Forrest General Outpatient Therapy Sending Child to School with Confidence

HATTIESBURG, Miss. – (July 01, 2024) In a few short weeks, Carmen Roberts will start kindergarten like hundreds of other young students across the Pine Belt. The five-year-old, who is full of energy and never meets a stranger, will be living her best life. Not bad for a child born with bilateral sensorineural hearing loss, meaning that she has hearing loss in both of her ears.

When Carmen was born on April 26, 2019, she couldn’t hear a sound and failed every test that hospital staff administered, not once, but twice, before her parents, Shakerria Nixon, and Cameron Roberts, left the hospital with her. But the problem didn’t become noticeable, and a bigger problem, until later when Carmen’s speech was supposed to be developing and wasn’t.

“Once she failed to hear voices, that's when we found out something had to be done,” said Cameron. “We spoke with multiple audiologists and that's when therapy services came into play, therapies to help out with speech and language development.” Carmen received her first hearing aid at the age of two. “We noticed a big difference at that point,” her dad said. “They gave us different practices. We would cover our mouth and see if she would respond to what we were saying without the hearing aids. She wasn't able to respond or fully understand what we were saying, but with the hearing aids, we noticed a major difference.”

Because of her hearing impairment, Carmen has language and articular delays due to hearing loss. This means that she doesn’t enunciate well or get words right sometimes for her age and development.

Carmen also has difficulty saying certain words and certain vowels. “Knowing different mouth movements so she can understand what we're saying and how we're saying them has really helped with her speech development,” said her dad.

She had been receiving speech therapy services previously, but began coming to Forrest General’s Outpatient Rehab Clinic (located at the south end of the YMCA on Veteran’s Boulevard) in August of 2024 when her family moved to Hattiesburg from Laurel.

“Carmen’s hearing loss delayed her speech development. That's why we are so thankful for the services we are currently getting here at Forrest General’s Outpatient Rehab Clinic,” said Cameron. “Her therapist, Stephanie, gives us a number of different practices or homework we can use to help Carmen at home.”

Carmen began her journey with two hearing aids, because she had a sense of near hearing loss in both ears. The right ear was worse than the left.

But according to her dad, Carmen’s hearing kept degrading over time. During repetitive therapy sessions, they noticed she was going to need something better and that’s when talk of a cochlear implant began. A cochlear implant is a small, complex electronic device that sits behind the ear and a second portion is surgically placed under the skin. A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds so they may be detected by damaged ears. Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve.

Carmen’s parents admit they were apprehensive about the implant in the beginning.

 “We were very nervous,” Cameron said. “It was very new to us, because we had never dealt with anything like this before.” After a lot of research and still some uncertainty, they decided to move forward with the implant.

Carmen received her cochlear implant on December 14, 2023. She continues to wear a hearing aid on her left ear.

“After the implant, we noticed a very, very big difference in Carmen's hearing and her development,” Cameron said. “It has been great ever since. We didn't know she wasn't able to make out certain sounds. We didn't know what all she was able to hear and not hear. Before, she didn’t sing any songs, she just mimicked all the stuff we wanted her to do. But now? Since the cochlear, we can hear her singing her favorite songs all over the house.”

Shakerria has homeschooled her daughter this past year due to the implantation of the cochlear and believes home schooling has definitely helped because she and Cameron are able to give Carmen the undivided attention she needs.

The cochlear implant will grow with Carmen, so it won’t need to be replaced, and there aren’t any repairs associated with it. While Carmen only has one implant right now, that’s not to say she might not need one for her left ear. “With bilateral sensorineural hearing loss, it doesn’t get better, but it can get worse. Eventually there is a possibility she will need another cochlear implant,” Cameron said. “At that time, we will go ahead and do that if needed.”

Carmen will be entering mainstream kindergarten classes once school gets started. “She’ll be starting without any special classes or special needs,” said Cameron, “and we’ll take it from there. The outpatient therapy services here have been very helpful in the development of Carmen's hearing. That's why we are so confident she will be able to keep up with other kids and not require any extra services in order to learn.”

Cameron said they have been astonished by the technology surrounding the cochlear implants. Carmen’s implant has Bluetooth capabilities which will allow her teacher to wear a microphone on a lanyard around her neck or pinned to her shirt. The microphone will automatically feed into Carmen’s implant so she can hear better without requiring the teacher to talk louder to the class just for Carmen’s benefit.

The cochlear implant will be with Carmen for the rest of her life. But it’s not something she’s embarrassed or ashamed of. “She loves it,” said her mom. “When we first introduced her to it, she was kind of nervous. I don’t think she fully understood, because she is so young. But once she got it, she understood and wants to show everybody. It isn’t beyond her to go up to a stranger in the grocery store to proudly show off her hearing device.”

“She doesn’t meet a stranger,” her dad proudly boasts.

Her hearing loss hasn’t put a damper on or deterred any of her big personality. From the first day Carmen got the implant, she wanted to customize and personalize it. She wanted it to have mermaids, because she thinks she's a mermaid. She has it decorated with sparkly tape and mermaids.

Stephanie Shelby, a speech pathologist at the Pediatric Outpatient Clinic at Forest General, has been working with Carmen one time a week for the last several months. She said when Carmen first started therapy, she had a lot of difficulty with age-appropriate language concepts, so their main focus was those language concepts.

She also had a lot of trouble with age questions, possessives, and nouns. She has been able to master those goals and move on to new goals. Now, they are working on some plurals and different concepts like number and quantitative concepts, and sounds with higher frequencies, which she wasn’t quite hearing yet.

“Carmen's family has been so grateful, sweet, and cooperative,” said Stephanie. “They have been the best support system for Carmen and for me, as well, because they work with her with whatever I send home and recommend for them to try. They have always been very willing to try anything. I think that's something that works in Carmen’s favor, that they are so supportive of her.”

 “A lot of times, speech therapy is also allowing the parents to come in and ask questions and help the patient gain skills, to help them in life,” Stephanie said. “Carmen is about to enter kindergarten, so we’ve been working really hard helping her parents feel comfortable about letting her go into regular classes. We want her to be able to use the progress she’s gaining while in speech therapy to feel comfortable with the progress that she's gaining while she's in speech, so she can use those skills in the school setting. Our ultimate goal is to get her caught up to be in school with her peers.”

She describes Carmen as sweet, very outgoing, and very excited about her new cochlear. “The first thing she did when she saw me was rush over and say, ‘I've got my cochlear implant, I can hear’” Stephanie said. “She was so excited to have the implant and to be able to hear really well.”

“There are a lot of different things that go into therapy, but truly, I would love for Carmen to be able to move past speech and not need us at some point. That's my goal for every child – to be able to come in and have something they need to work on and be able to progress. To not need us is ultimately my goal for every little child.”

For more information about Outpatient Pediatric Rehabilitation, visit www.forrestgeneral.org/pedrehab.

About Forrest General Outpatient Pediatric Rehabilitation

Forrest General’s Pediatric Rehabilitation, located at the Hattiesburg YMCA, offers physical, occupational, and speech pathology services for children with special needs for growth and development, or injury recovery. Services are open for children ages birth–15 years old. A comprehensive team approach helps children restore normal movement for functional daily skills, improve speech, and swallowing/feeding or assist with mobility and functional play. In a family-friendly environment, family members are encouraged to participate in a child’s therapy. Forrest General also hosts the Neonatal Developmental Follow Up clinic in cooperation with South Mississippi Neonatology Group and the University of Southern Mississippi. These groups partnered for Forrest General’s smallest patients by screening and monitoring the overall health and development of infants with a history or preterm birth and linking infants who have developmental needs with community services for follow-up.