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Audiogram / SSD child


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My daughter is six with SSD - implanted at age 5 and activated for 18 months.  We have been doing booth tests/audiogram/speech perception testing about every 3-6 months since activation. My question is - I have noticed her audiogram will fluctuate quite a bit from visit to visit.  Our last visit in March, she was within normal hearing for all frequencies - 10-20 dB.  We did a mapping and returned this week to do a check, and I had noticed on AngelSounds she was missing n, f, d, b, and g sounds or mixing them up such as "bud" instead of "bug", etc.  We put her in the booth and now her audiogram is 15-25 in all frequencies - the lowest at 500, 2k and 4k.  We did a mapping to turn her low frequencies up.  I guess I'm curious if this is normal.  We are supposed to only go 6-12 months now, but I find this too long when she fluctuates so much.  Her audiologist also says her speech perception isn't what she hoped it would be.  Her best speech perception was early after activation at 6 months.  Is there something we should be doing to help her?  Appreciate any input.  She will start 1st grade and we are purchasing the Roger Touchscreen for her classroom.  A little paranoid with spelling tests this year and getting words confused.  I have to remember that during the audiogram they test just her CI - so doesn't account for her good ear as well.

We are extremely thankful for this technology as she was profound before!  Just want to make sure we are doing everything possible to help her hear her best, since we know she can hear better through the implant as witnessed with her audiogram 3 months ago.

Thank you!

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Wishing your daughter the best!


Booth testing is very helpful for our audiologists but just as important are the phoneme errors you are reporting.  Great job keeping track of those errors and reporting them to her audiologist!  Monitoring those errors will let you know when a new MAP may be needed.  I use the IOWA phoneme test and if I am consistently getting the same phonemes wrong, I know I need a tweak to my MAP.  I will tag you in the post about IOWA.

Roger Touchscreen is a fabulous mic for school.

Since your daughter is SSD, you can record doing the IOWA test and then deliver that audio only to the CI side.  Maybe record the IOWa test more than once, so she doesn’t memorize the sequence!


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@Julie72 First, I would like to say that you’re doing a fantastic job for your daughter! I wish that when I was at that age that my parents would have put in the same level of effort and care with my SSD.

So with that said, here’s a little background on myself as I was in a very similar situation as your daughter. I was single-sided deaf (left ear) with normal hearing in my right ear (though even at that age, at the highest 6-8k Hz frequencies I was still at a mild loss in that right ‘normal’ ear; 100% speech discrimination though). That was about 40yrs ago, so given how poor my left ear was we just did nothing with it (CI’s weren’t as readily adopted then). I went thru my entire secondary education (not to mention college and the beginning decades of a professional career) on one ear alone, and to be honest, quite successfully at that. I bring this up NOT to talk about myself, but to hopefully let you know that you are not alone in this kind of situation and that simply by aiding her deaf ear (to any extent) that it’s likely going to do wonders given her other normal ear. She’s young and with another good ear her brain (and neural plasticity) is very likely to synthesize the sounds and information she hears quite well. And if it’s possible for someone like me to be successful with one ear alone, imagine the possibilities with a little help to make it binaural, even if it’s not absolutely perfect on that side. 

So keep up the good work and definitely continue monitoring her hearing diligently as she progresses, but at the same time try not to give yourself too hard of a time with the variance (that is bound to happen) and/or stress yourself out too much with some of the weaknesses on that side. And feel free to reach out to me if you have any other questions about my experience and I’ll try my best to lend a helping hand. 

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On 6/25/2020 at 12:12 PM, JosephG said:

Thank you both for your replies.  I will definitely try the IOWa test.  Thank you for sharing the link.  @JosephG also thank you as an adult from her perspective.  I am glad to hear that you were successful, etc.  She is very smart and I do not expect this to hold her back, but I have the parental fears that she will get "lost".  I appreciate the kind words.  @Mary Beth


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