Sound Decision

By Paula J. McGarvey - 04/19/2008

Photos by Walter Hinick / The Montana Standard Sam Ross was fitted with hearing aids at age 4 months, but continued to miss speech sounds.

On a recent Sunday afternoon the Ross family of Deer Lodge gathered to celebrate baby Sam’s first birthday.

Like any child, Sam tore his way through a rainbow of gift-wrapped boxes with delight. As the birthday candle burned brightly on his cake, there was hope in the hearts of all his guests that by this time next year, Sam will actually be able to hear the chorus of “Happy Birthday” being sung to him.

Born profoundly deaf in both ears, Sam’s biggest birthday gift is yet to come. He was scheduled for surgery in Missoula the following Thursday to receive a cochlear implant in his right ear. (See breakout.) It was just a little over a year ago when Alesha and Dave Ross heard the news that their newborn son had failed his hearing test. Sam’s follow-up test turned out to be inconclusive. Hoping for the best, they conducted their own testing at home.

“I took two frying pans and stood right behind him and ‘bang’ — no reaction. He didn’t even blink,” Dave recalled.

“We set up another screening test with the pediatrician, and he failed again,” added Alesha. Their worst fears were confirmed when Sam failed the follow-up diagnostic testing.

“I cried for weeks,” Alesha said.

“It’s one of those things where you pick yourself up and dust yourself off and do what you can about it,” Dave said.

Family challenge The couple’s first child, Isaac, now 3, had been born with normal hearing. The family now faced the challenge of raising a deaf child.

“The hardest thing for me is just how it changed everything. It set our family on a completely different path than what we had planned,” Alesha said.

With Sam’s diagnosis, the Ross family was given a booklet with guidelines on parenting a deaf child. They contacted the Montana School for the Deaf and Blind and began taking advantage of all the available state resources geared toward the hearing impaired.

By four months, the Ross’s had outfitted Sam with a hearing aid. Alesha said that the device provides Sam with some benefit, when he’s not pulling it out of his ear in frustration. Sam travels with his family to Dillon once a week for auditory training designed to teach him to respond to sound.

“He misses the speech sounds, but he will alert to louder sounds,” Alesha said.

By six months, sign language classes had begun.

“Our family adviser comes from Butte once a week on Tuesdays” said Alesha, adding that the event is a family affair.

“We have 12 to 15 people that come each week. It gets pretty crowded when everyone is here,” she said.

Sam has already learned to sign nine words and phrases, including fish, milk, more, light, water, fan, kitty, I love you, and Daddy.

“We’re working on Mom,” Alesha said.

Dave admits that learning sign language has been overwhelming.

“You don’t realize how many words there are in the English language until you try to learn how to sign them,” he said.

That’s not the case for big brother, Isaac.

“Isaac has about 75 words or more that he knows,” said Alesha, adding that Isaac has had some difficulty adjusting to his baby brother’s increased need for attention. Despite their proactive approach to their son’s deafness, the family still faces ongoing challenges meeting Sam’s needs.

“We do pretty good most of the time. I think his biggest problem is his patience. If we’re not right on top of it, he gets pretty mad,” said Dave.

Non-hearing world The family cannot take normal occurrences in the hearing world for granted. For instance, Alesha cannot use her voice to communicate with Sam when he cannot see her.

“When his car seat’s facing back and you’re driving down the road you can’t calm him down,” she said.

With the lack of hearing impacting Sam’s ability to develop normal speech, Alesha and Dave were concerned about Sam’s future ability to communicate. When they learned that Sam would be a candidate for cochlear implants, they elected to have the surgery.

The anxiety built in the days leading up to the procedure. A dry erase board on the home office wall counted down the days until surgery with the added words: “Pray for a Miracle.” On the day of Sam’s surgery, the family nervously waited during the two-hour procedure.

“I was terrified,” admitted Alesha, who said Sam recovered quickly. A two-inch scar behind his right ear is healing nicely.

Cochlear implants Dr. Peter von Doersten, an ear, nose and throat specialist and certified neuro-otologist at the Rocky Mountain Ear, Nose, and Throat Center in Missoula, said cochlear implants are offered to patients with certain types of deafness who have profound hearing impairment in both ears. While adults receiving implants typically have the procedure performed in both ears simultaneously during a three- to four-hour surgical procedure, von Doersten said that the process must be modified for infants.

“That’s a little long for an infant. There are pediatric anesthesia concerns,” he said.

To compensate, the implant surgery is broken down into two, two-hour surgeries. The process also presents challenges based on an infant’s smaller anatomy, though they routinely recover faster than their adult counterparts.

“Kids are amazingly resilient,” he said.

Once Sam’s scar has healed, the family will travel to Spokane in May to receive Sam’s external speech processor and begin the activation process.

“That involves having a computer analyze the device itself and the patient’s responses to sound. It’s called mapping. The computer will generate a map based on his responses,” said von Doersten.

Alesha and Dave have been watching video clips of the activation of other implant recipients on You-Tube in anticipation. Responses run the gamut from joy to tears.

“I’m hoping he’s not going to cry,” Alesha said.

Von Doersten said that the results of the process vary from person to person.

“Sometimes we just see spectacular results,” he said.

Results can vary Results can range from sound awareness to the ability to understand speech without relying on visual clues, such as lip reading, facial expressions and body language.

“It’s not just like turning on a hearing aid. There’s an absolute adjustment period,” said von Doersten. The activation will be followed by additional mapping sessions where the device is fine-tuned to Sam’s individual auditory system. If all goes well, Sam will have a second implant placed in his left ear within three to six months.

Von Doersten said that like all infants born deaf who receive cochlear implants, Sam will be faced with years of post operative auditory and verbal training to compensate for the months spent in relative silence.

“They’re starting from scratch and they’re starting one to two years later than their peers,” he said.

About cochlear implants According to the National Institute on Deafness and Other Communicative Disorders, cochlear (pronounced coke-lee-are) implants are composed of an internally placed receiver/stimulators that stimulate a part of the inner ear known as the cochlea using signals transmitted from an external speech processor.

The brain interprets these impulses as sound. With computer mapping, the electronic impulses are gradually fine-tuned to the individual’s ability to interpret sound.

Freelance writer Paula McGarvey may be reached via e-mail at pjmcgarvey@in-tch.com.