The Speech Banana
Wonderboy’s hearing loss came as a shock to us. Sure, we knew he’d failed the newborn hearing test. Three times. But those rounds of testing were administered in the NICU where there is always a humming and beeping of background noise, and the tech had told us that ambient noise could skew the test results. We had more pressing things to worry about: his (minor) heart defect; his recovery from omphalocele repair surgery; the genetic testing necessary to determine whether he had a potentially serious chromosomal syndrome; the fact that he was going home on oxygen. At least he was going home, and we tucked the hearing-test business to the back of our minds and focused on the immediate business of keeping him alive.
Every month the health department sent us a letter reminding us to have the hearing screen repeated. Sure thing, we said, just as soon as things slow down a bit. We were constantly having to take him to some specialist or another. The chromosome study came back negative: his medical issues were not due to a genetic syndrome. He was just one of those babies for whom something goes slightly awry early on in utero, resulting in a number of physical abnormalities down the line. An MRI had shown brain abnormality, but what its effects would be, no one could say: time will tell, they said. (They are still saying that.) He had extremely high muscle tone (hypertonia) and could not stretch out his arms and legs very far. His fists were tightly clenched. He started physical therapy at four months of age. He required emergency surgery to repair a double hernia with incarcerated bowel. The cardiologist was still keeping a close eye on his heart. The hearing test would just have to wait.
Besides, we told ourselves, we know he isn’t deaf. He startled to loud noises. Of all the things there were to worry about, we really didn’t think hearing loss was one of them.
But by six months, we had suspicions. He wasn’t babbling. He didn’t turn his head at the sound of my voice, lighting up with recognition before even seeing me, as our other children had. We took him back for another hearing screen.
The audiologist said something about a "mild" hearing loss, and I thought that didn’t sound too bad. "Oh, no," she told me, hastening to set me straight. "It isn’t like a ‘mild’ fever. ANY hearing loss is serious. Most speech sounds fall at the bottom of the scale, so if you have any hearing loss at all, you’re going to have trouble with speech."
As it turned out, Wonderboy’s loss was a bit more serious than the audiologist first thought. Further testing placed him at the "moderate" level on the scale of mild—moderate—severe—profound. Unaided, Wonderboy’s ears can’t detect sounds softer than 50 decibels. Most speech sounds fall in the 20-decibel-or-lower range. Our little guy can hear vowel sounds, the louder middles of words, but few of the consonants that shape sound into speech. For Wonderboy, people probably sound a lot like Charlie Brown’s teacher. Wah-WAH-wah-wah-waahh-wah. We learned about the speech banana: the area on a graph that shows where speech sounds fall in the decibel and frequency ranges. Wonderboy can’t hear sounds above the horizontal 50 line on that chart.
(More or less. He has a sloping loss which is slightly better at the lower frequencies.)
By his first birthday he was wearing hearing aids, and what a huge difference we could see! Aided, he tests around the 20-decibel range. He hears and understands a great deal of what we say. He is two and a half years old now, and he is finally beginning to add some consonant sounds to his verbal speech. Daddy used to be "Ah-ee" and now he is "Gaggy." (This cracks me up. You can get a lot of mileage out of calling your husband Gag.) Grandpa is Amp-Ha. Wonderboy’s baby sister is "Gay-gee." As you can see, he doesn’t have a B sound yet. His M is perfect, though; I have been Mommy, clear as a bell, for over a year.
But Wonderboy’s verbal speech is only part of the picture. His actual vocabulary is enormous, thanks to sign language. He uses a combination of sign and speech; we all do. Although it appears he will be primarily a verbal person as he gets older, sign language will always be an important second language for him. Hearing aids, incredible as the technology is nowadays, don’t do you any good at the swimming pool. Just for instance.
Hard of hearing. It used to be a phrase that conjured up in my mind the image of a grizzled old man with an ear trumpet. What? What’d ye say? Speak up, lad! (Apparently he is a grizzled old Scotsman.) Now it applies to my son. Words pop up on a TV screen, "closed captioned for the deaf and hard of hearing," and I’ll give a little mental jump: Oh! That means Wonderboy!
Watching our children learn to speak is one of the great delights of parenthood. We mothers tend to collect their funny pronunciations, their experimentation with the meanings of words. This time around, my joy has been doubled, for I get to see communication unfold in two languages. His funny little toddler signs are just as endearing as any "helidopter" or "oapymeal" ever uttered by a two-year-old. ("Oapymeal" was one of Jane’s. It meant oatmeal. I served it often just to hear her say it.)
I put some links in my sidebar for American Sign Language resources. I can’t say enough about the wonders and benefits of ASL, not just for deaf and hard of hearing children, but for all babies and toddlers, especially those with any type of speech delay. ASL is a beautiful, nuanced language, a visual poetry. I count myself privileged to have been put in the way of learning it. Jane is determined to certify as an interpreter someday, and I have to admit I’m a little jealous. I wish I’d learned at her age.
Wonderboy makes a fist and touches a knuckle to his cheek, wiggling the hand. "Ah-hul!" he shouts. Apple, in two languages. The speech banana? We’ll get there, one way or another.
*Audiogram image courtesy of GoHear.org.
Tags: special needs children, American Sign Language, baby sign language, hard of hearing
Thanks for this story, M. My oldest kidlet had speech delays (not hearing related, just his mysterious nature) and even our homemade baby signs helped ease the frustration gap between his spoken and receptive language. I wish that we had learned ASL.
Wonderboy is so lucky to have such a dedicated, loving family.
On June 5, 2006 at 5:38 am
My niece doesn’t have speech delays or a hearing problem is still has busy hands due to the ASL she is learning as a toddler. It is fun to watch her and learn with her.
On June 5, 2006 at 6:42 am
We are loving Signing Time here and everyone is learning so much. I’m tempted to start signing much more with my everyday speech because my dd doesn’t like to wear her one aid (it’s a unilateral moderate loss) – I see she is straining to hear and know she would benefit from more visual feedback (I need to move my mouth more when I speak too! I’m a mumbler, lol) Lissa – are you learning alongside your children and just signing as you can, or are you the “expert” in the family? How are you teaching yourself? Just curious! 🙂
On June 5, 2006 at 1:33 pm
My son has language issues, unrelated to hearing problems. When he was a toddler we taught him a few signs, which he subsequently taught to his little sister. We haven’t used them in years–wonder if he still remembers them?
On June 6, 2006 at 7:50 pm
This was very informative. I just showed the “speech banana” to my husband and he also thought it very helpful. Our 2 yo has a big speech delay. Hearing tests so far are “inconclusive”, but our SLP thinks taht he has a hearing loss, and can’t hear higher frequencies well. We have an ABR scheduled to find out one way or the other. The speech banana helped explain what the SLP has been saying. Thank you.
On June 17, 2006 at 10:48 am
Jim Bowker says:
I actually stumbled on this while looking for a graphic of the speech banana. Our daughter is 2 1/2 now and started wearing hearing aids at 4 months. Except when she’s cranky, she leaves them in from morning until night, and now is old enough to realize that she misses out on some things if she doesn’t have them in.
Your comment about being startled by loud noises brought me right back to the day when we were told she failed her hearing screening. In hindsight, she was startled by the door slamming becuase it was one of the few sounds she did hear clearly. (Her threshold of hearing is also around 50 db and is sloping)
I hope your little miracle is doing well and bringing you as much joy as our daughter is to us.
On a side note, the signing time videos are the only TV that our little one gets to watch, and she loves them. I was surprised to see that other kids visiting our house also enjoyed signing time much more than other kids videos. As her speech progresses, she uses signs less and less now, but they were definitely a vital part of her early intervention.
On February 21, 2007 at 6:14 am