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May 20, 2007

UNC program helps deaf children with hearing, speaking skills

From: News & Observer, NC - May 20, 2007

By ASHLEY WILSON, The Herald-Sun of Durham

CHAPEL HILL, N.C. -- Four-year-old Emily Hewett stuffs her mouth full of Bugles snacks as her mom asks her a series of questions.
"Where's Brooke?" her mom wants to know as Emily jumps around in her pink and white Disney princess sandals, her brown pigtails swaying with each movement. "At grandma's," responds Emily, telling her mom the location of her little sister.

Deaf since birth, Emily couldn't hear her mother's voice three years ago. But a UNC Hospitals program has given her the tools she needs to hear and speak.

At a year old, Emily received a cochlear implant from the W. Paul Biggers Carolina Children's Communicative Disorders Program or CCCDP. Her sister also has an implant. The family now travels from Columbus County to the program's offices in Durham for periodic two-hour checkups.

"I think the appreciation comes from the fact that she's totally deaf and she's able to process all those questions," said Carolyn Brown, program director of CCCDP and CASTLE, the program's preschool.

CCCDP was created in 1992 by Biggers, a UNC professor of otolaryngology, the branch of medicine that specializes in the treatment of ear, nose, throat and head and neck disorders. Biggers, who died seven years ago, envisioned a program that would use state funding to help children with speech and hearing disorders. Fifteen years later, his vision has grown into the only program of its kind in the state.

Since its inception the program has implanted 500 children with cochlear implants and provided services to at least 1,400 children in 88 counties in North Carolina. A cochlear implant is a small, complex electronic device that can provide a sense of sound to a person who is profoundly deaf or hard of hearing. Instead of amplifying sound like a hearing aid, cochlear implants bypass damaged portions of the ear and stimulate the auditory nerve.

"About 95 percent of deaf children are born to parents who speak," said Brown, who has two adult children and a grandchild who are deaf. "We've helped to lift that bar that keeps families from having to experience a child who has one language and they have another."

The program, which is based in the Department of Otolaryngology/Head Neck Surgery at UNC Hospitals, is made up of three components: the cochlear implant team, financial assistance and CASTLE, the Center for Acquisition of Spoken language Through Listening Enrichment.

The cochlear implant team, which includes four audiologists and one speech pathologist, does auditory evaluations on children who have severe to profound hearing loss. These evaluations can determine whether the child is a good candidate for a cochlear implant. The team also follows children who have implants, seeing them on a regular basis until they are 21.

"I am able to work with patients individually but also have a statewide effect on kids," said Tom Page, a speech pathologist. "I still have that individual relationship with kids that come through."

The financial assistance program receives applications from families who can't afford to provide their children with cochlear implants, clinic visits, speech therapy sessions or hearing devices. Using a three-page application, families can apply for a grant from the program. Recipients are chosen based on their income and the number of people living in their household. Most of the families make less than $40,000 to $50,000 a year. If approved, the program pays for the portion not covered by insurance.

"For these families, all of a sudden you have a baby and they say, 'They're deaf or hard of hearing, and you have to pay $6,000 to $8,000,'" Brown said. "This program helps with those families who are above Medicaid or other sources, who that wouldn't be a comfortable situation for."

CASTLE, which was created by Brown in 2001, is a model preschool and early intervention program that provides hands-on training opportunities for teachers of the deaf, students, speech pathologists and audiologists.

Seven children in two classrooms currently attend the preschool Monday through Thursday for three and a half hours a day. In addition to their activities in the classroom, each child, ages 3 to 6, goes to individual therapy sessions once a day. Most students transition into regular classes in public schools after leaving the CASTLE program.

While CASTLE is funded completely by private donations and grants, the financial assistance program and cochlear implant team are funded by the state.

"Jump, jump, up and down," sings Sindy Poole, a teacher in one of the classrooms, as 4-year-old Mylah Harris hops on a small trampoline. Mylah was doing the last exercise in an obstacle course that had the students bouncing on a ball and rolling on the floor. The whole exercise was to make the children tired and to give them a meaning behind the word "rest," a vocabulary word the group has been working on.

Three interns watched nearby as Poole went through the lesson. Through these internships in the classroom, a summer institute, mentoring and a fall conference, the program provides educational opportunities for professionals and university students. Many teachers of the deaf have been taught sign language but don't know the techniques used to develop hearing and spoken language in deaf or hard of hearing children. The program is trying to change that. More than 50 of North Carolina's 117 school districts have received some sort of training from the program.

"This helps teachers and then when they go back they help other kids, and there is a ripple effect," said Brown of the training the program provides. "To learn how to do this it takes a lot of experience."

The program also gives parents the tools they need to continue developing their child's skills at home. Parents of CASTLE children get an individual session once a week. The center also has a mock kitchen and a bedroom to teach parents how to expand their child's hearing and speaking ability during everyday practices. Once a week a "mommy and me" class meets to help parents learn how to provide language-rich experiences and to maximize the children's attention to and use of sound throughout their day.

With the Durham center running strong, CCCDP is now more than halfway toward its long-range goal: building three centers in the state.

At the end of January, the program opened a center in Wilmington, which includes a CASTLE, "mommy and me" class and all the intervention services. There are now three children enrolled in the Wilmington CASTLE program. In 2008, CCCDP plans to open another center in Hickory.


Information from: The Herald-Sun,

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