Hearing loss can be treated



Less than 1% of babies in Texas are born with some level of hearing loss. It may not seem like much. But that means up to 1,200 Texan children enter the world each year with hearing difficulties – or completely deaf.

Fortunately, the medical community is identifying children with hearing loss earlier than ever. Last year, 98% of newborns were screened for hearing loss, a marked improvement from the 10% screened in 1993.

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Thanks to new technologies, we can act early on the results of these screenings, effectively restore hearing and allow children to develop their spoken language skills. These new technologies allow families to choose how to deal with deafness with their children.

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A quarter of a century ago, most children with hearing loss were not diagnosed until they were two and a half years old, when their parents noticed that they were not speaking. Children born deaf usually never learned to read beyond the fourth grade level. Only wealthy families could invest the necessary resources to teach their children to communicate effectively orally.

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

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

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This confluence of events allows children 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 those of children without hearing loss, especially if they receive them within the first six to eighteen months of life. Studies show that seven out of eight test at a level comparable to or better than their hearing peers in reading comprehension.

For the record, some children with cochlear implants fare even better, growing up to pursue careers in fields previously considered off-limits to deaf people. The Listening Project, a documentary film that just premiered in Washington, features 15 of them – including doctors, neuroscientists, business analysts and musicians.

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

Many American parents are unaware that cochlear implants are an option. This is in part because much of the information provided to parents of Deaf newborns, particularly in some areas, comes from the Deaf cultural community and the Deaf Schools Network.

There is also no clear system or referral pathway for connecting eligible candidates with cochlear implant specialists. It’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. Speed ​​is essential because the best results are obtained when children have an implantation before the age of two – or even before the age of one.

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

But more than nine in ten parents of deaf children have normal hearing. They don’t know sign language. They are more comfortable with technology that can help them teach their children to speak, read and write. Children with cochlear implants still need engaged parents and supportive schools to realize their potential. Some will need to use multiple modes of communication, especially if they are implanted late or due to other medical and social factors.

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

Parents have a choice of how to approach deafness with their children. The choices they make will have profound and lasting consequences. We in the medical and hearing-impaired communities must do all we can to provide parents with the best scientific research so that they can make informed and timely decisions for their children.

Sorkin is executive director of the American Cochlear Implant Alliance and a cochlear implant recipient. Colin Driscoll, MD, is Chairman of the Board of Directors of the American Cochlear Implant Alliance and Professor and Chair of Otolaryngology – Head and Neck Surgery at the Mayo Clinic.



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