Some good news: an FDA change in the age limit for cochlear implants from one year to nine months of age has led to immediate results. Baby Liv, who turned one on June 13th, first heard her mother’s voice at just ten months. Watch as the baby hears her mom for the first time. The joy on both their faces is priceless.
Cochlear implants have been around for decades, but substantive improvements in technology have made them a completely viable auditory solution for profoundly deaf children. Here’s the trick: the younger the implant recipient, the better the results, because the brain has the time and plasticity to decode the sounds the implant creates.
For baby Liv, it was a 10-month long road that started almost at her moment of birth.
The Family’s Decision
Liv’s parents, Marnie and Derrick, knew she had hearing loss very early, thanks to a newborn child hearing screen performed within 24 hours of her birth. Liv was “referred,” meaning loss was detected, and her parents were surprised; there’s no hearing loss in their family medical histories.
A more sophisticated test, called an auditory brain stem response (ABR), garnered more specific results.
“They did that test on her and it came back with a moderate hearing loss in the right ear and a severe sloping to profound in the left ear,” Marnie told Parentology. “That was the first result that we received. It’s not that we didn’t believe it, but we just were like, “It can’t possibly be that.”
From that point on, the parents had some decisions to make. When a child is born with hearing loss, there are a few options. One is for the family to learn sign language (ASL), another is perhaps hearing aids, and yet another is cochlear implants. The family was handed a large binder outlining these choices.
“There was no pushing either way. There really wouldn’t have been any dialogue if we didn’t even ask questions. So, it’s a very personal decision and they really put it on the family to decide,” Marnie explains.
So the family did copious amounts of research. “We spent months, months and months and those early days were almost like 24 hours of research. We barely slept. We really put a lot of thought and a lot of our heart into it to decide if this is going to be right for our family, but for Livy, most importantly,” Marnie says.
Because she has an older brother, they wanted to mainstream Liv into school. The implants seemed the best way to do that. According to the Cochlear website, “up to 80 percent of children who received cochlear implants younger than 12 months of age demonstrate receptive vocabulary knowledge within the normal range by school entry, and 81 percent of children who receive cochlear implants early attend mainstream schools.”
Time Is of the Essence
Unlike hearing aids, which amplify existing sounds, cochlear implants create the sounds directly. Cochlear implants are designed to mimic the function of a healthy inner ear (or cochlea). They replace the function of damaged sensory hair cells inside the inner ear to help provide clearer sound than what hearing aids can provide.
The brain must learn to decode the sounds and make sense of them. And in the case of children, the earlier one receives the implant, the better for developing speech. “Language development happens in the first year to the first three years of life. So, if you wait beyond three years, the brain doesn’t know what to do with the input at that point and the cochlear implant doesn’t provide much for that person,” Marnie says.
Liv did have hearing aids for about six months (a prerequisite to getting implants). But she didn’t have great results. It made the decision much more clear: get her implants.
Liv was able to take advantage of the FDA age change, although her surgery happened at ten months rather than nine due to COVID-19. She had her surgery April 9, and her implants were “turned on” two weeks later.
Since then, Liv’s understanding of noises and speech have rapidly progressed. “She’s making new sounds in the last week. She understands when you ask her to wave, she’ll respond to her name, turn her head toward the sound. She’s doing normal baby babbling. She loves the sound of whistling, and she sways to music,” Marnie said.
Liv will have her progress monitored by audiologists and will have speech therapy, plus preschool for hearing impaired kids, until kindergarten. It’s not a short road, but her parents hope that she’ll have no limits placed on whatever Liv decides to do and be in her future.
Liv’s implants are from Cochlear Limited, which was the first implant to receive FDA approval in 1990. Implanted during outpatient surgery, implants’ sound processors can log data for audiologists to peruse (and help them tweak performance when necessary).
“Cochlear implants are one of the most revolutionary and effective modern-day implantable solutions that can restore hearing to children and adults with significant hearing loss,” said J. Thomas Roland Jr., MD, Co-Director, Cochlear Implant Center, and Chair, Department of Otolaryngology – Head and Neck Surgery, NYU Langone Health in a press release. “Through our diligent research and years of treating children with hearing loss, we know the earlier a child receives access to sound the sooner they can develop speech and language that will transform their future. It is important that children born deaf have access to cochlear implants as soon as possible to give them the tools to hear and participate in their life to the fullest extent.”
One tech upgrade, Bluetooth and Apple/Android product compatibility, will come in handy later in Liv’s life. She’ll be able to hear phone calls, stream music, and listen to movies and TV without sacrificing battery life or needing intrusive attachments. But for now, this feature is a source of amusement for the parents.
“Derek has the app on his phone as well and for some reason, we can’t figure out how to unpair it but phone calls go to her,” Marnie said, laughing. “Yeah, when he tries to play music and he’ll be like, ‘Why isn’t it playing? It sounds it’s playing but it’s not making any sounds,’ and Livy’s over there like a deer in the headlights, it’s right in her ears.”