Emmett’s story: A big personality and big potential

Emmett’s mom, Catherine, describes her son as goofy and a kid who always lets her know how he feels — often just with his eyebrows. He’s “in his math era” where he loves building with blocks and often impresses people with his addition skills. Those skills serve him well at school, where he and his twin brother Cayden just started kindergarten.

“Somehow Cayden and Emmett manage to communicate even when Emmett isn’t wearing his cochlear implants. I don’t really get how they do it, but it seems to work,” Catherine laughs.

You might never guess that these two energetic 6-year-olds came into the world very early — when Catherine was just 26 weeks pregnant.

Four months in the NICU

Emmett and Cayden both needed four months of NICU care, including feeding and oxygen support. They also had hearing screens before they left the hospital, because premature babies are at higher risk for hearing changes.

“Emmett seemed to love the music therapist and would always turn his head toward the music,” Catherine says. “If anything, we thought Cayden would be the one with hearing issues because he didn't respond to the music therapist at all.”

But when Emmett didn’t pass his hearing screening, he needed a more comprehensive evaluation.

Hearing care focused on kids’ needs

Emmett had an auditory brainstem response (ABR) evaluation, which is a hearing test often used for babies who aren’t old enough to do a typical hearing test. The test revealed that he had auditory neuropathy.

Auditory neuropathy happens when the ear can detect sound, but the brain may not be able to process the sound appropriately.

“We see auditory neuropathy most frequently in very premature babies whose hearing pathway didn't fully develop before they were born,” says Rachel St. John, M.D., NCC, NIC-A, Director of the Family-Focused Center (FFC) for Deaf and Hard of Hearing Children at Children's Health℠ and Professor of Otolaryngology at UT Southwestern. “It’s a tricky type of hearing change because it can look very different in different kids. Some seem to hear well one day but not the next. Some don't respond to any sound.”

Baby Emmett started seeing Dr. St. John at the FFC. She discussed Emmett’s hearing in more detail with Catherine and connected the family with Early Childhood Intervention through Texas Health and Human Services. That’s how the family met Mrs. Quinn, a specialized teacher for deaf and hard-of-hearing kids, to help him start learning language as early as possible.

“The vast majority of deaf children have hearing parents, which means they usually don’t have a shared language,” Dr. St. John says. “Learning language as early as possible – whether it's spoken language with technology and/or sign language – is crucial, because language learning is a very early process, and if it is delayed it can affect overall development.

Catherine remembers Dr. St. John showing her “the speech banana,” a chart that uses a banana-shaped curve to show the range of sounds kids need to hear, learn and communicate in spoken language. Emmett could hardly hear any of the sounds on the chart.

Doing what’s best for Emmett

Emmett’s parents learned about different options, including cochlear implants. The team at the Cochlear Implant Program at Children’s Health explained that cochlear implants are small medical devices that help people with very significant hearing loss process sound. Kids need surgery to place the device, which connects to a sound processor that sits outside their ear.

“We were nervous about surgery because he’d had some surgical complications when he was in the NICU, but decided cochlear implants would be the best thing for him,” Catherine says.

Emmett had cochlear implant surgery a few months after his first birthday and his vocabulary started growing. He started saying single words like “ma” and “da,” then longer words, then full sentences.

Dr. St. John has continued to support Emmett over the past few years, and Catherine deeply appreciates her support.

That includes closely monitoring his development and milestones because research shows many kids who are deaf or hard of hearing have other diagnoses too.

“A deaf child with ADHD, autism or another condition may be recognized earlier at our clinic. Since pediatricians may not see many deaf children, they may not be sure whether a behavior is typical, related to hearing or a sign of another diagnosis,” Dr. St. John says.

So, when Dr. St. John saw Emmett showing signs of ADHD, she helped connect the family with a specialist and additional resources.

Excited for kindergarten and everything to come

Catherine is a teacher and is happy to have her boys at the school where she teaches. Emmett and Cayden love that campus and especially the big playground. Meanwhile, Mrs. Quinn has helped bring Emmett's other teachers up to speed on his hearing needs.

"Mrs. Quinn is basically part of our family," Catherine says. “And we now have two rules for Emmett's cochlear implants at school: The first is that we always make sure we have them when we walk through any door. The second is if one does get lost, whoever finds it gets ice cream.”

Catherine would tell another family raising a kid with hearing differences:

“Find a support team and make sure they’re people you feel comfortable asking questions – even the questions you think might be ridiculous, but they probably aren’t,” Catherine says. “Having people on your side makes all the difference.”

Learn more

Children’s Health provides comprehensive care for kids with hearing differences, from birth through early adulthood. Our Family Focused Center for Deaf and Hard of Hearing Children offers expert care for kids with hearing differences and connects families with a wide range of resources – including school support, cochlear implants and coordinated care with other specialties. Learn more.