Deaf children receiving implants at younger ages

Nathan Greene is 18 months old. And deaf.

Just like his mother.

And his 3-year-old sister, Nicole.

On Thursday, the spunky toddler with the megawatt smile became the third member of his family to receive a cochlear implant. Unlike the others, however, Nathan received the hearing device at a much younger age.

Doctors say cochlear implants, long used to treat profoundly deaf adults and older children, are becoming increasingly common in children as young as 1. In Pennsylvania, the increase has been fueled by a 2002 law that requires hospitals to screen infants for hearing problems soon after birth.

"If you wait until a child is 7 or 10 years old, it may be too late for them to do well," said Dr. Douglas Chen, co-director of the hearing and balance center at Allegheny General Hospital, where Nathan received the implant about a month ago. "If you can put in the device earlier, you can expect better results long-term."

Doctors say an earlier diagnosis of ear trouble can help a child avoid serious speech and language problems, as well as learning and reading disabilities.

"He's behind most kids his age, so he already has a lot of catching up to do," said Nathan's father, Peter Greene, of East Lake, Ohio. "The earlier you do this, the faster he can catch up."

Candidates for the implant have hearing so damaged that hearing aids do no good. The implant, surgically placed in the inner ear, converts sound into electrical impulses that stimulate auditory nerves. The nerves then signal the brain. Experts say one of every 1,000 children has hearing loss severe enough for an implant.

At Children's Hospital of Pittsburgh, where doctors do roughly a dozen implants every year, hearing experts said implants are going into younger and younger children.

"The younger kids that we're seeing were identified at newborn screenings," said Melanie Naylor, an audiologist and coordinator of the cochlear implant program at Children's. Doctors there have put implants in children as young as 14 months old. "The law is definitely having an impact."

It often takes months before doctors see the full effect of an implant in a young, profoundly deaf child.

Yesterday, Nathan was a bit overwhelmed when audiologists tested his implant for the first time. The ring of a bell, the sound of clapping and even his daddy's voice generated the same response: Nathan sucked his left thumb. Then he smiled. And he latched on to the dad he'd never heard before.

Nathan's implant is not expected to provide him with perfect hearing. But it will help him communicate and maybe someday attend a regular classroom.

His sister, who got her implant at 2, has seen remarkable improvement. She can speak more clearly and pronounce words better, her father said. The word "cup" is no longer just "up," the word "boy" no longer "oy."

Greene's wife, Jennifer, who is expecting the couple's third child in about five weeks, received her implant in 1997.

A government study recently linked cochlear implants in children to a small but increased risk of bacterial meningitis. Chen said children should receive a pneumococcal vaccine before getting the implant.

"The advantages of implants far outweigh the risks," Chen said.