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September 29, 2005

Hospital milestone highlights newborn hearing screening

From: - Philadelphia,PA,USA - Sep 29, 2005

The Associated Press

PITTSBURGH - Blond-haired and blue-eyed, Nathan Valukevich sits at a table at Children's Hospital of Pittsburgh in silence, playing with little toy people and multicolored, foam turtles. Then he hears a noise and looks up at the audiologist sitting in front of him.

"Are you listening?" she asks the 2 1/2-year-old boy, pointing to his ear where doctors four weeks ago put in a cochlear implant. His mom, Tina, sits nearby, smiling and clapping, while his dad, Brian, records each moment with a video camera..

Nathan is the 100th patient at Children's Hospital of Pittsburgh to receive a cochlear implant, a tiny device implanted in the skull that will allow him to hear. Doctors say more early screening and an awareness of childhood hearing loss have made a difference in detecting problems, changing some children's lives.

"The only way this can be offered is first they are diagnosed and then with close follow-up," said Dr. David Chi, the director of the hospital's Hearing Center.

About 12,000 babies are born with permanent hearing loss each year in the U.S. Three out of every 1,000 babies born have some form of hearing loss, making it the most frequently occurring birth defect, according to the Utah-based National Center for Hearing Assessment and Management.

There are varying levels of hearing loss, from mild (difficulty hearing soft sounds) to profound (inability to hear any speech).

Most commonly, children with hearing loss undergo certain therapies or are fitted with hearing aids; in more severe cases, cochlear implants are used. Hearing aids amplify sounds, while implants bypass the damaged part of the ear and send sound directly to the auditory nerve.

None of the devices, however, will ever fully restore hearing.

"People don't understand that hearing loss is not a dichotomy. Many people think that you either hear perfectly or don't hear at all," said Karl White, director of the National Center for Hearing Assessment and Management.

But doctors say the key still remains getting babies screened. Studies have shown that babies develop language skills in the first few months of life and that therapies started before six months are most effective.

Thirty-eight states have laws mandating that newborns be screened for hearing loss. Pennsylvania's law, which took effect in 2003, sets a target having 85 percent of babies born in the state screened. Before the legislation was passed in 2001, less than 30 percent of babies born in Pennsylvania hospitals were being screened.

Technology has also played a role.

"We're seeing children's performance greatly improving, not only because of early detection, but the hearing aids are much better," said Diane L. Sabo, associate director of the Department of Audiology and Communication Disorders at Children's Hospital of Pittsburgh.

For Nathan, a combination of therapies is being used. He has a hearing aid in his right ear, which has severe hearing loss; the cochlear implant is in his left ear, which has profound hearing loss. Nathan also gets early intervention therapy from an expert who visits his home once a week.

On his visit to the hospital Thursday, audiologists adjusted the levels of Nathan's implant, something that will be done often during frequent trips to the hospital. He'll wear a processor on the outside of his ear that captures sound, and then sends that sound as digital signals to the internal implant.

It will be a process of continually adjusting the implant. But Nathan takes it all in stride, sucking down apple juice from a sippy cup and gobbling up graham crackers from a plastic sandwich bag.

"He talks a lot, but not very crisply or clearly," Nathan's mom, Tina, said. "But that's really what we hope to fine-tune with this whole process."


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