Seven-month-old Eva Sternoff of Bellevue has alert blue eyes and an infant-size hearing aid that fits on her right ear. It is neatly held in place by a pink headband. Eva was born with stage 3 microtia, a deformity of the outer ear that left her with hearing loss in one ear.
Since Eva started wearing the hearing aid — a bone conduction processor that converts sound into vibrations and sends it through her skull bone to her intact inner ear — her family has noticed a difference.
“She lights up more; she’s really focusing,” says her mother, Jodi.
Simon Nessan is an active 3-year-old from Seattle who has blond hair and small electronic devices attached to each ear. They are cochlear implants, surgically implanted devices that allow Simon —who is profoundly deaf in both ears — to access sound by directly stimulating his auditory nerve.
Diagnosed at 18 months of age, Simon received his first implant at about age 2. Six months later, he was saying some words and singing his ABCs. His language skills are now very close to the normal range of development. “My profoundly deaf child loves to sing and can carry a tune,” says Simon’s mother, Tara Nessan. “That, to me, is a medical miracle.”
Early diagnosis for hearing loss
Eva and Simon are two examples of the dramatic advances in the diagnosis, treatment and support of early hearing loss that have taken place over the past 15 years.
First, universal screening of newborns for hearing loss has allowed deaf and hard-of-hearing infants to be identified much earlier. Although the screening isn’t mandatory in all states (including Washington), it is offered to all parents, and 95 percent of newborns in the United States are now screened.
The screening doesn’t catch every child, but experts agree that it has had a big impact. “When I started my career, we were looking at children being diagnosed between 18 and 30 months [of age],” says Mollyshannon Neal, who coordinates the Family Conversations early intervention program at Seattle Children’s Hospital. These days, babies as young as 8 weeks old are enrolled in the program.
The options for technological support for children with hearing loss have improved significantly. Cochlear implants are now approved for children as young as 1 year old, helping children in that ultracritical language-learning window.
Today, infants and young children with hearing loss benefit from hearing aids that are digital, programmable and designed for tiny ears, as well as from surgical procedures that improve hearing. Also available are hearing assistive devices such as FM systems that allow sound to be directly transmitted from a speaker’s microphone to a child’s ear or hearing aid.
Focusing on families
Finally, early intervention programs fill in another critical piece of the puzzle: coaching families to maximize a child’s language exposure as early as possible.
The Seattle area is home to three high-quality early intervention programs for deaf or hard-of-hearing children, offered free of charge to any infant or child younger than the age of 3 with hearing loss.
Listen and Talk, a Seattle-based educational center for kids with hearing loss, is the largest program, serving about 60 families in the greater Puget Sound area with early intervention services that focus on listening and speaking skills.
The demand for the program’s early intervention services has grown in recent years due to the rapid development of cochlear implants and digital hearing aids.
Seattle Children’s Family Conversations emphasizes a “total communications” approach that supports listening and speaking skills, as well as a type of signing called Signing Exact English. The Hearing, Speech & Deafness Center’s Parent-Infant Program offers another option, supporting families in a bilingual American Sign Language/spoken English approach.
Although each program emphasizes a different mode of communication, the home-centered focus — itself a recent trend in early intervention — is similar.
Specialists make one-on-one visits to families in the home and coach parents on supporting their child’s language development through everyday routines, from diaper changing to eating to reading.
The Sternoff family, for example, receives monthly visits from a Listen and Talk specialist who helps the family monitor the sounds Eva makes to see if she is on track.
The Nessans chose the Family Conversations program because they liked the dual focus on signed and spoken English. Simon began signing quickly, and after he received a cochlear implant, his spoken language started taking off.
At age 3, Simon is enrolled in Listen and Talk’s preschool program. His parents expect that by age 5, he’ll be ready for kindergarten in his neighborhood school.
That outcome is becoming more and more typical, say educators. “It’s been an incredible time,” says Suzanne Quigley, executive director of Listen and Talk. “We are getting kids much earlier, and it makes a tremendous difference in their success.”
Elisa Murray is ParentMap’s Out + About editor.
Resources for Children with Early Hearing Loss
Seattle Children’s Hospital's Childhood Communication Center
Hearing, Speech & Deafness Center
Listen and Talk
Washington state’s Early Support for Infants and Toddlers
Washington State Department of Health, Early Hearing Loss resources (EHDDI)
Washington Hands & Voices