Va. gives deaf babies a head start

Early diagnosis called key to dealing with disability

March 15, 2001|By Liz Szabo | Liz Szabo,KNIGHT RIDDER/TRIBUNE

NORFOLK, Va. - Four-month-old Caleb Reynolds gurgles and coos just like any other baby. When his mother, Kelly, whispers to him, he tries to talk back. When she speaks from the other side of the room, he turns his head to watch.

She said it never would have occurred to her that little Caleb is deaf.

If Caleb's hearing hadn't been tested at birth through a new Virginia program, Reynolds might not have realized her son's disability for another year or more. Many deaf children aren't diagnosed until age 2 or 3 - after they've already suffered irreversible language delays that keep them from learning to read or write as well as their peers.

`We can move forward'

"They say that if you start early on, babies have a much better chance of not falling behind," said Reynolds, who lives in Virginia Beach. "Now we can move forward."

Reynolds has already arranged for her son to begin intensive early language therapy. Soon, he'll be fitted with tiny hearing aids, and the whole family will begin learning sign language.

Caleb is one of at least 47 babies identified as hearing-impaired since July 1, when a state law requiring universal newborn hearing screening took full effect, according to preliminary data from the Virginia Department of Health.

In only five months, doctors identified twice as many hearing-impaired babies as were previously diagnosed in an entire year, said Dr. Barry Strasnick, a Norfolk surgeon who was one of the law's chief promoters. Doctors say they'll likely identify greater numbers of children as hospitals become accustomed to performing the tests.

The law, passed three years ago, required hospitals with specialized intensive-care units to begin the testing by July 1, 1999. The screening became standard at all Virginia hospitals last summer.

Paying for screenings

Supporters hope to expand the law during the current General Assembly session by passing a bill that would require health insurance companies to pay for the screenings, which typically cost $20 to $50.

The automated tests are quick, painless and rely on brain-stem response, so they can be performed while a baby sleeps. Babies who fail the tests are referred to audiologists for follow-up exams.

The bill is sponsored by Sen. J. Randy Forbes of Chesapeake. So far, Forbes said he hasn't heard of any opposition. Even the Virginia Association of Health Plans - which represents managed-care companies - has no problem with the legislation, said Director of Policy Lynn Warren.

"The costs are so minimal compared to the benefits you get," said Forbes, who also sponsored the original legislation. "In the long run, this saves money, and by getting to these children early, it makes such a difference in their quality of life. Bills like these don't get much attention, but this is one that will touch as many lives as any bill we've gotten through."

Hearing loss is the most common birth defect in the United States, affecting about one to three of every 1,000 newborns, or about 24,000 babies a year nationally, and 100 to 500 in Virginia.

Deafness is far more common than other diseases for which babies are routinely screened, such as phenylkentonuria, or PKU, which affects about 400 newborns a year nationwide.

Seeking early diagnosis

The American Academy of Pediatrics has championed newborn screening since 1994. The sooner children are diagnosed, the sooner their parents can begin learning sign language - a difficult process - and investigating technology such as hearing aids or cochlear implants, which use electrical impulses to process sound.

Deaf children diagnosed by 6 months often perform at about the same level as other children by the time they're 5 or 6 years old, said Dr. Andrew J. Schuman, adjunct assistant professor of pediatrics at Dartmouth Medical School.

Today, however, deaf children aren't diagnosed until an average age of 14 months, according to the American Academy of Pediatrics. Those children miss out on critical months of early language stimulation, as well as emotional bonding with their families. Most deaf high school graduates today read at only a fourth-grade level.

Ninety percent of deaf babies are born to hearing parents like Dr. Mark Boston, a resident at Eastern Virginia Medical School. He's seen the difference that early diagnosis has made for his own children. Four-year-old Matthew and 18-month-old Claire are both deaf.

Matthew was diagnosed when he was 13 months. Because that put Claire at high risk for impaired hearing, she was screened soon after birth. She was fitted with hearing aids when she was just 3 months old. At 3 1/2 years, Matthew received a cochlear implant.

"It's ironic that I, as a physician, and my wife, an early childhood education teacher, didn't pick up on my son's hearing loss until he was 12 months old," said Boston, who specializes in care of the ear, nose and throat. "Then it took time to convince the pediatrician."

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