We have been busy working with Alexander’s newly activated ear. Being apart of his rehabilitation process I am continually reminded how amazing the brain is. Just the fact that the brain processes billions of pieces of information without us asking it too makes me grateful for the one I have. With Alexander’s brain, I feel as though we are spoon feeding it, shoveling down jars of information it has not yet experienced.
I’ve often imagined myself in therapy having a conversation directly with Alexander’s brain. It might go something like this, “Brain, when I say “Ha, Ha, Ha”, I am referring to a jack-o-lantern. Do you see why? It is really a pumpkin, but there is a face carved in it and it looks as though it is laughing…”
With a cochlear implant, Alexander must learn to process sound and develop meaningful use of acoustic input. Some of the cognitive processes that result in meaningful use of sound are as follows: attention to sound through time, the ability to judge two sounds as same or different, auditory imagery and memory for auditory images, memory span for auditory events, maintenance of the sound sequences, associating sounds with their referents, use of sound for linguistic purposes and retrieval of sound images for linguistic expression (Daniel, et. al., 1999, Pisoni and Geers, 1998).
Since he processes the sound well we have focused on mouth time which include oral sensory-motor exercises. His therapist at chattering children has given me some great ideas.
ORAL SENSORY-MOTOR EXERCISES
• Imitate mouth postures (open, closed; tongue in, out)
• Use toothbrush to stimulate cheeks, lips, tongue
• Explore frozen metal spoons on cheeks and inside mouth
• Rub lotion on cheeks
• Rub lemonade or cherry powder on lips
• Imitate tongue movements (elevate, depress, lateralize)
• Practice controlled airflow by blowing feathers, cotton balls, tissue paper
• Lick lollipops
• Imitate sequence of oral positions (“ooee, ooee”)
• Recall 2 or more speech sounds in order (“mm-ah-sh”)
• Hold articulatory position for a few seconds
• Sequence back (“k”) and front (“t”) sounds
Symbol Play is another helpful listening tool. The goal is for Alexander to be familiar with common sounds and offer them a systematic and predictable way to organize the sounds. The /oo/ and /m/ sound are difficult to distinguish, so I have worked specifically with him listening for the difference between the two.
SYMBOL SOUND EXAMPLE
A few months ago Alexander’s amazing therapist helped him make a family placemat. On one side they cut out our printed faces then glued and laminated them to the placemat. On the other side they glued foods that he was familiar with. As a result of this his language jumped. He is able to speak and sign all of his family members and the foods he regularly eats.