August 28, 1997 in Nation/World

Sound Decision Hospitals Agree To Start Hearing Tests For Infants

By The Spokesman-Review
 

Nine-month-old Cassidy Walter didn’t always respond to her name.

“A door would slam, and she wouldn’t jump at all,” recalled her mother, Cathy.

So Cathy and Jeff Walter of Spokane decided their baby might not be hearing properly. Now, after six months of delays and examinations, Cassidy wears a hearing aid.

She was lucky. Most hearing loss in kids isn’t discovered until they are 2 or 3 years old and way behind in their development.

Cassidy was unlucky, too. She was born at an Inland Northwest hospital, none of which routinely screens babies for hearing problems.

That’s starting to change.

Deaconess Medical Center plans to start testing all newborns within a matter of months. Kootenai Medical Center in Coeur d’Alene has made a commitment to do the same, although no timetable has been set.

The need for universal screening is a continuing topic of discussion at Sacred Heart Medical Center, where Cassidy was born.

Some experts were recommending infant hearing tests 50 years ago. But the idea took off with better technology and a 1989 goal set by then-Surgeon General C. Everett Koop. He wanted universal screening by the year 2000.

In 1993, the National Institutes of Health recommended screening of all infants before they are 3 months old. Because most babies are born in hospitals, experts agree that is the logical time and place to test them.

Spokane’s Sacred Heart and Deaconess are the only hospitals in the region that test hearing in high-risk infants. Those include babies who are premature, have physical deformities, are being given antibiotics or have a family history of deafness.

About six babies out of every 1,000 are born with significant hearing loss, according to Dr. Thomas deTar.

“If we screen only high-risk babies, we’re going to miss 50 percent of those,” said deTar, an ear, nose and throat specialist who has offices in Post Falls and the Spokane Valley.

DeTar is Cassidy Walter’s doctor.

“It’s very satisfying to pick them up,” he said of her relatively early diagnosis.

“Most of these kids traditionally are not detected until they’re 2 or 3 and don’t start speaking. They’re developmentally delayed.”

When a baby is diagnosed as deaf, the family can start using sign language to communicate.

When nerve damage is limited, babies can benefit from a hearing aid.

But that hardly provides instant communication, Cathy Walter said.

“I thought, ‘We’re set.’ But she had never even heard her name before. So when I said ‘Cassidy,’ she didn’t know what I was talking about.”

Chuck Whiteley wants kids to get help as soon as possible.

For decades he’s done volunteer work for hospitals in California and in Spokane, even parachuting and bungee-jumping to raise money to identify and help hard-of-hearing kids.

A member of the Coeur d’Alene Kiwanis, he decided the service group should help babies born at KMC.

Early this year, Whiteley showed up unannounced at a KMC board of trustees meeting and challenged the hospital to do universal hearing screening. In his retirement he sells hearing aids for adults and knows that good tests are available for infants, too.

“You put headphones on the baby, punch some numbers and bingo! - it’s pass or fail,” he said.

What Whiteley described is the OAE, or otoacoustic emissions test. It sends clicks into the ear of a baby, who’s normally asleep for the procedure, and uses a sensitive microphone to determine if a sound bounces back.

If the proper sound isn’t produced, and the baby fails that test, a second test can be used to confirm a hearing problem.

Called ABR, short for auditory brain stem response, it involves putting monitors on a baby’s scalp and measuring impulses in response to sound.

ABR is being used in the Spokane hospital and some doctors’ offices to test high-risk infants.

Jean Bening, Kootenai Medical Center’s director of perinatal services, will recommend that her hospital get a $25,000 device that will allow both tests to be done.

On Wednesday, she bounced that idea off a group of local activists and got an enthusiastic response. Among those present were members of the Kiwanis and Rotary clubs, and Self Help for the Hard of Hearing.

They pledged to start a drive to raise the money. The hospital will gratefully accept contributions, but will buy the equipment in any case, Bening said.

The cost of the equipment is small compared with the cost of rehabilitation for deaf children, she noted.

John Centa of the Idaho Council for the Deaf and Hard of Hearing said the early testing will save a lot of misery as well as money. But he hopes Idaho won’t go the way of other states that have mandated the newborn screening.

“If it takes place at the local level and with local support, it beats the heck out of government intervention,” he said.

An Eastern Washington University audiologist has tried unsuccessfully to get grant money to develop a pilot program at Sacred Heart Medical Center, said Karen Harmitz, nursing manager for the neonatal intensive care unit.

“I for one would certainly like to see it,” she said.

Deaconess Medical Center has $30,000 to buy a new testing device. The money came from the Children’s Miracle Network, a citywide telethon.

Ann Seaburg, manager of the neonatal intensive care unit, said the hospital decided to buy the best equipment available.

“The cheaper equipment gives a higher false-positive rate,” she said. “It’ll say there’s a problem when there’s not. You have to explain that to parents, and (without the better equipment) wait two months until we can retest. That causes a lot of anxiety.”

, DataTimes ILLUSTRATION: Color Photo

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