ECHO - Expanding Children's Hearing Opportunities
"ECHO is a comprehensive program that provides diagnostic services and
treatment for any child with hearing loss, regardless of their communication mode, where
they live, or the cause of their hearing loss," -Dr. Michael Novak,
Medical Director of ECHO
email: echo@carle.com
The ECHO Program
The ECHO program at Carle Foundation Hospital in Urbana, Illinois, brings together one
of the nation's finest teams for identifying and treating children with hearing loss.
Michael Novak, MD, a Carle otologist, leads a multidisciplinary team trained in audiology,
speech-language pathology and education of the hearing-impaired.
The ECHO program also has a licensed clinical psychologist and licensed clinical social
worker available for consultation and support. By specializing in pediatric evaluations
and treatment, providing close follow-up and facilitating education, we are able to
provide service that draws families from across the country.
The primary goal is to help children develop their communication skills to their
fullest potential. Accomplishing this goal requires more than just treatment, it demands
an all-encompassing commitment on the part of the child, parents, family and primary
educators. The team strives to bring awareness and understanding of each child's needs by
addressing five major areas of service:
- Providing direct service to children (ages birth to 21)
- Advising parents
- Providing consultation services to educators
- Developing materials for assistance
- Conducting research
The ECHO team is dedicated to achieving a comprehensive program for each child.
Realizing every child's needs differ, ECHO team members work with families to develop
individual treatment plans, which may consist of any or all of the following services:
ECHO Services Expand Children's Hearing Opportunities
Identification
When developing hearing and communication skills, early identification and intervention
are essential. For this reason Carle Foundation Hospital staff conduct universal
screenings in the infant nursery. This offers an opportunity to detect hearing loss
shortly after birth. Whether a child is born deaf, or loses hearing later in life, once
hearing loss is confirmed, the family is referred to the ECHO program to learn more about
its impact on communication and overall development.
Initial Evaluation
Every child who is referred to the ECHO program receives an initial evaluation to
determine the extent of hearing loss. When young children are tested, two team members
participate. The first operates the equipment and observes the child for responses to
sound. The second assists in watching for or confirming responses and explains the testing
procedure to parents. Initial evaluation could take several sessions to ensure accurate
measurement. An auditory brain stem response test and other objective test measures may
also be performed to confirm the loss or to obtain more information regarding the child's
hearing levels.
Hearing Aids
After hearing loss has been confirmed, the child begins a hearing aid trial. This is
the next step in assessing the functional hearing necessary to develop spoken language.
Once fitted, aided hearing testing is done to determine how much hearing the devices
provide. Again, to ensure accuracy, test results may need to be confirmed over the course
of several visits. The trial period with hearing aids may take three months or more to
determine the degree of benefit the child receives. Parent education, support and
parent-infant therapy are all critical for monitoring the child's progress with the
hearing aids.
Advising Parents Through Education
After evaluation and hearing aid fitting, education for the family is expanded upon. At
this point, families are connected with resources and local services for more information
about raising a child with hearing loss. This includes referral to a parent-driven support
group where families find strength in sharing their experiences. Parents are also
encouraged to enroll their child in parent/infant therapy at St. Joseph Institute for the
Deaf at Carle or with local providers. This will help families learn more about the impact
of hearing loss and explore communication options.
Communication Goals and Opportunities
Determining the best communication option for a child is an ongoing process. After the
parents have considered all of the available options, it is important to establish
communication goals. The ECHO team can provide education as well as speech, language and
listening therapy using any mode of communication the family chooses, including
auditory-oral communication, total communication or cued speech.
If the communication goals include speech and spoken language development, then the
focus of treatment and therapy is placed on maximizing the child's hearing through the use
of hearing aids, an FM system, a cochlear implant or other appropriate technology.
Cochlear Implant Surgery
Cochlear Implant Evaluation and Surgery
If the hearing aids do not provide enough information for speech and language
development, the cochlear implant is the next option. A cochlear implant is an electronic
device that has internal and external components. The internal component is surgically
implanted and has an electrode array that directly stimulates the auditory nerve. The
external components consist of a microphone, which picks up and transmits sound, and a
speech processor that converts sounds to electrical signals.
Making the decision to receive a cochlear implant and have the necessary surgery can be
difficult for families. Therefore we provide as much information as possible, so that
parents develop realistic expectations. Parents are educated on implant choices and may
receive counseling from a clinical psychologist or social worker familiar with the impact
of hearing loss. They are also encouraged to speak with other families who have gone
through the process. Once the parents have made an informed decision to proceed with the
implant, Dr. Novak evaluates the child's medical condition and consults with the parents
regarding the best device for their child.
Next, a surgery date is set for Dr. Novak to perform the implant procedure. After the
surgery, it takes about one month for the incision to heal. Once healing is complete, the
external equipment is hooked-up and customization of the device begins. Using a computer,
each electrode on the array is programmed to determine the softest and most comfortable
sound settings for the child. The external equipment is then activated and the child hears
sound. Most children will need to learn how to interpret the auditory signal from the
implant so it becomes meaningful. Programs like St. Joseph Institute for the Deaf at Carle
provide this type of training.
St. Joseph Institute for the Deaf at Carle
Auditory-Oral Education at SJI-C
Today, improved technology, such as high-powered hearing aids and cochlear implants
often makes speech and spoken language development attainable. Because this is an option
many families desire, ECHO helps parents connect with oral educational programs in their
community. St. Joseph Institute for the Deaf at Carle (SJI-C) located in Champaign-Urbana,
is an auditory-oral program that provides speech and listening training to children with
hearing loss in a model that best suits the child's and family's needs. Typically,
children under two are served through the parent-infant program, with parents and children
being active participants in play activities. Between the ages of two and six, children
participate in the nursery or preschool program, or receive supplemental therapy outside
of their regular school program, depending on the child's needs.
Consulting with Educators
Many children from ECHO resume their education in their local school program. Because
it is very important to support these children, we maintain contact through school visits
and educational consultations. The purpose of these visits is to make educators aware of
the special needs of children with hearing loss and to maximize the use of the child's
hearing device in the school environment. We can attend individual education planning
(IEP) meetings to establish goals for children with hearing loss and make recommendations
to help the school best develop the child's auditory skills.
Continuing Evaluations
To ensure maximum sound quality, the implant is evaluated regularly. These evaluations
are performed every few weeks during the first months following initial stimulation of the
implant. Over time, hearing levels tend to stabilize, but periodic programming and
evaluation of the child's overall skill development are still necessary.
Performing Research and Developing Materials
The ECHO program is an FDA clinical trial site for cochlear implants. Additionally,
research is conducted in the areas of diagnostics, efficacy of treatment plans, speech
perception and production and language development. One of the goals of our ongoing
research is to determine if early intervention results in a more natural development of
listening skills and subsequently, communication development. We also develop materials to
assist with home intervention, classroom management, and diagnostics. These efforts have
led to recognition for the ECHO program on state, national and international levels. The
Carle ECHO team provides the most advanced methods of hearing evaluation, treatment,
therapy and education available.
Referrals and Information Requests
Parents, physicians or other professionals can refer patients, or patients can
self-refer. DSCC, Medicaid, HMO or private insurers may reimburse the fees for many of our
services. Financial counseling is available. If you have questions about the ECHO program,
or would like to schedule an appointment, call (217) 383-4375 (voice) or (217) 383-3137
(TTY).
Carle Therapy Services
ECHO Program (NCW4)
602 West University Avenue
Urbana, Illinois 61801
email: echo@carle.com
Web Resources
www.oraldeafed.org
www.nidcd.nih.gov
www.medel.com
www.cochlear.com
www.cochlearimplant.com
www.auditory-verbal.org
www.agbell.org
www.web7.mit.edu
Hearing Aid Manufacturers
www.oticonus.com
www.phonak.com
www.gnresound.com
www.unitron.com
FM Systems Companies
www.audioenhancement.com
www.phonicear.com
www.lightspeed-tek.com
This program is funded in part or in full by charitable gifts made to the Carle
Development Foundation. You can support this or similar programs by making a charitable
gift to Carle through a variety of gift options. |
