For the first year of Sam's life, my wife, Teresa, and I worried about his place in the hearing world. The promise of a cochlear implant offered hope, but we still didn't know what to expect. Now, as Sam approaches his third birthday and his second year with a cochlear implant, we no longer worry about what the future holds for him. We're confident that Sam's deafness won't limit his options.
Our family ritual of visiting the hospital twice a week for therapy sessions will soon be coming to an end. Sam's speech therapist recently delivered the news: Sam, she said, no longer needs to attend regular therapy sessions. Once a week for the rest of the summer, and then, as Sam might say, "All done."
The reason? Sam speaks and understands language spoken to him at least as well as his hearing peers. It is time for him to move on.
Getting to this point was supposed to be difficult. With about 200 outpatient and in-home therapy sessions since his implant was activated, it hasn't been easy. But as different as life seemed at first, attending therapy and encouraging Sam's language development at home just became part of our routine. We gave our child opportunities to grow, and Sam seized them.
Sam's First Words
From the day Sam's implant was activated until now, Teresa has faithfully carried a purple composition book in her bag, jotting notes from every therapy session, listing pointers for us to follow and chronicling our son's progress. It is pages and pages of black ink, with one notable exception. On January 20, 2007, she used red ink to write, "Sam said his first word today — 'uh-oh.' Yeah, Sam!!"
In less than 3 months, Sam went from noises to consonant sounds to his first word; 4 months later, the list of words and sounds we kept topped 30. As the number grew, he learned concepts, identified objects, understood action verbs, and started using adjectives. Tests given at the anniversary of his first therapy session showed Sam to be on par with 2-year-old hearing kids.
Today Sam has too many words in his vocabulary to list. He often starts his day by rising from bed, pointing to his right ear and saying, "my implant," which he sleeps without. During the day, Sam speaks and Teresa uncurls the fingers in her cupped hand one at a time to count the words in his sentences and phrases. Increasingly, she needs both hands for the task.
Our oldest son Jack, now 4 years old, plays a big role in Sam's progress. Like all older siblings, he's a role model to Sam. He also has been exposed to the implant and therapy for a good part of his life, enabling him to be the helpful big brother he wants to be.
Jack says sounds he learned from therapy for Sam to repeat, and using the audiologist's standby noise —"bop, bop, bop"— seeks to get a response from Sam whenever he wants to ensure the implant is working. In the morning, Jack helps his mom assemble the parts of Sam's implant, and at night, he presses the start button on the machine that dries the day's moisture from the equipment.
Teresa and I, who are so technically challenged that we've yet to use the iPod we received as a gift 3 years ago, can strip the implant components down and reassemble the unit with military speed and precision. We remove the external components when Sam takes a bath, swims, or sleeps. Help messages on the implant's display assist in identifying low battery power and other issues that might arise, and the manufacturer has been quick to ship replacements when parts have worn out.
Just One of the Boys
On car rides, Jack and Sam point out fire hydrants, school buses, Dunkin' Donuts restaurants, and other objects of interest to each other. They giggle, they fight, and when things get too loud, Teresa and I make eye contact and smile. Before telling them to quiet down, we make it a point to recognize the irony in shushing Sam, whose ability to speak was once a major concern for us.
Not only can Sam speak, but he can also demonstrate subtleties of speech, like intonation and inflection. His listening skills are equally impressive. On a recent visit to his grandmother's house, Sam overheard Teresa ask her mother in a normal speaking voice where he was. Separated by a wall with a doorway around the corner, a little voice from the family room said, "I'm in here."
It's hard to distinguish Sam's performance from the typical hearing child his age, but sometimes we notice him working to determine where a sound came from. We were told that localizing sound could be a challenge, but at this point it hasn't been a big issue.
Teresa and I think the cochlear implant is amazing. We truly enjoy turning a stranger's curious stare at the little contraption Sam wears into an opportunity to educate someone else about the incredible device.
The implant was introduced to us as a prosthetic with potential that could only be fully realized through commitment. That wasn't a problem for our family. We've also been very fortunate. We've received excellent services, generous flexibility from my employer, and invaluable insights from other parents of children with implants.
Sam's journey is far from over. Every event — from getting dressed and eating a meal to a trip to the store or time on the playground — presents new language opportunities for him. Teresa and I will investigate schooling and the latest research on the potential benefits of an implant for his other ear, but we'll do so with a confidence we couldn't have imagined when we set out on this path. We'll also carry on with a sense of wonderment and gratitude that helps us appreciate our experiences as a family that much more.
During the course of Sam's therapy, he saw the doctors at the hospital who performed his surgery. On those two separate occasions, he said "Thank you, doctor." From the first person who imagined the cochlear implant to the doctors, nurses, therapists, friends, and family who have touched our lives since, we also send our sincerest thanks.