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>Mercy and iLs

April 21, 2011

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Mercy’s choice of free play at the end of her first iLs session

As I shared at the end of my last post on auditory processing, I was surprised, reading Teri Bellis’s book, When the Brain Can’t Hear, to find internal bells going off about possible auditory processing deficits in Mercy and Joy –more so than Hope.

Mercy so far has played only a supporting role in this blog story because she is just so…. Well, I will say it out loud: easy to parent. Which doesn’t give me much to write about. But the truth is: God knew ahead of time we would need one “easy” in our repertoire. Mercy is a great mercy in our family life.

We were waiting in our agency’s Waiting International Child program when we received Mercy’s referral. Some unusual circumstances led to our match being made in Korea and we didn’t even need to see her referral to feel sure that she had been hand-picked for us, then labeled WIC to technically match her with our family. (All speculation of course.) The important thing for this post is: there is nothing in her background to make her at known risk for anything.

Mercy has excelled at just about everything she has tried, including her first standardized tests for home school last fall. One month into first grade, she tested at a third to fifth grade level on every test and sub test –with one exception. She scored slightly below average for grade level on a sub test that required her to select the beginning sound of each word in a list. Not a dismal score since she was still within the range for typical first graders. But it was a 49 point discrepancy from her lowest score on any other measure.

I was surprised (because I had not guessed that), but also not surprised (because I have lived with her for seven years). I recently rediscovered a list of some of her speech quirks at age two, like “The kitty tickled him with my back,” when I thought she mean to tell me, “The kitty tickled my back with his tail.”

Or, “Hope is my brother.” “Honey, Hope is your sister,” I corrected. “Yes. Faith is my brother, too.”

Mercy mixed up other opposites  like hello/goodbye; hot/cold; happy/sad. And I remember thinking how sincere she was. She made no effort to correct herself. Like she had no idea she had made any mistake. But I chalked it up to her precocious ability to speak. She was talking in short paragraphs at an age when many of her friends were still majoring in one or two word phrases like,”More juice!” and “Night-night!”

She seemed to outgrow many of these speech quirks as she grew older, as I expected she would. Mercy’s odd intonation lingered –a slightly muffled quality like she has a chronic sinus infection (even though she doesn’t; allergies are under control, too). But everyone understands her and no one has raised any concerns that her voice sounds a bit off. It is just her. So much so that I have found her few remaining quirks endearing. Like until Joy’s surgery, it had been a while since the word “hospital” was routinely afloat in the family. Recently, when the word came up again, it made me nostalgic about Mercy’s preschool years to hear her still pronounce “hospital” as “hostable.”

As an introverted toddler, when taking  her social cues from the environment, Mercy didn’t copy audible cues quite right. For a few years, her demeanor at any cousin’s birthday was family entertainment. The other kids would be party-happy, but when Mercy copied them, her laughter came out almost manic. When they were sad to leave their fun, Mercy moped like Eeyore.

It all came together reading Bellis’s book: could Mercy’s quirks reflect what the world sounds like to her?

Solely based on the standardized test finding last fall, I had already decided that since we would be buying an iLs system for Hope, we would also use it with Mercy before next fall’s standardized tests and see if it helped pull up her ability to correctly identify the first sound in a word. But after reading Bellis, I asked the OT who will oversee our iLs program (which is done at home) to give Mercy a formal auditory discrimination pre-test.

Besides the iLs pitch discrimination test, she administered the SCAN. Mercy wore headphones, Against background noise for competition, her ears heard words she needed to repeat. The therapist wrote down what Mercy said. I haven’t seen the scored test yet, but from what the therapist showed me, Mercy had a hard time discriminating individual words. Many of the words she repeated back (some of which she could not hear at all) were distorted fragments. Like when the word was “find,” Mercy echoed “ind”–not just dropping the “f,” but also morphing the vowel sound into the first syllable in “Indian.” She was better able to echo back whole sentences –because, the therapist explained, the collection of words in the sentence contextualize each other and help her decode a message that makes sense.

The other significant finding is that Mercy is much better at discriminating sounds that go in through her right ear than her left. That also made sense because while her gross and fine motor skills have always been on target, she is clumsy at tasks that require bilateral coordination, like cutting with a knife and fork, and handling balls. The right and left hemispheres of her brain do not communicate very well.

So I laid awake in bed last night (listening to Joy reciting  “Big Pig on a Dig” and “Barn Cat” at midnight) wondering: How long would Mercy have flown under the radar in a bricks-and-mortar school like she did in private-school Kindergarten? An “A” student with model behavior doesn’t attract attention. Would I have put it together if I didn’t spend all day every day with my daughter? When would I fit in the hour a day of auditory integration therapy? After she came home from school and was worn out from the mental effort of hearing her teacher’s instructions over the classroom din?

And what about how hard she has to work to make sense out of what she hears? Might that explain the vaguely anxious, over-eager to please trait that has been part of her personality since the day we met her?

So many of these questions don’t have answers. But auditory integration therapy like iLs may be even more crucial for Mercy than Hope. So Mercy started iLs today, too. And with several baseline tests behind each child to compare to post-tests, we won’t have to rely on my impression of whether iLs helped them or not.

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