

When Best Buy contacted us about how technology was impacting parents and children’s lives, we felt obliged to respond. Lily's mom and I often talk about what life would be like if we weren’t living in the technology-enabled times we live in today. From the miracle of our daughter’s bionic ears to the myriad of gadgets we use everyday to share our journey with others, technology has made our lives richer and more meaningful. 

When we first heard of Lily’s hearing loss our laptops and the Internet gave us the link to the information and resources we needed to understand the situation and take action to make our daughter’s life better. Within minutes we had found details on cochlear implants, hearing loss, and educational options available.

More than that, it gave us the link to a community around the world to laugh, cry, and learn with. Over the past year we have met lifetime friends and have used our  laptops, digital cameras, iPods, and cell phones to stay connected, share our journey, and help others along the way . The riches of technology have been profound in our lives and the future is bright because of it.

Kih and New Programming Technology

Lily is on a roll.  It seems the Kih sound has arrived as well.  Such as Kih Kih Kick the ball.  No problem she found the ball and kicked it.  Other words she learned today or let on that she knew included wheel (as in the wheels on the bus go round and round) and xylophone. 

In other more technical news, a new company to watch is Audigence.  They have created software that helps improve the programing of both hearing aids and CIs.  It focuses on an automated approach to fine-tune digital hearing devices to a user’s needs. The automated evaluation is based on the most common features of speech that affect device users. The patient hears a nonsense word then repeats the sound. Next, an optimization algorithm processes the patient’s response and selects the next set of parameters to modify. This process continues until the patient reaches an optimum state of hearing.

The president of the company is a CI user and has partnered with the University of Florida to bring this idea to market.  They are currently negotiating with the CI manufacturers and have clinical trials going on with an undisclosed hearing aid company.

There are so many exciting advances just waiting in the wings to help Lily hear even better.  Technology is making all the difference.  When Lily grows up, I am sure she will be either a Scientist or a Techie like her Dad. 

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.

AG Bell Presentation Materials Now Available

Susan, Lily and I had a fantastic time at the AG Bell Conference in Milwaukee this past June. Fabulous information, insights, and inspiration. For those not able to make it, AG Bell has now made the presentation materials available online. I'd highly encourage you to browse and learn from these. Great research and great info from professionals from around the world.

Also, while not a requirement to download, consider becoming an AG Bell member so resources like these can continue to be available to parents and their families. Happy surfing.

"It's A Stroller From the Future!"

That's just one of the comments we heard recently on a daily outing with Lily's Stokke Xplory stroller. While I can't vouch for when this amazing contraption was developed, I can vouch for it being the best stroller we could have possibly received long before we found out about Lily's hearing impairment. The stroller is so perfect because every walk has allowed Susan and I to be in Lily's face, making eye-contact, talking, and communicating. Plus, how many times can you go out and meet new people simply by walking down the street.