Learning to listen and speak is something every infant and toddler should be doing. For those who suffer from hearing loss, these years are no less crucial, but they do require more support.

The Parent Infant Program (PIP) at Sunshine Cottage School for Deaf Children is celebrating 50 years of early intervention and equipping infants and their parents with what the staff calls “a sound start.”

When John and Dela White founded Sunshine Cottage for their daughter Tuleta, their goal was to see their daughter live self-sufficiently in the hearing world. To do that, they knew she would need to be able to understand spoken words and communicate through speech rather than sign language.

The Whites founded the listening and spoken language school in 1947. By 1966 they realized the importance of early intervention and added PIP.

A replica of the original Sunshine Cottage is located near a playscape.
A replica of the original Sunshine Cottage where the concept was born 50 years ago is located near a playscape on the property. Credit: Scott Ball / San Antonio Report

To communicate with the hearing world, people with hearing loss overcome remarkable obstacles. While hearing technology continues to improve drastically, it cannot perfectly replace the delicate and complex biology that deciphers the nuanced soundscape of our world.

The earlier a child is able to begin decoding and ordering sounds and their meanings, the more likely they are to develop alongside their peers socially, academically, and emotionally.

PIP Director Lisa Lopez has worked for the organization for 39 years. Looking back over her career thus far, she considers newborn screening the single greatest advance made in hearing loss therapy.

Soon after a baby is born, it is screened for hearing loss. In two or three of about every 1,000 cases, that screening detects some form of hearing loss. For parents whose newborns are diagnosed with hearing loss, the next weeks and months are crucial.

Knowing what we know now about the importance of auditory input in building brain pathways, the race to get neurons firing is already well underway by the time a baby is born. Hearing develops at about 20 weeks gestation, and the associated neural pathways begin to develop right away. At birth, babies with hearing loss have ample ground to recover.

PIP begins that process immediately by implementing best practices in early childhood development. The goal is to give the babies and their families the best chance they can to be prepared for a listening and speaking world.

Hearing technology – hearing aids, implants, etc. — has progressed significantly since PIP was founded, and staying up to date with advances keeps Lopez and her team busy. Every time you get a new phone, Lopez said, there’s a comparable upgrade in hearing technology: The fidelity of sound improves and the packaging gets smaller.

Despite technological advances, Lopez stresses the importance that parents play in the stimulation of their infant’s brain.

“Therapy should be an all day activity,” she said.

At PIP, the therapy rooms look like playrooms. They are designed to get parents on the floor to interact with their children. While the youngest children are in a sort of holding pattern until they are old enough for a cochlear implant – usually around 12 months of age – the specialists at PIP teach parents how to build the skills associated with conversation, such as facial expression reciprocity. They encourage them to constantly talk to their children and take advantage of what hearing the child does have.

The Art Room at Sunshine Cottage.
The art room at Sunshine Cottage. Credit: Scott Ball / San Antonio Report

In essence, these are best practices for all parents. Lopez recommends continuous narration, as children need to hear 15,000-20,000 words per day in order to prepare for school. Ideally, parents and caregivers would read 10-20 books per day. This sounds ambitious, but most infant and toddler appropriate books take only a couple of minutes to read.

“We say that brains are built, not born,” Lopez said.

In addition to being trained on these everyday therapies, families are assigned an audiologist and one of PIP’s seven certified teachers of the deaf to act as a parent-infant advisor. They meet with this support team once a week for an hour to 90 minutes. After three of these meetings, the support team visits families in their home.

Two rooms at PIP hold the equipment for non-invasive screening. Babies are screened every three months to track their hearing, as most hearing loss is gradual. Even if babies passed their newborn screening, they could show signs of hearing loss – such as not responding to sounds or perhaps having limited verbalization – at a later date.

It occurs far too often, Lopez said, that parents whose child has either failed the newborn hearing screen, or shown signs of hearing loss in the first few months, will be told to “wait it out” and not to jump into action. Because every week and month of intervention is crucial, Lopez encourages parents to follow up persistently to track their child’s development.

All services are free of charge as PIP is funded entirely through donations to Sunshine Cottage.

Sunshine Cottage also lends hearing aids to families that are in the program. This gives parents time to come up with the necessary funds to purchase their own hearing aids, which usually cost between $1,500-$3,000 and are not covered by most insurance providers.

Sunshine Cottage has been recognized widely for serving families from diverse income levels, making it possible for many children to access interventions and therapies that would have posed a crippling burden on their parents.

“We’re grateful to the San Antonio community for their continued support of our work,” Lopez said.

A 5th grade classroom at Sunshine Cottage.
A 5th grade classroom at Sunshine Cottage. Credit: Scott Ball / San Antonio Report
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Bekah McNeel

Bekah McNeel is a native San Antonian. You can also find her at her blog, FreeBekah.com, on Twitter @BekahMcneel, and on Instagram @wanderbekah.