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July 23, 2005

Providing a means to hear

From: Lynchburg News and Advance, VA - Jul 23, 2005

Cynthia T. Pegram
July 23, 2005

While pregnant, Sarah Garrett had a fleeting uneasiness that her unborn son might have a hearing impairment.

A friend, also expecting, had noticed that some low noises made her own unborn baby jump.

"I made the noises and mine didn't jump," said Garrett, of Lynchburg.

But when Khyler was born three and a half years ago, he passed the screening tests for hearing loss, and later more advanced tests, as well. The state requires hearing screening of newborns.

So, his mom hoped he was just a sound sleeper because noises didn't wake him. And he definitely cried with volume, something hearing impaired children don't usually do.

Yet Garrett was to learn that her baby was among an estimated 300 children born in Virginia each year with some hearing loss.

Beginning in May, the Virginia Department of Health established a hearing aid loan program for children under age 3, a program that includes the loaning of specialized FM equipment as well.

The program will make it possible for children to be helped earlier, and not linger without sounds in their rapid developmental age, while waiting for needed hearing aids.

"This will definitely benefit the children," said Anne Simmons, program manager for early intervention for Central Virginia Community Services, the entry point for the Health Department service.

Hearing is essential to a young child's speech fluency, although some deaf children communicate well with sign language and cued speech. Yet, "for some children, no amplification will help, and they need a cochlear implant," said Simmons.

The Department of Health's new program makes the hearing aids and FM systems available through an application form available at the child's audiologist, who has confirmed the need.

The Hearing Aid bank has 54 loaner hearing aids and 35 FM systems, which are used to improve hearing at a distance.

The hearing aids are loaned for six months but that can be extended for up to another six months.

Using a loaner also gives the parents and the child some sense of how the hearing aids will work for the child - without having to pay what can be a $700 to $3,500 price tag for each hearing aid.

For some families that cost can be unbearably steep, especially when the child will no longer need them if a cochlear implant will overcome the hearing loss. The surgically implanted electronic device bypasses the normal hearing mechanism and sends signals directly to the brain.

To get the implant, children must have tried and failed with hearing aids.

In the past, to meet the need, some audiologist and speech pathology practices have set up loaner programs, and others have obtained them through the Virginia School of the Deaf in Staunton.

Garrett, for example, was able to get used hearing aids on loan through Denice Clapp, a speech language pathologist in Lynchburg. Clapp got the hearing aids through the donation of the hearing aids from parents whose children had been through the process.

"Families of hearing impaired children are awesome," said Clapp. "They support each other - even when they don't know each other."

Private insurance often does not cover hearing aids for children, and state programs have specific income requirements. Not being able to hear can create a learning lag that's hard to overcome by school age.

"The only thing wrong is that they can't hear," said Clapp. "Their minds are fine. If you get sound to them, they'll learn, too."

Helping a hearing impaired child means helping a family help the child, she said.

"With coaching and guidance, by the time they hit kindergarten, they don't need anything else but the equipment."

The FM loaners are to make it easier for a child to hear sounds at a distance. Many hearing aids decline in quality sound after about 3 feet.

"Distance, noise in the environment and reverberation cuts down tremendously on what the child is hearing," Clapp said.

Even a cochlear implant is good for only about 12 feet, she said.

The FM systems put a speaker about 6 inches from the mouth of the speaker, and an adapter, called a boot, goes on the hearing aid or implant - the speaker's voice goes directly to the hearing system.

Because of the high cost of the equipment, parents must sign a contract to be responsible for it, said Simmons of CVCS.

Although some children can't be helped by hearing aids, they must try them before undergoing the surgical procedure for the cochlear implant.

"For some, it is either a cochlear implant or the signing (sign language)," said Simmons. "That's a debate in speech therapy and in the deaf community. No one choice is right."

Currently, some 15 children with hearing loss are enrolled through early intervention services at CVCS. However, some children's hearing loss isn't detected until they don't start talking at the expected developmental age.

"Sometimes parents don't pick up on it," said Simmons. "Children can compensate for varying degrees of hearing loss."

No single cause exists for the loss, but cases include family history, post-natal infection, medications that are toxic to hearing, Down syndrome and chronic ear infections.

Some, such as Garrett, sense something is wrong, but end up having to struggle to get that recognized.

Khyler was having hearing problems, but she says she could not get that documented. He didn't turn toward the sound of a really loud noise. And he had delays in speech and in walking - the inner portion of the ears help with balance.

Ultimately he was diagnosed at the University of Virginia, where he underwent testing while sedated. With the hearing loss documented, and hearing aids unable to correct the problem, Khyler underwent a cochlear implant about a year ago.

Garrett says her son can hear and "is having great progress" working with Lynchburg Speech Therapy.

© 2005 Media General Inc.