Since I started in school studying speech and hearing (Emerson College, 1961), I remember hearing about Better Speech and Hearing Month. BHSM was started by the American Speech-Language-Hearing Association (ASHA) in 1927 , when they were known as the American Speech and Hearing Association. In 1986 Present Ronald Reagan issued a formal proclamation designating May as the official month to “heighten public awareness” about hearing loss and speech disorders.
BHSM was then and is now a time to improve awareness about speech and hearing. Certainly in 1927 people did not pay a lot of attention to speech and hearing issues. Adults assumed hearing got worse and you couldn’t doing anything about it. People had trouble talking after strokes and that was that. Certainly no one paid a lot of attention kids development until it was noticed that Kids were not talking. But in 1927 what could they do? If kids speech was poor, well, that kid was “slow”.
We’ve come a long way
ASHA, AAA, and all the hearing aid and cochlear implant companies have picked up the flag and now everyone celebrates better Hearing and Speech Month. We now know that many speech, language and hearing disorders can be managed. We recognize that we can identify hearing loss in newborns (thanks to the awareness that BHSM provided). We fit babies with technology in the first few months and they start therapy very early. As a result, they function as part of the hearing world.
Newborn hearing screening
One of the most obvious successes of BHSM and all the awareness about speech and hearing disorders is early identification. We now have newborn hearing screening in all 50 states so babies are identified early, fit with technology, and are on their way. Schools screen hearing regularly. Pediatricians, teachers and other school personnel recognize speech and language disorders and kids get referred to speech-language pathologists for evaluation and management.
In high school, I started volunteering at the New York League for the Hard of Hearing in their Saturday morning program. At that time, there were no teachers of the deaf providing services for children in the mainstream setting, so children came into the League on Saturday morning for pre and post teaching that should now be provided by teachers of the deaf in their schools. After a year volunteering I knew what I was going to do when I grew up.
I went to Emerson College and met my mentor, David Luterman, who taught me a great deal more than I could learn from books. He taught me an attitude about what was possible for kids with hearing loss and about how important providing family support is. Off I went to the University of Wisconsin to get a Master’s degree. In the olden days we got a combined speech and hearing degree, and although I knew I wanted to work primarily in audiology, I cannot tell you how much I value all I learning in speech/language courses and clinical practicum. It helped me to recognize all variety of speech/language disorders in children who came to see you for audiology evaluations and I know made me a better diagnostician.
In 1965, David Luterman decided to start one of the first integrated nursery programs for deaf children with two typical hearing children in the group as both language and behavior models. David wanted parents to see that a lot of that 2 year old behavior had nothing to do with hearing loss but was just typical two year old behavior and should be managed as such. I returned to Emerson to be the audiologist in the nursery. One day, I came into David’s office after trying to test a child and said to him “This child is untestable”. David then said what may have been the most important thing that anyone has ever said in my professional training. “What you mean is that you don’t know how to test this child.” He was right. I never said that again. If I could not test a child I said, and wrote in my report, “I am unable to test this child”. I did not want to write that a lot so I worked very hard to develop testing skills so that I would not have to often say I couldn’t test a child.
Oh how technology has changed!
I returned to Wisconsin to get my PhD in 1969 and then began 45 wonderful years of clinical work. In the early days technology was not so wonderful. BTE hearing aids were around from the late 50’s but they were not great. They were analog, they had static, they had limited gain and frequency response. How deaf kids learned to listen and talk with them is really beyond me, but they did. A testament to the auditory brain. Kids with severe and profound hearing loss did not get enough gain. I used to fit them with body worn FM systems and have parents wear an FM transmitter. I could be sure then that they got more sound. Everyone hated them but they did hear better. When I see parents and kids now who had worn these “boxes” they still talk about then.
It wasn’t that easy to tell families that they had a deaf child. After I broke the news I would often go into my office, shut the door, and cry. I knew that the families would work very hard to get their kids to were they wanted then to be. Badly as they heard with that technology we had physicians, lawyers, teachers and absolutely every possible career in those kids. They were wonderful.
Hearing aids are much better than they were. Now we know that kids were mild to moderately severe hearing losses will hear well with hearing aids (as long as we get them to wear them.)
And then along came cochlear implants
I was not a believer in cochlear implants in the beginning. How could this stuff possibly work? Well, to put it mildly, I was wrong. We are putting implants on babies now so that their listening age is close to their chronological age. They are an entirely different group. You can hear from their voices that they are hearing sooooo much. Those “deaf” voices are gone. They are hearing children. They still need therapy and they still have problems hearing in noise but it is not the same ballpark.
What’s left to do?
Of course, the work is not done. We need to continue to educate new parents, adults as they get older, new physicians and teachers about the effects of speech and hearing disorders and help them identify disorders and figure out who to refer to and how to treat them.
We also need to spread the news to the rest of the world. In many countries, people are not paying attention to speech and hearing disorders. We need to help that change.