When a Child Can't Hear

July 24, 2000 -- At 8 months old, Angie King's daughter Erica didn't babble like other children her age. Instead of gentle gurgles and cooing sounds, Erica made high-pitched squealing noises. King's husband Mark suspected a hearing disorder, but Angie was reluctant to consider the possibility.

There were other clues as well. Erica didn't react when a dog suddenly began to bark nearby. She would dance along with television programs, but wouldn't imitate their sounds. After conducting her own in-home hearing test by dropping pots and pans on the floor -- with little response -- the Celina, Ohio, mother scheduled an appointment with her pediatrician who referred the family to an audiologist. Soon the results were in. Erica was profoundly impaired in both ears.

The way the Kings' story unfolded is not unique. In fact, they discovered their child's hearing loss just as other parents of hearing-impaired children do: by realizing that their child hadn't started to talk or respond to sounds. By that time, months of critical language development have been lost, possibly for a lifetime. But if Angie, now president of Hear US, a national advocacy group pushing for coverage of hearing testing and treatment by insurance companies, has her way, her daughter Erica's story will soon be the exception, not the norm.

Words started to come quickly after Erica was fitted for her first hearing aids at 11 months. "The results were amazing," says King. "Within six weeks, she had learned six words."

The hearing aid alone didn't loosen her tongue -- it took a lot of hard work by both mother and daughter. Having been deprived of auditory input for her first year, Erica had to get used to having a completely new sense.

At the advice of a speech specialist, King spent entire days on the floor with Erica, playing with flash cards, making up word games, trying anything she could think of to engage the girl's ears and trigger vocal responses. Each week, she posted a list of target words on the refrigerator, and both parents tried to use them as often as possible. Within a year of receiving her hearing aids, Erica was speaking at the same level as other kids her age.

All was going well until Erica turned 3, when for some unknown reason, the hearing aids stopped helping her hear. The family decided to try a different approach -- a cochlear implant.

While hearing aids are placed in the outer ear to magnify incoming sounds, a cochlear implant is surgically installed within the inner ear, says Karl White, PhD, director of the National Center for Hearing Assessment and Management at Utah State University. A receiver is placed on the outside of the head to transmit sound signals directly to the implant, which in turn stimulates the auditory nerve, sending sounds straight to the brain.

The procedure, which is irreversible and somewhat risky, is normally considered only after hearing aids have failed. That's because the child's damaged cochlea -- the nautilus shell-shaped part of the inner ear that normally directs sound energy to the auditory nerve -- is destroyed in the implantation process, eliminating the possibility of returning to hearing aids if the procedure isn't a success. Still, complete implant failure is rare, and the results can be astounding. After receiving her implant at 3-1/2 years old, Erica could hear again. "I understand how they work, but to me it's still just a miracle," says King.

However, the surgery and the implant are very expensive, usually costing between $50,000 and $70,000. Almost a year later, the Kings are still fighting with their insurance company to pay for the procedure; many insurance plans don't cover the implants.

King's second daughter, Jaime, was tested for hearing problems at birth, and as is common in households with one hearing-impaired child, their second child also had profoundly impaired hearing. The family chose to wait until she was 4 months old to fit her for a hearing aid. Erica is now 4 and Jaime almost 2, and both children are speaking at levels above their age group. However, King has recently learned that the hearing aids are no longer helping Jaime, and she too will likely need a cochlear implant.

"When a child is born, you want everything to be perfect for them. But when you realize they are deaf, part of your hopes for that child die," says King. However, as King found, with today's advances in hearing technology, dreams don't have to die. "The treatments that are available today are so effective that people can have almost normal speech if the problem is caught early."

Will Wade, a San Francisco-based writer, has a 5-year-old daughter and was the co-founder of a monthly parenting magazine. His work has appeared in POV magazine, The San Francisco Examiner, and Salon.