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Tele-therapy Helps Bridge the Gap for Deaf Babies in Rural California

Once a week, Karen Nalley Artalejo and Spanish language interpreter Olga Rice make the 40 minute drive from their office in Salinas to an apartment in Greenfield to work with Samuel Lopez.  He’s a toddler just a couple months shy of his third birthday.

“I see him weekly until he turns three,” says Nalley Artalejo.  She’s a Deaf and Hard of Hearing Specialist with the Monterey County Office of Education.  When a baby is diagnosed with hearing loss in Monterey County, their families are referred to her office for therapy paid for by the school districts.

Samuel has cochlear implant in his right ear, and will soon get one in his left. The device helps him hear,  not the way the rest of us do, but he’s getting sounds.  Karen Nalley Artalejo’s job is to help him make sense of those sounds through these weekly therapy sessions.

“His hearing age is 13 months, so that’s how long his implant has been activated.  His listening skills are between 18 and 24 months, and his receptive language skills are between 22 to 24 month, so a little bit better.  And his expressive language skills are between 12 and 18 months,” says Nalley Artalejo.

Her goal is to close that gap between those numbers and his actual age.  For an hour every week, she runs Samuel through a series of hearing games.  The therapy session is multi-lingual.  Samuel’s parents are originally from Mexico.  They moved here to work in agriculture nearly 15 years ago. 

Nalley Arteljo says how much therapy a toddler with a cochlear implant needs can vary, though it’s safe to say the more, the better.   But with limited resources and a long list of clients, she can only make it down here once a week.

“That birth to three is their window of opportunity for learning language. It’s the critical period of language development, so we need to get them as much services as possible as early as possible,” says Nalley Artalejo.

About two years ago the Monterey County Office of Education started partnering with a program called BabyTalk.    It’s a tele-therapy program for families who have chosen hearing aids and cochlear implants to help their kids here.

So every week, Samuel also meets with another therapist, but this one visits via FaceTime on an iPad from her office at the Weingarten Children’s Center in Redwood City.  It’s an school for deaf children.  Weingarten and Stanford School of Medicine created this tele-therapy program  after seeing a need among children receiving cochlear implants. 

“Many of the children we worked with had access to this technology, but then returned home to rural and impoverished communities without the support structure to help them be successful.  Language barriers, distance and lack of adequately trained professionals resulted in less than desired outcomes,” says Jan Larky of the Stanford Ear Institute and BabyTalk’s Audiologist.

The program, which started three years ago, currently serves nearly 40 families, including twelve in the Monterey Bay Area.    While there are other tele-therapy programs out there, BabyTalk’s Meg Farquhar says this program is unique for a couple of reasons.

“Number one, the numbers -- how many people we are working with and number two, the diversity, and in particular this lower socioeconomic bracket,” says Meg Farquar, Director of Family Services with Stanford Department of Otolaryngology.

The program can reach low income families because it’s free to families like Samuel’s thanks to a grant from the Giannini Foundation.  It covers the cost of the therapy, iPads and even internet service.  “If we are funded after this year our target increases to 45 then 50 the following year,” adds Farquar.

Because of the BabyTalk program, the amount of therapy Samuel receives is doubled.  BabyTalk Speech Language Pathologist Patricia Gomez works with Samuel and his mother once a week for an hour.  She says the most important thing she can do in these sessions is empower his mother, Floriana.

“I want to educate the parent to really understand and own this process, and to know that seeing a therapist once a week for an hour or two, if you are lucky, is nowhere in comparison to the amount of hours they are with their child,” says Gomez.

Back at home in Greenfield, Floriana talks about her journey from grieving Samuel’s hearing loss to optimism.  She says at first it has hard to believe the doctor’s diagnosis.    Then she was skeptical about the cochlear implant because she didn’t see fast results. 

But one day Samuel lost the processor and they had to get a replacement.  That’s when she realized what a difference the implant and all this therapy was making.   And now Floriana says she can see the difference she can make and what she sees for Samuel’s future is a normal life.  

Both programs will work with him until he’s three years old then Samuel transitions into preschool.