BCBSGA HMO Plan @jym626
If your mom still works in the school system, she should have good coverage.
@jym626 yep she works for Gwinnett County Schools…
Would have had more options with PPO than HMO, but it is what it is.
My kid was covered for the APD eval with a BCBS POS plan which required pre-authorization.
NP evals were trickier. Medical issues like a history of head injury can facilitate authorization. Having been burned, I would recommend never going into an np way without verified authorization, no matter what any insurance rep or np says.
Many insurers will not provide a preauthorization, and even with one, many insurers still won’t pay. Cigna recently got successfully sued for this smarmy practice. Its very frustrating to the providers, and the insurance companies, who are happy to find reasons to deny a claim, will make it look like its the provider’s fault, which it typically isn’t. That said, sometimes the patient calls the insurance company and is not familiar with what they should or should not say, and it muddies the waters further.
My 28 yr old son with ASD had auditory integration training (now called auditory processing disorder) 20 years ago. We were grasping at any therapy to help him, but this ended up being amazing! He had a baseline test with an audiologist and then we found 2 therapists in the midwest who traveled a few times a year to our state. His audiogram looked like it came from 2 different people as his ears did not hear evenly, plus he tested deaf at the outer ear level and highly sensitive at the inner year. He did not sleep well and his speech was fair. He could hear a pop can open in another room, but often appeared deaf in a noisy room.
After 10 days of intensive training, he was sleeping through 5 of 7 nights (usually it was one at most), his conversation skills improved, and he was not bothered by background noise. It was like the filters had been reset to normal. We told no one at his school we had done this, but after the first day back in the fall, his teachers called to ask what had changed over the summer as he was a different kid. We did it again the next summer, but there was little change and his audiogram showed both ears testing almost identical. Our insurance did not cover any of this besides the initial audiologist evaluation. We have teacher’s insurance.
I know this is anecdoctal and a survey of 1, but this worked for him. @early_college I have followed your posts since you first began posting; thanks for the updates. You have certainly faced many obstacles. I hope you find the help and diagnosis as you face these new challenges. You have to pursue finding the right therapists, probably starting with an audiologist certified in APD.
I am a speech pathologist. It’s fine that Auditory Intergration Training worked for your son…but there is no research evidence that this treatment is worthwhile.
And in my experience it was used for students with Auditory sensory issues…not APD.
But like I said…if it worked for your kid, that is what matters.
Because of the lack of supportive research…it’s very hard to find someone who does Auditory integration training.
@early_college Is there a pressing reason for you to begin grad school this fall? Could you defer for a semester or a year? You have a rather daunting list of ailments to deal with, evaluations to pursue, and therapies to consider. In the long run, it may make better sense for you to get your physical and mental health fully on track first, and start
grad school later.
@dentmom4 a peripheral hearing loss (at the outer, middle, or inner ear) is distinct from a central (meaning in the brain) auditory processing disorder. I am afraid your description of your son’s hearing loss does not really make sense to me. Perhaps it was described poorly or is being misremembered. Treatment for being “deaf in the outer ear” would be surgery to eliminate a blockage. Is it possible he has something called auditory neuropathy where the inner ear functions but does not seem to connect to the brain as a coherent signal (or at all in some cases)? (I have an audiology degree, teach in an audiology program, and am a parent to a deaf child so have background in these topics)
http://www.asha.org/policy/PS2004-00218/
They suggested this be reexamined IF empirical research data was available. It hasn’t been.
@thumper1 I appreciate your input. We were dealing with an autistic son in the early 90s when there was very little therapy available privately or in the schools. We had a hard time just getting a diagnosis. He was in the middle of the spectrum, not high-functioning or severely impaired. When he started school at 4, he was in a PPI class, only kid with autism; speech therapist and physical therapist had never worked with a kid with autism; ABA was just in its infancy. When AIT info came to us, we decided to try it because, why not? That’s why I say our experience is anecdotal. It was a very frustrating time for us, but AIT had positive results for him.
Thank you for that connection to sensory issues; that makes a lot of sense to me (20+years later!). He spent 8 years with a sensory integration therapist.
I looked at your link–from 2004, too late for us, but many years to gather data and come to conclusions.
@LBowie. I was not clear and I probably remember poorly. Our son has no hearing loss nor did he ever. However, he could act like he couldn’t hear or be so bothered by noise, he covered his ears. The “deaf” came from the audiologist as a descriptive term, not a fact. Today he is only upset by very loud sudden noises, i.e. fire alarms, fireworks.
FWIW, my son was going to be tested at age 7 for APD, but he couldn’t be - he had hearing loss of more than 50% in each ear unbeknownst to us!!! Turned out that he has problems with fluid in his ear, and he got ear tubes which helped so that his hearing returned to normal and he could be tested for APD in a few months.
I know he still has issues with hearing now that he is in college, but knows that he actively has to try harder, or take some decongestant sooner than most might.
Anyway, he was found to have a mild but definite APD, and when we took the results to the school, they refused to give him the FM set-up, and said “we’ve seen much worse”. It was really really tough for him to get beyond his issues with APD, and he still has trouble following speech to some extent.
The insidious thing about fluid in the ears off and on is that sometimes you can hear great, other times not. It can actually damage the ear drums to have fluid then not.
I also have had ear tubes, and the relief from the pain of the fluid in the ears was amazing - I will NEVER EVER doubt that a child would need an ear tube if there is substantial fluid that won’t drain - I literally couldn’t work due to the pain before I got the tubes!
Prolonged or recurrent middle ear infections may contribute to the development of auditory processing disorders. Here are abstracts of some articles on that topic: https://www.ncbi.nlm.nih.gov/pubmed/26881324 and https://www.ncbi.nlm.nih.gov/pubmed/15885328 though the second one does not show a strong effect.
I know this is an old thread, but maybe someone still checks. @LBowie @rhandco
my daughter has a unilateral hearing loss; she had an ear level FM in the good ear this year, but she said it “made things worse” - after questing her, her audiologist suspects APD is also amproblem, which makes sense since she has many other sensory issues, and has received OT for some. She is hearing impaired and loves LOUD music while she moves-especially swings on her swing in the basement - but she also covers her ears or screams when there is a loud sudden noise like fire alarm, someone dropping a metal pans in the kitchen, etc.
We have been told that it may be difficult to test her for APD since she has an assymetric loss. also that she should have “Auditory training”. What IS that?
Yes I think it would be impossible to test for an auditory processing disorder. A requirement for testing is normal hearing. Many of the tests use mismatching stimuli to both ears simultaneously. But even with symmetric hearing loss in two ears, it is not really possible to do the testing because you will never be able to be certain hearing loss alone is not to blame.
There is a name for aversion to loud noise: hyperacusis.
There are some auditory training programs. Check out LACE (for adults) and FastForward. The research is mixed on whether or not they really work.
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Your kiddo has hearing acuity issues. It will be mighty hard to impossible to sort those out from a APD issue.
Auditory Training Programs are not well supported research wise in terms of efficacy. The research on Fast Forward was mostly done by…Fast Forward…hardly an independent endorsement of the program.
These programs are also not designed to be used with students with hearing losses.
Does your school district contract with an educational audiologist? If so, this person would be the go to person for help in the school setting.
thank you so much for your replies. We have tried for 5 years with our district; although she has 2 other medical dx, and misses an average of 40 days per school year due to illness, hospitalization, or specialist appointments, she had been denied an IEP, AND the services of an ed.Aud. After initiating a lawsuit this fall, they modified ONE of her classrooms (in February, just before our private evaluators came in) and have been providing once a week, 40 mjnutes sessions with a ToD(frequently missed due to illness and school holidays falling in Friday’s).
We have enrolled her for the fall in a private day school which has a special program for executive function and language based learning disabilities. If she continues to miss a lot of days, they will be able to provide her individualized time to catch up. Intellectually (state evaluation) she is bright average to above average, and even tested 99%tile in some areas (a lot of scatter). In PS she is at the 38 and 46 %tile in standardized testing. So we need to move her before she falls so far behind that she can’t catch up. It is already affecting the type of friend she has and her attitude towards school.
Met a FastForward provider who trialed her and kept shaking her head. She said she does too well, and probablynwouldnt get
She did very well i. the FF trial so the SLO gave us some free APPs to try, and she will let us know how they look remotely.
She also complains about trouble reading, sheninly wants to read graphic novels because she says the “lines get mixed
up, and i skip lines and then the story doesn’t make sense and I have to read it over and over””.
I feel lost- like I can’t figure out the right person to take her to to tell us what would help with each problem.
I haven’t gone back and read the whole thread, but you might want to consider a full neuropsychological assessment.