Health Scan: A.V. Israel helps officials hear the demands of the deaf

The time has passed when a child was doomed to living an isolated existence because he or she is hearing impaired.

By JUDY SIEGEL-ITZKOVICH
human ear 88 (photo credit: )
human ear 88
(photo credit: )
The time has passed when a child was doomed to living an isolated existence because he or she is hearing impaired. Digital cochlear implants, which are now in the basket of health services even for qualified adults, have brought about a revolution. And in Israel, their successful use is the result of 13 years of hard campaigning and fieldwork by A.V. Israel, a voluntary organization founded by Elaine Matlow Tal-El - the mother of twin daughters diagnosed as profoundly deaf at the age of two - along with other interested parents and friends. Today she is an active chairman of the organization, which has facilities in Jerusalem and Ra'anana. A.V. Israel uses an audio-verbal approach that has helped thousands of children around the world to become fully integrated in the regular education system. It is the only integrated auditory verbal center in Israel that teaches deaf children to learn language through hearing. Technological interventions coupled with innovative educational strategies enable these children to perceive sound, interpret what they hear and learn to communicate through speech like children without this disability. Hearing loss is the most common birth defect in Israel, affecting approximately three out of every 1,000 newborns. Among such children, a fifth will suffer from a profound loss. In up to three percent more, hearing loss will develop after birth due to infections or drugs. Tal-El, a former immigrant from the US who married an Israeli, says the latest trends in rehabilitation of the deaf show that bilateral cochlear implants brings deaf children to previously unattainable levels of functioning. Unfortunately, the basket of health services covers only one implant. A grassroots non-profit organization, A.V. Israel uses highly trained professionals to work with children from infancy through their teens. At its "bar-mitzva" celebration recently at Jerusalem's Renaissance Hotel, Tal-El announced plans for an ambitious plan to build the first one-stop audiology center in Jerusalem for the hearing impaired - if it can raise the money. The audience of more than 400 supporters were amazed by the young people who were born or became deaf and now speak three languages, study at university and play the drums (one of whom accompanied the famous Israeli singer and singer Dudu Fischer, who donated his services). Bypassing the trauma of regular hospital visits, the new community-based, all-inclusive rehabilitative and diagnostic center will become an essential element in the improved services for deaf children and their families. The goal is to ensure that every Israeli with hearing loss will have the opportunity to communicate through spoken language and maximize his or her potential in the hearing world. The latest technological advances, especially digital hearing aids and cochlear implants, have led to a revolution, but educational strategies are crucial. Auditory-verbal education uses trained therapists, with an emphasis on parent involvement and empowerment, to teach deaf children to listen and speak. Clinical studies have shown dramatic results in which children who receive early and aggressive intervention require far fewer special-education services and less assistance in adolescence and adulthood. Fully 70% of A.V. Israel children have at least one cochlear implant, and all are listening, speaking and studying in mainstream schools. Only five surgical centers in Israel provide the critical ongoing maintenance and constant adjustments - "mapping" - needed for the care of these implants. A.V. Israel, through the proposed one-stop audiological center, will provide wide access to mapping services without the trauma of a hospital visit, and in any case, the numbers of cochlear implant users are growing and taxing existing hospital facilities. Tal-El and her colleagues continue to lobby the government to reduce or supplement the prohibitive costs of hearing technology (digital hearing aids can cost over $5,000, with government reimbursement of only $1,200; the average annual cost of cochlear implant replacement parts can exceed $2,400), while pushing for greater assistance to individuals and organizations that serve the needs of the hearing impaired. Meanwhile, in the next decade or so, a new technology on the horizon that some experts predict will be even better than cochlear implants is being studied. An ultra-thin electrode in the auditory nerve of the ear is being tested on cats, attached to their auditory nerves and transmitting a wide range of sounds to the brain. Dr. John Middlebrooks of the University of Michigan's Kresge Hearing Research Institute believes that the promising implant could allow deaf people to converse in a noisy room, identify high and low voices and appreciate music - areas where cochlea implants are limited. Studies of the electrodes in humans are five to 10 years away, he predicted. ONE-STOP RESEARCH CENTER The Hadassah Clinical Research Center (CRC) has been opened at the new BioTechnology Park at Hadassah University Medical Center in Jerusalem's Ein Kerem. The CRC, together with the Hadasit team, provides all the services and facilities needed for pre-clinical through Phase IIII drug and medical device studies. The staff is comprised not only of physicians but also of experienced research professionals who respect study protocols and work in accordance with high international standards. This is a crucial deliverable, especially for Phase I safety studies, says Prof. Yoseph Caraco, a leading clinical pharmacologist who is director of the CRC. As a referral center, Hadassah regularly treats large numbers of patients with a wide variety of conditions and illnesses - a reality that enables trial recruitment for most studies to proceed reasonably smoothly. By offering a full-service GMP (Good Manufacturing Process) center that provides high-quality production at lower cost than other GMP sites around the world, CRC management believes its leading clinical teams and a large patient pool will make it in much demand.