Wyatt Randal can hear for the first time.
It’s an adjustment the 2 1/2 year old International Falls boy is making thanks to a cochlear implant he received at the University of Minnesota.
“It is amazing now with the implant,” said Denise Romanowicz, Wyatt’s grandmother.
His mother, Darcy, said that all the trips to the Twin Cities do not weigh in comparison to seeing Wyatt turn his head in response to hearing vehicles drive by their house.
All the work is worth it to see him respond to his name, she said.
The son of Darcy and Will Randal, Wyatt was born with a deformed cochlear. He was screened for hearing loss as an infant, and the extent of his deafness was discovered as his audiologist noted a lack of progress with speaking and hearing response.
Hearing aids caused discomfort as his inner ear filled with fluid, according to Darcy. “He didn’t want to wear the hearing aids until he was a year and a half,” she added. “He fought us tooth and nail.”
A team of doctors at the University of Minnesota started working with Wyatt last April. When CT scans revealed the trouble with his temporal bone and inner ear, Wyatt was fitted for a cochlear implant.
A device was surgically implanted into Wyatt’s snail shaped cochlea. An earpiece microphone transmits sound to an external device that is held in place by a magnet under his scalp, that in turn transmits sound to his inner ear.
“It stimulates the electrodes in his ear and simulates hairs and follicles and allows him to hear,” said Darcy.
A separate battery pack is positioned on his back. When Wyatt gets older, his ear will be big enough to hold the battery piece on the microphone.
Expected complications after surgery required follow up operations to reposition the implant and install a lumbar draining tube on his lower back.
“He came out of that surgery just fine but lost some muscle tone and some coordination in his hands from the long sedation,” said Darcy. “This is not permanent, and he has made a tremendous turnaround in six weeks of physical therapy.”
Wyatt tested at low frequency hearing at 110 decibels without hearing aids before the operation. That is like not hearing a jet engine, according to Jennifer Ward, an audiologist at the University of Minnesota.
With hearing aids, Wyatt was responding at the loudest end of conversational levels at 60 to 80 decibels. The low end of conversation is at 40 decibels. A whisper is about 35 decibels.
“Wyatt wasn’t receiving enough benefit from the amplification of his hearing aids,” said Ward, noting that he was tested at 45 decibels after the implant.
“He has done fabulous,” said Ward. “Now he is hearing soft speech.”
As Wyatt adapts to his implant, Ward said she tweaks the device to help him hear at all levels with a good dynamic range of sound. She controls the current flow to 22 contact points on the electrode that was inserted into his cochlea.
The implant processor operates on software that receives updates to the external implant via computer during six month check ups. Ward noted that equipment upgrades are retrofitted to allow replacement without surgery whenever possible.
Wyatt should eventually hear at his normal range of sound. Ward said that means being able to hear soft sounds without the loud sounds seeming too strong.
“We will continue to do testing and fine tune the programs,” she said.
At home the Randal’s can tell if the device is working by LED lights that indicate current, cable connections and battery life.
The transition from deafness to hearing takes more than the technology. Wyatt is now learning to associate new sounds into speech and learning.
“Wyatt has a great support system in his parents and grandparents and that is key in order for this to work,” said Ward.
Roxanne Skogstad–Ditsch works with Wyatt, along with 41 other deaf and hard of hearing children, Early Childhood Special Education and young people with autism for the International Falls school district.
Skogstad-Ditsch said that until the extent of Wyatt’s hearing loss was known he learned sign along with some hearing related curriculum. His audible responses were reduced to clicking and mumbling sounds before the implant. After the implant he made babbling sounds as early attempts to associate hearing.
“Now we have to convince him that it is really good and fun to use auditory,” said Skogstad-Ditsch. “He really didn’t use too many sounds when he was signing but he does now.”
Wyatt’s brain was “wired” for sign and touch communication modes, Skogstad-Ditsch said. Although he remains comfortable expressing complete thoughts with sign, she said Wyatt is extremely bright and is confident that he will become comfortable with hearing learning over the next several months.
“That adjustment is not complete yet and at this point we are using a combination of voice and sign,” she said. “At some point we are going to slowly drop the sign and are hopeful it will be a smooth and easy transition to go to completely auditory learning.”
The transition becomes noticeable as Wyatt begins to associate sounds and forms spoken words in response. They begin with cassette tapes to associate sounds, such as a dog barking, a door closing, a hammer hitting a nail.
Skogstad-Ditsch said the family helps at home by looking for responses to statements, such as, “Is that dad coming to the door?” or “What is that noise?”
At home Wyatt has the support of parents and grandparents who know sign language and understand what how to transition to auditory learning.
Darcy was born with moderate hearing loss and was fitted with hearing aids at age two. Her father and mother are also deaf or hard of hearing, and have been since birth.
In Wyatt’s case, it takes patience and a lot of attention, said Darcy. All learning was done by sight, touch and feel until the implant. Wyatt eventually learned from 75 to 100 signs.
