Triad Hitchup

Wednesday, May 30, 2007


Join us for a discussion of:
The Impact of Hearing Loss on Auditory Processing and Development
Debara Tucci, MD, MS
Director Duke Cochlear Implant Program

Join us to learn about and discuss:
Reading and Language: How do they Connect?
Sharon Moore, CED, Cert. AVT, NBCT
Office of Education Services

Triad Hitch-Up pool party-- date and location TBA

Patricia A. Roush, AuD
Dept. of Otolaryngology
University of North Carolina School of Medicine

Beth Witfield, M. Ed, Certified AVT
CASTLE Program Coordinator
Topic TBA

Open discussion meeting

No meeting. Happy Holidays!

Monday, May 28, 2007

Meeting Info 5/29

Join us for an informal discussion:
Growing up with hearing loss: What is it like from the other side of the hearing aids?
A small panel of people graciously willing to discuss their experiences.
Panel Members will include, possibly among others:
John Pendergraft, a 15yo with moderately-severe loss,
Fletcher Prusia, a 14yo with profound loss and a CI since 2 yrs of age
Miriam Bradley, a mother with significant congenital hearing loss,
Chase Chromer, rising high school senior with moderate hearing loss

Tuesday, May 22, 2007


Please note new directions in the "Meeting Info" section! Please use these to navigate to the meeting next week. I apologize for the error!

Monday, May 21, 2007

Article on combined CI and HA technology

Published: May 17, 2007 12:30 AM
Modified: May 17, 2007 06:56 AM
1-2 punch could help hearing-impaired
Jean P. Fisher, Staff Writer
James A. King has always had poor hearing, but now it's so bad the Warren County pharmacist often can't understand patients at his store counter, waiters in restaurants or the high-pitched voices of his six grandchildren -- even with the help of hearing aids.
King, 64, hopes an innovative surgery he recently underwent at UNC Hospitals in Chapel Hill will change all that.

Last month, a surgeon implanted a small device above King's ear that will directly stimulate nerves involved in hearing. The device, called a cochlear implant, will work in tandem with a special hearing aid to help him hear a more complete range of sounds. King is among the first patients in the country to receive the combination treatment, which is being tested at UNC-Chapel Hill and elsewhere as part of a national clinical trial sponsored by Med-El, the Austrian company that makes the technology.

The dual device is aimed at people who, like King, hear too well for a cochlear implant alone but not well enough for hearing aids to be effective. It's hard to say how many patients might be candidates for the combination treatment. But hearing loss is highly prevalent, affecting about 28 million Americans of all ages. About 17 out of every 1,000 children younger than 18 experience hearing loss, according to the National Institute on Deafness and other Communication Disorders. After age 65, the rate jumps to 314 out of every 1,000 people.

"Have you seen a child on his first Christmas morning?" said King, describing his delight at being included in the trial. "This is a chance for me to really enter life again. Right now, I'm horrified to even answer the phone. It's embarrassing."

An innovation that was first approved for use in the United States in 1984, a cochlear implant has a microphone that picks up environmental sound and a speech processor that interprets it. It also includes a transmitter and receiver that collect signals from the speech processor and convert them into electric impulses, which are then routed via implanted electrodes to different regions of the patient's auditory nerves. The device can be placed in a short surgery, with no need for overnight hospitalization.

Full cochlear implants, used without hearing aids, provide hearing to patients who are profoundly deaf or nearly so. The implants, approved for use in patients as young as 1 year old, don't enable normal hearing but can make it possible for the deaf to hear a representation of sounds in their environment. With practice, many can learn to understand speech. The surgery, including the device, can be upwards of $40,000, though health insurance often covers the cost.

Most people with milder hearing loss, however, can't benefit from a cochlear implant. That's because their residual hearing is still better than the approximated sound provided by the device. So instead, more mildly impaired patients use hearing aids, which help by amplifying sounds.

Dr. Craig Buchman, the UNC-Chapel Hill ear surgeon who did King's surgery, said the combined implant and hearing aid system may become a new treatment option for patients like King who aren't candidates for full cochlear implants.

The dual device, called the electro-acoustic system or EAS, aims to solve such patients' hearing problems by using the partial implant to restore middle- to high-pitched sounds, which most patients with severe hearing loss can't pick up. Then, a specially designed hearing aid joins in to amplify the lower-pitched sounds patients can detect. It's already available to patients in Europe, but it is still considered investigational in the United States. Results from the clinical trial could pave the way for approval of the dual system in this country.

"You're actually adding the portion of hearing that they're missing to the portion that they do have," Buchman said.

Buchman said most people with age-related hearing loss would likely not be impaired enough to be candidates for the EAS procedure. Patients with severe enough hearing loss to qualify generally have a history of infections, exposure to certain antibiotics or hereditary factors that contribute to impairment.

James King, who has battled hearing impairment since childhood, doesn't yet know how much his partial implant will help. He is still healing from surgery and expects to return to UNC-CH later this month to have his device activated. According to his doctors, it may be up to six months before King adjusts to the system and begins to notice improvement.

"I'm hoping that I'm going to be able to communicate with people again," he said. "I don't really know what to expect, but I think it's going to be great."

Staff writer Jean P. Fisher can be reached at 829-4753 or

Sunday, May 13, 2007

Too many babies don't get second tests for hearing

Too many babies don't get second tests for hearing

By Rita Rubin, USA TODAY

A third of newborns who fail their hearing screening test don't get a follow-up evaluation, leaving them susceptible to delays in language development that they might never overcome, a report says today.

The proportion of newborns screened for hearing loss has climbed steadily in recent years, hitting 95% by mid-2006, says author Karl White, director of the National Center for Hearing Assessment and Management at Utah State University.
About 3.8 million newborns are screened for hearing loss each year, according to the Centers for Disease Control and Prevention. The screening takes about nine minutes and should be done before 1 month of age, preferably before the baby leaves the hospital, according to the CDC.
About 2%, or 76,000 babies, don't pass and are referred for a diagnostic assessment of their hearing. Additional testing is needed to determine whether they are among the one to three babies per 1,000 who actually have hearing loss, the CDC says.
Until recently, only about half of babies who failed the screening were reported as having the additional testing, but that proportion rose to two-thirds in the past year, White found. "One year doesn't make a trend," cautions White, whose study was paid for by the Maternal and Child Health Bureau of the Department of Health and Human Services. "We think we're getting better, but there's still a huge problem here."One problem is a shortage of audiologists who do diagnostic tests on babies, White says. Reimbursement rates are the same whether the patient is an adult or an infant, he says, even though adults are easier to test.

Among other contributing factors, White says, are "parent expectations and parent lack of understanding." As far as most parents are concerned, he says, hearing is a dichotomy: "You either have it or you don't." But babies who startle at loud noises, such as pots slamming, might not be able to hear lower-decibel sounds, White says.
Newborn hearing screening programs have lowered the average age of diagnosis to 3 to 4 months, he says. But if babies who fail screening don't receive follow-up testing, White says, they won't be diagnosed until they're around 2 or 3 years old. By then, language and social skills are lagging, he says, and they might never catch up: "There are deaf people who are identified at 6 years of age who turn out to be incredibly successful, but, on average, that doesn't happen."

11th Annual Cochlear Implant Conference Has Important Implications for Patients

11th Annual Cochlear Implant Conference Has Important Implications for Patients
CHAPEL HILL, NC — New clinical and research data presented at the 11th International Conference on Cochlear Implants in Children (CI 2007) identified new groups of patients that can benefit from advances in hearing technology. But, equally as important, some of the more than 350 presentations given at the international conference identified patients who do not benefit from cochlear implants.

CI 2007 was hosted by the Department of Otolaryngology-Head and Neck Surgery of the University of North Carolina (UNC) at Chapel Hill School of Medicine. Course co-directors were Harold Pillsbury, MD, chair of the department; and Craig Buchman, MD, professor and medical director of the Carolina Children's Communicative Disorders Program at UNC. The conference, held April 11-14 in Charlotte, NC, was divided into three clinical areas: cochlear implantation in very young children; patients with auditory neuropathy; and bilateral cochlear implantation.

Presentation highlights included:

Children with Significant Residual Hearing Benefited from Implants. Dr. Pillsbury presented findings on cochlear implantation in patients with significant residual hearing. "We showed that at a year and 2 years out, they were doing significantly better with a cochlear implant than they ever had done with a hearing aid," he said. This is useful new knowledge, contends Pillsbury, because many practitioners believed that this group of patients would not benefit from cochlear implants.

Cochlear Implants Significantly Improved Socialization Skills in Children. Cochlear implants greatly improved the socialization and advancement of children who received them compared to deaf and hearing-impaired children without cochlear implants, according to research presented by John K. Niparko, MD, of Johns Hopkins University.

Implants in Baby's First Year Prove More Beneficial. Researchers Ona Boe Wie and Sten Harris from the University of Oslo presented findings on the effect of bilateral cochlear implantation on spoken language skills in children from five months to 18 months old. "The idea is that you need to put the implant in by the age of one. If you wait until the child is two, the results are much worse, and that was surprising to me," says Dr. Pillsbury.

Children Diagnosed With Auditory Neuropathy Can Improve with Implants. Jennifer Weinstock, an audiologist at the University of North Carolina at Chapel Hill School of Medicine, demonstrated that a common baseline hearing test, ECAP (electrically evoked compound action potential) for children with auditory neuropathy can help identify which of these children will benefit from cochlear implants. That contradicts the commonly held belief that children with auditory neuropathy would do badly with a cochlear implant. Intracochlear testing identified children with a positive ECAP score that indicated they were good candidates for cochlear implants.

Cochlear Nerve Deficiency More Common Than Previously Thought. A presentation by Dr. Buchman identified one group of patients that do not benefit from cochlear implants: those who do not have a cochlear nerve. His presentation featured the story of a young boy whose cochlear implant was not working. An MRI scan showed that the boy did not have a cochlear nerve, and thus a cochlear implant would never work for him. Dr. Buchman's presentation showed further that cochlear nerve deficiency, which was thought to be an extremely rare condition, is much more common than previously believed. Currently there are 37 children with this condition who are being followed at UNC Hospitals.

The UNC Health Care System is a not-for-profit integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care.

Source: University of North Carolina School of Medicine

Sound Off on Hearing Loss: a Recent Article in PARENTS

MAY 2007: PARENTS magazine

Sound Off on Hearing Loss
Hearing loss is surprisingly common in babies -- but a shocking number of children aren't diagnosed or treated until much too late.
By Ilisa Cohen

The Most Common Birth Defect
Beth Trama, of Smithtown, New York, was watching her son, Luca, sleep peacefully in the hospital nursery, when the newborn next to him let out a loud, high-pitched scream. Luca didn't wake up. Trama couldn't believe that the noise didn't startle him, but she assumed he'd just gotten used to being with all those crying babies -- until he failed his hearing screening the next day.

You're probably surprised to find out that hearing loss is the most common birth defect. Every day, about 33 babies are born in the U.S. with a hearing impairment. But the news hasn't gotten through to parents -- in fact, only 1 percent of new and expectant moms ranked hearing loss as their top concern about their child's health, according to a survey by the Alexander Graham Bell Association for the Deaf and Hard of Hearing, in Washington, D.C.

A Recessive Gene
Many parents figure their baby isn't at risk if they don't have a history of deafness in their family. However, about 90 percent of deaf children are born to hearing parents. Deafness can be caused by a dominant gene -- meaning one or both parents are deaf -- or by a recessive gene, so a child can inherit the trait even if no family members are hearing-impaired. That's what happened to Luca. After his diagnosis, doctors discovered that both of his parents had a recessive gene for a genetic disorder that damages the hair cells in the inner ear so they can't carry sound to the auditory nerve. As a result, Luca is severely deaf in both ears.

Hearing loss can also be caused by many nonhereditary factors, including infections, prematurity, severe jaundice, or a lack of oxygen during delivery, says Ellen M. Friedman, MD, chief of pediatric otolaryngology at Texas Children's Hospital, in Houston. Unfortunately, most of these causes aren't preventable.

Testing 1, 2, 3
You can't count on your baby's doctor to identify a problem -- most pediatricians don't have the proper equipment to do infant hearing tests in their offices.

Before you give birth, check with your hospital to make sure that hearing testing is part of their newborn screening process. If it's not, or if you give birth somewhere other than a hospital, ask your pediatrician to recommend a pediatric audiologist or otologist to screen your baby within her first three weeks. Hearing tests for newborns are mandatory in 42 states and in Washington, D.C. (although small hospitals may be exempt). "However, every baby's hearing should be tested at birth so that parents can get help quickly if there's a problem," says Simon C. Parisier, MD, cofounder of the Children's Hearing Institute, in New York City. Testing is especially crucial because research has shown that parents' impressions about their infant's hearing are often wrong. Even deaf babies can coo and make gurgling sounds. If you're not sure whether your baby has been tested, contact your hospital to check her records.

How It Works
A hearing test is easy and painless. Doctors use one of two measures: an otoacoustic emissions (OAE) test, which measures the response by the hair cells inside the ear when they're stimulated by sound, or an auditory brain-stem response (ABR) test, which measures brain-wave activity in response to sound. Both of these tests are given while the baby is asleep, and for babies, they're both pass-or-fail: They only tell doctors if a baby can hear 30 decibels (the sound of a whisper), which is the definition of normal hearing. If your baby fails the initial screening test, you need to make an appointment with an audiologist for more comprehensive testing in order to confirm the results, determine the severity of the loss, and get proper treatment.

"I wish I'd pushed the doctors to treat my baby's hearing loss sooner," says Heather Conar, of Nashville. Her son, Jacob, failed his hearing screening at birth, but he wasn't officially diagnosed with hearing loss and fitted for a hearing aid until he was more than a year old. "They thought the trouble was caused by fluid in his ears that would drain, but it turns out his hearing loss was permanent from the beginning," she says.

Doctors initially thought that Jacob had conductive hearing loss, which is caused by a blockage in the middle ear that makes sounds muffled. Babies who've had frequent ear infections can experience this type of mild, temporary loss due to fluid buildup in the ear. It can usually be corrected by putting tubes in the ears to drain the liquid. Sensorineural hearing loss, the kind that Jacob actually has, is more serious -- and usually permanent -- because it's caused by a problem with a child's auditory nerve. A child will need a hearing aid, which Jacob now has, or a cochlear implant (an electronic device that is surgically implanted behind the ear to stimulate the auditory nerve) in order to hear normally.

Even if your baby passes her infant screening test, it's important to continually pay attention to her behavior and reactions to sound, says Dr. Friedman. Hearing loss can be progressive or can occur as your child gets older. Risk factors for delayed-onset hearing loss include a family history of childhood hearing loss, recurring or persistent ear infections for at least three months, head trauma, and serious infections like bacterial meningitis. If you're ever concerned, take your child to get a hearing test.

Don't Delay
Sadly, many kids aren't diagnosed with hearing loss until age 2 -- which is way beyond the critical window for developing speech and language skills. Your child learns to speak correctly by hearing sounds around him and listening to your voice. If he can't hear during his first six months, he's missing an important opportunity. Children with a hearing impairment often learn new words more slowly than other children, understand and produce shorter sentences, have trouble with quiet speech sounds like the "s," "sh," "f," "t," and "k," and don't do as well academically.

While it's never too late to get help, experts say that it's ideal to start early intervention -- including speech and listening training -- before 6 months of age. With an early diagnosis and hearing aids or other interventions, most kids who are deaf or hard-of-hearing will develop language skills comparable with their peers by first grade. Children as young as 3 months can be fitted with hearing aids, and those with profound hearing loss can get a cochlear implant at age 1. Cochlear implants have been controversial within the deaf community because they try to "fix" the trait that's central to deaf culture. "Having known many deaf people, I used to be more wary of implants, but now I've seen how fantastic they can be for kids," says Dr. Friedman. Children who have hearing aids or cochlear implants usually go to mainstream schools, can speak relatively clearly, and are less isolated than those who rely only on sign language.

To make the best decision for your child, it's important to speak to doctors, audiologists, and other parents. "We have a whole 'new family' of people who've helped keep us informed, find schools, interview surgeons, and do anything necessary to help our son," says Beth Trama. Luca got a cochlear implant just a few months before his first birthday. Now 3 1/2, he's communicating well, attending nursery school, and, most important, says Trama, "He's a happy, spunky little kid."

Can You Hear Me Now?
Even babies who pass the newborn hearing screening can develop hearing loss later on. If your baby doesn't reach these milestones, it's a good idea to have her hearing retested.

At 3 months
Turns her eyes or head toward loud sounds

Begins to imitate some sounds

Smiles at the sound of your voice

At 7 months
Looks at you when you call her name

Responds to sound by making sounds

Babbles chains of sounds like "ba-ba-ba-ba"

At 12 months
Responds to "no" and simple requests

Says words like "dada" and "mama"

Understands common phrases like "bye-bye"

At 24 months
Says at least 15 words

Uses two- to four-word phrases

Repeats words overheard in conversation

Saturday, May 5, 2007

Meeting Info 2/12/07

On 2/12/07
We met
Erin Lucas & Diane Doak, Beginnings Parent Educators
And talked about
Independent Education Plans and Parent Advocacy

Home - Schedule - About Us - Resources - Contact Us - News