A+ (...and Incomplete)

James's developmental therapist (accompanied by his Early Intervention coordinator) came for a session on Friday, and she was very pleased with his progress -- she had been working with him on holding a toy in each hand and banging them together. During the first session, he would mostly just drop the first toy to grab the second toy, but now, he's holding two toys and banging them with ease. She was impressed with how quickly he got the hang of it! Now the next step is clapping. (There's always a next step!)

James's auditory-verbal therapist also came on Friday, and she too was happy with all the progress he'd made since she started working with him. Of course, a lot of that progress was simply growing into different developmental stages, but still, he's doing a lot of things now that he wasn't doing in December when we first saw her. So, A+ for James!

This morning we went for a hearing test that was intended to assess cortical activity in response to sound (essentially, looking for brainwave activity in a different part of the brain than the previous hearing test, which measured activity in the brainstem). This test required that the baby be awake but quiet. So...that didn't work out so well. James can do awake and quiet, but he was not at all amused with people putting things in his ears (little microphones to transmit the sounds) and sticking electrodes on his head. They were able to get some measurements from the right ear (which indicated a response at 75 db), but he was moving too much for them to get measurements from the left ear. So, the fact that there was some cortical response is a good thing, but other than that it didn't give us too much new information. He's scheduled for the behavioral test next Monday, and the audiologist thinks that he's ready for the test and that it should give us some good information. However, she warned us that sometimes with babies it takes multiple sessions to actually get a complete picture of their hearing.

The audiologist mentioned again that there are two issues with auditory neuropathy -- the level of hearing (detecting sounds, which they can assess with the behavioral test and help address with hearing aids) and whether the sounds are too garbled to permit speech perception (which is hard to diagnose until the age when kids start developing more language skills). For the second case, cochlear implants usually seem to help. And although she was saying that James has a lot of good things going for him (excellent attention skills, educated parents, expert medical facilities, etc.), it was still depressing to have all that scary uncertainty out there. (I think I surprised her a bit by starting to cry when she was actually telling us all the encouraging things about James's case! "What did I say?" she asked. "It's nothing you said, it's just the situation.") So, we'll see; at this point all we can do is to keep on with making sure he's exposed to lots of language, and keep hoping for the best.