Sometimes the clues were subtle: Maggie Johnson’s daughter Lucy, 4, wasn’t developing language skills at the same rate as her peers; while Pam Bakken’s son Daniel, 5, rarely turned his head when she called his name.

For others, it was obvious: Rebecca Wanha’s daughter Annika, 5, had meningitis as an infant; and Mark Lindemer’s daughter Mae, 3, failed a newborn screening test.

Gathered together, these parents share the unique stories of how they discovered their children were hard of hearing and the similar conclusion that followed: they wanted their children to hear. And to speak. And to mainstream into regular classrooms.

Ten years ago, such a solution wouldn’t have been an option for Minnesota parents with hard-of-hearing children. The nearest oral language school was the Moog Center in St. Louis, Mo., and the few parents who even discovered the school’s existence had to uproot their families in order to attend. But in the late 1990s, a group of local parents contacted the school about creating an oral language school based on the Moog Center that could serve Minnesota. From that initial idea came Northern Voices, which opened its doors in 1999 to 12 students and offered parents an auditory/oral education plan for deaf and hard-of-hearing children without the interstate commute.

“A lot of parents have to come see it to believe it,” says Northern Voices Program Director Valerie Maynard of the students, who range from mild to profoundly deaf. “Not every kid will be able to talk, but they have to see it’s a possibility; the biggest thing we give parents when they visit is hope. They see 4- and 5-year-olds talking, fighting, just being typical kids; and it gives them hope.”

Baby steps

More than 90 percent of children with hearing loss are born to hearing parents, so the desire to have hard-of-hearing children as part of the mainstream is a natural one for parents who have little experience with deafness. That inexperience leaves many parents at a loss. At Northern Voices, the paths parents take to the school are often as varied as their children themselves: some get referrals from their audiologists, others are directed by their school districts, and some resort to a basic Google search. “If you don’t know there’s even a possibility to learn to talk, and you know nothing about deafness, how do you know where to begin?” asks Maynard. “One of our missions is to educate parents that there are options. I have heard horror stories from parents where audiologists say, ‘Your child is deaf, she needs to learn sign language,’ and no other options or information is given.”

According to the National Institute on Deafness and Other Communication Disorders the most intensive period of language development is during the first three years of life. That means parents interested in oral education begin working with Northern Voices when their children are infants. Maynard, who teaches the one-on-one parent/infant classes, focuses just as much on educating parents about how to stimulate language in their children as she does on working with the children themselves. “The whole point is to empower the parents to teach their child to talk,” explains Maynard. “Parents are the first teachers, and they need to capitalize on every moment. That means doing the things you do naturally but being conscious of describing it all out loud and being verbal as much as possible.”

Beginning language instruction involves a lot of repetition, and Maynard uses engaging props like a box full of toys dubbed the Listen and Learn Box with her youngest students. At the hour-long, twice-weekly sessions, infants watch from a high chair as Maynard follows the same routine of pulling out the box’s contents and cheerfully describing a toy cow, Mr. Potato Head, etc. “Soon, the child knows exactly what I’m going to say next,” explains Maynard. “It’s like learning a foreign language to them. Soon they are beginning to say the words with me.”

At around 18 months, children move from the infant program into the toddler room, where the focus moves to learning specific vocabulary words. Maynard says the school’s specialty is making every lesson fun, such as the vocabulary game that lets kids match words with pictures by placing Cheerios on images that correspond with the word a teacher says. Preschool lessons use the newly acquired vocabulary words to create sentences, and teachers work with children both in small sessions and in large groups to stimulate conversations.

Maynard is the first to say that Northern Voices children have to work hard to achieve the results that will help them start kindergarten on par with their hearing peers. Toddlers have class five days a week from 8:30 a.m.-12 p.m. while preschoolers face a grueling 8:30 a.m.-3 p.m. schedule five days a week. And a regular summer break is out of the question. “These kids can’t take the whole summer off. They need to continue their language and vocabulary development,” explains

Maynard of the programs, which lighten up slightly in summer but are still intensive.

Hearing help

While Northern Voices’ intensive beginning instruction is essential in laying the foundation for language, technology also plays a major role in helping students learn to speak: Maynard estimates that 65 percent of students at the school have cochlear implants, while the remaining 35 percent have hearing aids. The popular cochlear implant is a small electronic processor that is surgically implanted in the ear and connected to an external transmitter that provides a sense of sound to the wearer. While a hearing aid amplifies sound so damaged ears can detect it, a cochlear implant bypasses the damaged portion of the ear to directly stimulate the auditory nerve.

Because language development begins almost at birth, implantation typically takes place early on – Maynard has seen students as young as 7 months old receive implants. Most children have just one implant, but a growing movement suggests that being bilaterally implanted is even more beneficial, especially for localization, which helps the wearer know where a sound is coming from and how to tune out other noises. Wanha’s daughter Annika is one of two Northern Voices students with bilateral implants, a decision Wanha came to after her doctor discovered that Annika’s bout with meningitis had caused her cochlea to slowly turn to bone. “There was a pretty good chance that if we waited on the second implant she wouldn’t have been able to get it later on,” says Wanha. With one Cochlear implant running between $40,000 and $60,000, the price of bilateral implantation can be prohibitive. Luckily, most major health care providers (including Wanha’s) are covering dual implantation. “For us, we had nothing to lose,” says Wanha of the decision. “Annika has two ears, so why not let her use both?”

Cochlear implants also make it easier to mainstream Northern Voices graduates into their local school districts, which is the goal of the program. Almost all of the Northern Voices students leave the school at age 5 or 6 and graduate into regular kindergarten classes, where the only accommodation they need is an FM system worn by the teacher to project sound into the implant. “We try to make the transition smooth by working with the district and having the teachers come see our classes,” explains Maynard.

School districts are slowly recognizing the benefits of early oral education as a cost-effective way of handling an expensive issue: accommodating a hearing disability. Bakken, who lives in the South St. Paul school district, found her district was happy to invest in several years of the $23,100 annual tuition at Northern Voices because the specialized school was better able to serve Daniel than the district. “We would not have agreed to send a student to Northern Voices if we didn’t think it was the best educational plan for the child,” says Linda Gardner, director of special services for the South St. Paul school district. “Small districts don’t have the resources to provide that kind of support, so this is a more appropriate way for children to get the kind of training they need.” Bakken sees benefits for both the district and her son. “When he graduates and mainstreams, he won’t need an aide for the next 10 years,” says Bakken. “For them, it made sense to invest in three to four years in this environment so that they aren’t spending thousands of dollars each year for the next 12 years to accommodate him.”

For Bakken, the chance for Daniel to attend the same school and the same classes as his twin brother John is the best result to come from his tenure at Northern Voices. “We want him to have as normal of a childhood and blend in as much as possible,” explains Bakken. “He shouldn’t be thrown out of the mix because he has a disability.”

Monica Wright is Minnesota Parent’s assistant editor.

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