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August 11, 2003

Implant helps deaf child hear

From: Syracuse Post Standard, NY - Aug 11, 2003

The world changed for 16-month-old when the implant was turned on.

By Amber Smith Staff writer

Austin Botts may hear loud trucks and airplanes, but it may be their vibrations he notices.

With his hearing aids in place, conversations probably sound like the muffled teacher in Charlie Brown.

He doesn't know any different. Botts was born profoundly deaf.

On the day he turned 16 months old, he was at Dr. Hayes Wanamaker's Syracuse office with his parents, Denise and Tim Botts, and his 7-year-old brother, Brendan.

They were there to watch Austin hear for the first time.

Austin Botts was born on Good Friday 2002. His adoptive parents, Denise and Tim Botts, of Lakeland, brought him home from Community-General Hospital on Easter Sunday. He'd failed the newborn hearing screening. They were overwhelmed by the thought that something could be wrong with their new son.

In the months ahead, they learned how profoundly impaired Austin's hearing was. Speech therapists and teachers worked with him. He wore a hearing aid in both ears. He learned sign language for common words: Mommy, Daddy, drink, yes, no, bye-bye.

As he grew, he babbled like a baby, "but there was definitely parts of speech that he wasn't hearing," his mother says. "And he wasn't speaking."

Wanamaker surgically placed Austin's cochlear implant on June 19.

On July 29, the family crowded into an examining room for Wanamaker to see Austin.

"Hi, you probably don't remember me," he says to the boy. Then the doctor peeks behind his ear, where he sewed the receiver into place. "Ah, that looks perfect."

He asks how Austin's balance is, and how he's walking. The boy appears fully recovered, ready for the device activation.

"Don't be surprised if he seems a little startled or upset," Wanamaker warns the family, before sending them upstairs to audiologist Helen Waters. "He's not going to have an idea what this is."

Wanamaker says any good otolaryngologist can surgically place an implant. "The hard thing and real art is programming," he says. "She's one of the best in the country."

Waters sits at a conference room table with a black Compaq laptop open before her. Clicking and tapping on the keyboard, she checks to make sure the electrodes are functioning properly.

Her partner, audiologist Lisa Guidone, entertains Austin in a high chair. "Mmmmm," she says, then mouths, "Mickey," and "Minnie," the plastic dolls she presents.

Austin has been wearing the processor for a couple hours a day since his operation, just so he gets used to it. It attaches by magnet to the receiver beneath his skin behind his ear.

Wires thread to the processor from an external microphone he'll wear on a harness. The sounds will be converted to digital signals and sent through an electrode in the cochlea. There, the nerve bundle responsible for hearing will be stimulated and Austin will hear.

Guidone presents a second Mickey Mouse and draws Austin's attention to the pair. "Look at that," she says. She puts fingers from both of her hands together as she speaks the sign language: "The same. It's the same."

Though theimplant will help him hear, Austin may also communicate through sign language, and he continues to learn it.

Tim Botts videotapes his son as a series of beeps begins. The audiologists are checking Austin's ability to hear the softest sounds. Denise Botts periodically slips a frosted animal cracker to Austin, keeping him occupied.

Austin plays, oblivious.

"Is he hearing anything at all, Helen?" the father asks. "Is he supposed to be?"

Waters' hands remain on the keyboard. "We're just seeing the reaction we get, Tim, to be honest with you."

They start with the softest sounds. They don't want the first sounds he hears to be so loud as to scare him.

She makes adjustments, and then she's ready to go live.

"Austin," Waters calls, repeating, "Austin . . . Austin . . ."

Blocks inhand, the boy looks up to the ceiling. He stares, looking for where "Austin . . . Austin . . ." is coming from.

He refocuses on the blocks.

"Austin . . . Austin . . ." Waters continues, and Austin again stops. He stares at the ceiling. He laughs. Then he coos at the ceiling.

Waters switches to a vibrational sound, "Bub, bub, bub, bub, bub, bub, bub . . . ." That, too, intrigues the little boy.

Denise Botts watches with her fingers pressed over her lips, containing a smile. Her husband films, watching the moment through the video screen. Brendan snacks contentedly on Cheez-its.

Austin keeps staring at the ceiling. "Mmmmm, mmmmm," he says, mimicking the new sound Waters is making.

Then Guidone directs him to put the blocks into a bucket. As he completes the task, the audiologist applauds. He looks at her hands. "Clap, clap, clap," she says. "Can you make noise?"

Austin will return for adjustments of his cochlear implant. His family's task is to help him become familiar with regular household noises, like blocks being placed in a bucket and dogs barking. They're supposed to keep calling his name, and keep a journal of his responses to various noises. This will help Waters tweak the settings next month.

She tells them to be patient, and repetitive. "He needs to hear something 100 to 150 times before he has a concept of what it is."

Tim Botts understands. "Every sound he hears, he's one step closer."

© 2003 The Post-Standard.