Polk County Itemizer-Observer
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His door to the world
1-year old Ben Casalegno adapts to hearing for the first time
Ben’s parents, Adam and Jen, and Willamette ESD early intervention specialist Angie Mulkey put Ben’s outer implant on him for the first time.
January 20, 2010
EDITOR'S NOTE: This is the second of a two-part series following 1-year-old Ben Casalegno, who was born almost deaf, as he went through surgery to install an implant in his right ear that allows him to hear.
DALLAS -- There's a world full of sound out there. Ben Casalegno is ready to experience it -- a little bit at a time.
On Dec. 23 Ben, who recently turned 1, had surgery to place an implant in his right ear. Born profoundly deaf in his right side, the implant will allow him to detect sound and help him develop verbal communication skills.
Almost a week later, the family was given the external equipment Ben will wear while using the implant that lets him get used to wearing the processor which will magnetically connect to his head.
On Jan. 5, he went through the next step: implant activation. It's unlikely Ben noticed. That was the intent.
The goal was to make Ben's introduction to sound as comfortable as possible. Too much sound too soon could be scary for him.
"The good news is that you can hear, and the bad news is that you can hear," said audiologist Nadine Palmateer, who has worked with Ben almost since his birth. "The world can be a noisy place, so they start out slowly."
Ben played with his favorite hammer and other toys and ate crackers as Dr. Don Plapinger, an audiologist in Oregon Health & Science University's cochlear implant program, activated the implant. He provided the youngster's parents, Adam and Jen Casalegno, with four sound programs that have gradually turned up the volume on Ben's world. They are able to control the sound level through a remote.
Most of the appointment that day was spent distracting the energetic boy from yanking the external receiver off his head and keeping the earpiece on his tiny ear.
Plapinger said it is difficult to accurately measure what Ben hears based on observation. Generally speaking, though, Ben's parents know their little boy is experiencing sound for the first time. First they noticed a behavior change. He temporarily stopped playing with loud toys and toned down his vocalization.
"We think he was starting to hear the sounds he was making for the first time," Jen Casalegno said.
Soon, Ben adapted and was back to his noisy self, she said.
In another first, Casalegno said she saw him react to sound about six days after the initial activation. She said he was walking across the room when she slammed his toy box lid closed.
"He dropped to the ground and turned to look at me," she said. "It was very exciting."
Plapinger said Ben is embarking on a process that will eventually progress beyond hearing sound and accepting it to understanding what sounds mean. Plapinger said Ben will learn through interaction, observation and continued work with his early intervention specialist, Angie Mulkey.
All things being equal, Ben should be able to hear all speech sound and enjoy music, Plapinger said.
"We never know how kids will respond," he said. "This gives him the opportunity."
The youngster will have his first testing in a controlled environment on Friday, Jan. 22. That test will determine what decibel level Ben is able to detect. The results will enable Plapinger to adjust the implant and increase the amount of sound Ben can hear.
His doctors estimate Ben will begin speaking in about eight to 10 months. Ben will continue to learn sign language while adapting to sound.
Palmateer said adding spoken language to what he is already learning will open a world of communication for Ben.
"He's going to explode with language," she said.
Palmateer gives the boy's family much of the credit for Ben's success so far. The goal is to put him in a mainstream school, though depending on his development, he may begin his education at a school for deaf and hard-of-hearing children.
"We expect him to do really well because of his family," Palmateer said.
Plapinger said Ben's journey is a good example of the opportunities early testing and diagnosis gives deaf children.
Since 2001, newborn screening tests have been mandatory in Oregon, Plapinger said. Without the tests, the average age of hearing loss identification is 2« years, putting children that far behind in developing communication skills, whether they be verbal or sign.
For those whose families choose an implant and have it done early, speech development is often on track with children with no hearing loss, Plapinger said.
"It's important for parents to realize that younger is better," he said.
Palmateer said 30 years ago when she started her career, audiologists could only dream of the kind of technology Ben is using today. Watching the devices develop and help children has been amazing.
"This is the door to the world," Palmateer said. "It's fabulous stuff."
While implant technology is impressive, the Casalegnos are committed to teaching Ben that deafness is a part of who he is. The implant doesn't cure Ben, but is simply a tool to help him communicate, Jen Casalegno said. She added they have a responsibility to educate Ben in deaf heritage and history.
She said he will learn about deaf people and their many successes in life. His parents also want Ben to develop friendships with other deaf children and those who have implants, so he feels included in the deaf community.
"We hope to have a child who is proud of who he is and that his options in life are limitless," Casalegno said.