Hearing impairment can be treated — but parents often choose not to.(Parents have choices about how to approach deafness with their children).

18 Apr , 2018

Hearing impairment can be treated — but parents often choose not to.(Parents have choices about how to approach deafness with their children).

Less than 1 percent of babies in Texas are born with some level of hearing loss. That may not seem like much. But it means that up to 1,200 Texas children enter the world each year struggling to hear — or completely deaf. Fortunately, the medical community is identifying kids with impaired hearing earlier than ever. Last year, 98 percent of newborns were screened for hearing loss — a vast improvement over the 10 percent screened in 1993. Thanks to new technology, we can act early on the results of those screenings, effectively restore hearing, and allow children to develop spoken language skills. These new technologies allow families to choose how to experience deafness with their children.

A quarter-century ago, most kids with hearing loss weren’t diagnosed until they were two and a half, when their parents noticed they weren’t talking. Children born deaf typically never learned to read past a fourth-grade level. Only well-off families could invest the resources necessary to teach their kids to effectively communicate orally.

That began to change in 1999, when the federal government enacted legislation encouraging states to screen hearing in newborns. Texas passed a law that same year requiring doctors to screen for hearing loss in the first 30 days after birth. Early identification opened the door for early intervention, essential for language development.

Cochlear implant technology also began to take off in the 1990s. These surgically implanted electronic devices help provide a sense of sound to people who are deaf or have severe hearing loss. As the technology — and patient outcomes — improved, the FDA gradually lowered the age when children could receive cochlear implants to 12 months.

This confluence of events makes it possible for kids born with hearing loss to learn to speak and read at the same pace as their peers. Children who receive cochlear implants develop language skills at rates similar to children without hearing loss — especially if they receive them within the first six to eighteen months of life. Studies show that seven in eight of them test at a level commensurate with or above that of their hearing peers in reading comprehension.

Anecdotally, some children with cochlear implants fare even better, growing up to pursue careers in fields previously thought off-limits to people who are deaf. The Listening Project, a documentary film that just premiered in Washington, profiles 15 of them — including doctors, neuroscientists, business analysts, and musicians.

Yet only half of all American children who could benefit from a cochlear implant actually receive one. Compare that to Europe, where nine in 10 receive implants.

Many American parents don’t know that cochlear implants are an option. That’s partially because much of the information provided to parents of newborns who are deaf, particularly in some regions, comes from the Deaf cultural community and the network of schools for the deaf.

There’s also no clear system or referral pathway to connect eligible candidates with cochlear implant specialists. That’s a shame, because cochlear implants are covered by insurance in most states. Indeed, Texas enacted a law last June that requires health insurers to cover cochlear implants when medically necessary. Timeliness is critical because the best outcomes are achieved when children undergo implantation under age two — or even under age one.

Some people who are deaf, and choose not to hear, argue that cochlear implants and other advanced hearing technologies deprive children who are deaf of their rich Deaf cultural heritage, as well as immersion in the natural language of the deaf, American Sign Language.

But more than nine in 10 parents of children who are deaf have normal hearing. They don’t know sign language. They’re more comfortable with technology that can empower them to teach their child how to speak, read, and write. Children with cochlear implants still need committed parents and supportive schools to reach their potential. Some will need to use multiple modes of communication, particularly if implanted late or because of other medical and social factors.

There is no right way to be deaf. For some families, a cochlear implant and immersion in the world of listening and talking may be best. For others, sign language and a specialized education in the deaf community may be optimal. For still others, a combination of the two may be appropriate.

Parents have choices about how to approach deafness with their children. The choices they make will have profound and long-lasting consequences. We in the medical and hearing-loss communities ought to do all we can to furnish parents with the best scientific research so that they can make informed and timely decisions for their children.

Source: Houston Chronicle
Image credit: Jason Fochtman, Staff Photographer / Houston Chronicle