Camila Marcelino loves karate and soccer.
She’s a silly and fun 5-year-old who is super social. She’s quick to give hugs and to make sure other kids feel included in all activities.
She dotes on her little brother, Eddie, 1, and she’s learned to not let her older brother, Leo, 7, give her much trouble.
Camila is fluent in Spanish and English, and is approaching that level in another language:
ASL.
Born deaf and never experiencing sound until she was around 14 months old, Camila is one of the most accomplished graduates of CHOC’s Cochlear Implant Program, led by pediatric otolaryngologists (ENT) Dr. Nguyen Pham and Dr. Jay Bhatt.
Tests reveal bilateral sensorineural hearing loss
Uziel and Lisa Marcelino weren’t too concerned when Camila failed her initial screening for hearing as a newborn.
“The nurse told us it was probably fluid in her ear and she’d be fine,” Lisa recalls.
After failing the test a second time during a follow-up visit, Camila’s parents took her to the Providence Speech and Hearing Center, which plays a key role in CHOC’s Cochlear Implant Program. There, she received an ABR (Auditory Brainstem Response) test, in which electrodes were placed on her forehead and near her ears.
The test confirmed she had profound bilateral sensorineural hearing loss, meaning that she was deaf.
At 8 months old, Camila underwent numerous medical, language and cognitive tests to see if she’d be a good candidate for cochlear implants.
The choice for cochlear implants
A cochlear implant is a small, complex electronic device that can be implanted to gain a sense of sound. It has two main parts: an external portion sits behind the ear, and a small device is surgically placed under the skin just above the ear. The internal device includes thin electrode wires that are threaded into the inner ear to the cochlea, where they stimulate the nerves that perceive sound.
“Once we found out there was an opportunity to give our daughter a chance to hear, we talked about it and ultimately decided this would be a good thing for her,” Uziel says. “There was some fear that something could go wrong, but Providence and CHOC made us feel so comfortable. We sat down with the CHOC team and decided this was the route to take.”
“We grappled with whether this was the right choice for her, mostly because she wasn’t able to make this hugely life-impacting decision for herself,” says Lisa. “Also, many members of the deaf community see being deaf as a blessing you are born with. There’s some thought about whether having cochlear implants is the right thing to do, but we really thought about it and decided to allow her to hear, and if she wants to be part of the deaf community, she can take off her implants. We saw it as really the best of both worlds.”
Practicing speech before cochlear implants is key
Prior to her cochlear implant surgery, Camila began wearing hearing aids and learning American Sign Language.
Kate Quillin, speech language pathologist on CHOC’s cochlear implant team, started working with Camila when she was 9 months old.
“She’s an amazing little girl,” Kate says. “A big part of my job is teaching parents what to expect and how to support their child at home. I provide them with tools to give their child a language-rich environment. I love empowering families and making them feel confident in helping their child.”
It’s important, Kate says, for parents to continue talking to their deaf child prior to cochlear implant surgery.
“Our goal is the child is eventually going to be able to hear his or her parents, and this is just a moment in time,” she explains. “Don’t just gesture – you need to talk to them. It’s really about getting them used to a routine so when they’re hearing, they will be able to quickly pick up on the auditory cues.”
One of the things that sets CHOC apart from other cochlear implant programs is the close collaboration between the audiologists and the speech therapy team, says Dr. Valerie Guzzo, lead audiologist at Providence Speech and Hearing.
“Audiology and speech therapy have the ability to co-book appointments together,” she explains. “Having a speech therapist who can assist in hearing tests and provide their input on what the child is hearing during appointments decreases the time it takes to program a cochlear implant for optimal hearing. Not all centers have this type of collaboration between speech and audiology.”
With speech language pathology, ASL bridges to oral language
Camila’s cochlear implant surgery was on Dec. 10, 2018. Most patients don’t require an overnight stay and recovery typically is not difficult, Dr. Pham says.
Four weeks later, which is standard to allow for healing, Camila’s device was activated. Her parents, brothers and extended family were there for the big day on Jan. 11, 2019.
“We don’t want the sensation of hearing to be too overwhelming all at once,” Kate explains. “It’s kind of like a dimmer switch, but for hearing. We start out softly and look for a response, then slowly increase it. I recall Camila being really curious. Many kids cry because it’s new and unfamiliar.”
Lisa and Uziel got emotional, as did other members of Camila’s family.
After surgery, Camila had weekly therapy sessions with Kate. At home, she began connecting the ASL that she was learning to this new auditory input that she was now getting in English.
“It was the perfect bridge to oral language,” Lisa says.
The one-year checkup following cochlear implant surgery is especially rewarding for providers.
“I love those visits because you have a patient that went from speaking no words to now talking,” Dr. Pham says.
Parent involvement is critical for cochlear implant success
Camila graduated from speech therapy on Jan. 6, 2020. She was considered to be performing at an above-average level, and her communication was comparable to hearing peers her same age after hearing for only one year.
When she turned 2, Camila’s parents introduced her to Spanish.
“It’s very realistic for our implant patients to be as successful as Camila,” Dr. Guzzo says, “but what stands out about her is her success not only in English, but also Spanish and sign language. She’s a deaf child who can communicate in three different languages.”
Adds Kate of Camila’s success: “You have to have this amazing combination of very involved parents who are taking every single one of your recommendations and doing it all day, every day. A big reason she was successful is because her parents were extremely involved. She’s also very bright, and she enjoys learning.”
Camila’s parents praised the care Camila received at CHOC.
“We were very lucky to land in such good hands,” Uziel says. “CHOC has always shown us all the care and love they have for all their patients.”
Learn more about cochlear implants at Providence Speech and Hearing Center
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Learn more about CHOC’s otolaryngology program
At CHOC, our pediatric otolaryngologists provide comprehensive care for children of all ages – from newborns to teens – with conditions of the ears, nose, throat (ENT).
