A Little Update

In the next few weeks, Audrena will be evaluated as part of the transition from Birth to 3 to the school district for services. I am interested to see what the evaluation brings. She is putting 3-4 words together. However, I feel like her vocabulary is still lagging behind a bit, and she is still leaving out the beginning and ending consonants more often than not. For example, one time she might pronounce "puppies" crystal clear, and the next time it might be "uppies." "On" and "off" both lack the endings more times than not. We are working on it, and we've seen some improvement. Our current SLP through Birth to 3 has done a great job with Audrena, and we are seeing some really nice progress.

We have been using the Naida processors nearly exclusively now. It's new technology, and there have been some bugs. We kept losing mic protectors from one of her processors almost daily, and before long we noticed that the mic just wasn't crisp and clear like the other. So we switched back to the Neptunes and sent the Naida in for replacement. The replacement had issues of its own, giving random red lights or orange lights. The orange light would ordinarily mean the battery was low, but we found that it didn't matter what battery we put in, it would still show that the battery was low. So again we had it replaced. Audrena is hard on cords, so we have had to replace those a few times as well. We went through that with the Neptune cords, too. She is just rough with them. That's why it is SO important to be very conscious of your child's cochlear implant equipment. We constantly monitor things because if she is not getting good quality sound, she can't catch up as quickly with her speech and language.

The Naida processors can use the T-mic 2. We have heard they are generally not recommended for small children because there is no good way to monitor whether they are working. However, our Audiologist wanted us to use the T-mic 2 because it delivers the sound into the opening of the ear, where it naturally would be heard. Also, studies show better outcomes with T-mic usage than without. As closely as we monitor Audrena's equipment, that concerned us because we couldn't really check the T-mic's function, yet we wanted her to have the best possible listening opportunity. Dr. M. explained that she would be programming it to use 50% T-mic and 50% processor mic. That would really function as a 100%/100% arrangement because if the T-mic were to fail, Audrena would still get the sound through the processor mic. She could monitor the T-mic via booth testing outcomes by switching off the processor mic during testing and then testing again with it on. So we agreed to try it. We also think we have figured out on our own how to test the T-mic with it being programmed this way. When we do listening checks, we simply tightly cover the processor mic with our fingertip, and we can hear the sound only through the T-mic. We know the sound is coming into the T-mic because if you get close enough and the air from your mouth hits the mic, you can hear it just like wind. I'm not sure if that's in any way reliable, but it seems to be working for us.

We feel like Audrena is getting better sound with the Naidas. It may or may not be coincidence, but she has had a speech & language explosion since we have started using them. One thing we haven't quite figured out is how to keep them on without using toupe tape. Her glasses get in the way, so they don't sit perfectly on her ear. Tape seems to be the only solution, and it works well, although we sort of hate it. Her hair seems to get stuck in it no matter how careful we are. If anyone has a solution, I would love to hear it!

Our Naida review.

We have been waiting for the FDA to approve the new Advanced Bionics Naida processor since Audrena had her second CI surgery in May. Approval came a few weeks ago, and Audrena had her processors programmed about a week ago.

What we love:

• The smaller size. We felt like the Harmony was just too big for a kid. Audrena is 2 1/2, and the Naida fits her ear nicely with the 110 battery. We also got the 170 battery, and it hangs just slightly below her ear, so it's a reasonable size as well.
• The shorter cord. We really love the Neptunes, and they have served Audrena well, but the shorter cord is so much easier for her when the headpiece gets knocked off. She can reach it better to put the headpiece back on.
• The program button is easily accessible. We never kept the Neptune Connect on her Neptunes. Instead, we used the cap so that the settings wouldn't be accidentally bumped. The program button on the Naida is easily accessible, but it doesn't really seem to be easily bumped, either. It makes changing the program to Clearvoice so easy when we need it!

What we don't love:

• The Naida, like the Harmony, does not have an external audible beep when the battery is low, or when the headpiece gets knocked off. This is a must for small kids! It was so helpful to us when Audrena was smaller and her Neptune headpieces would fall off because we knew immediately. (She couldn't put them back on by herself when she was younger. Fortunately for us, now Audrena is getting pretty good at putting the headpiece back on when it falls off.) I realize that mostly adults and older, more self-sufficient children will use the Naida. But they did make it smaller, and it fits younger children better now, so why not build it with the capability of having that alarm?
• The indicator light is hidden by Audrena's hair. Going back to my rant about the lack of an audible alarm, if they didn't give the Naida an external beep, then it would be nice to have the indicator light in the front like *gasp* Cochlear so that it's more visible to parents. I know, I know...it's more discreet this way.
• We're back to using toupee tape to hold her processor in place like we did with her hearing aids.

Overall, we are very pleased with the Naida! Audrena wears it without complaint. It frees her up from wearing the special pocket cami under her shirt every day. We are excited to have the behind-the-ear option for her. The t-mic technology (which places sound input in the most natural place, in the ear opening) should improve her speech understanding in noise. The Naida was definitely worth the wait!

This was taken just after her programming appointment. She does not have the t-mic on the processor in this photo.