I Can Hear You Whisper Page 26

  Children in the attention classrooms—those who took a ride on the “brain train”—made the biggest gains across the board on standardized measures of language and nonverbal IQ, including working memory. Groups of children whose parents had also received the more extensive weekly training did the best of all. Problem behavior went down in the children and social skills increased. Using EEG, the children all underwent the same study of auditory attention in the lab that I did and tried to focus on the Blue Kangaroo and ignore Harry the Dog. “There were changes in cognition,” says Pakulak. “We saw neural enhancement with focused attention within a tenth of a second, even with three-to five-year-olds. In the winning group, we saw greater gains in that measure. It made them look like higher socioeconomic status kids.”

  Will those gains last? To answer that, Neville’s group has been following the children longitudinally, bringing them into the lab and visiting them in school every year. The data from the first eighteen months suggested that the kids were maintaining their gains, but only time will tell.

  “Attention is a force multiplier,” says Neville. “It’s key to everything. If you want to learn soccer, if you want to learn to play the cello, if you want to learn to use your cochlear implant, it doesn’t matter… . If you don’t have the ability to focus and suppress distracting information, you can’t do anything. And if you do have control of it, you can do anything.”

  Straightforward though it was, I thought this might be one of the most useful pieces of information I’d learned yet.

  21

  “I CAN’T TALK!”

  MOMMY! MOMMY! MOMMY! MOMMY!” the voice was screaming. It was early morning and we were at our farm in central New York State. When I’d gone out a few minutes earlier to walk the dog and enjoy the bright and chilly December day, the boys had all been asleep. Usually, they’d have stayed that way for at least another hour. From the hill behind the house, I turned and looked back. A small figure was standing in the doorway on the front porch, yelling and waving. It looked like Alex.

  I turned and ran.

  “I can’t talk! I can’t talk!” he cried, panic-stricken, when I reached him. His face was bright red and tears were streaming down his cheeks. It took me a few minutes to realize what was happening. He could no longer hear himself talk.

  After Alex lost the hearing in his right ear completely, we expected he would probably lose the remaining hearing in the left ear, too. Every time he smacked into a table or came too close to a flying toy, my heart skipped a beat. We would frantically do our listening checks, but everything stayed marvelously the same. Eventually, our anxiety level lessened. Two and a half years had passed and he was now five.

  But the night before, he had had a bad fall. He was climbing a ladder to the sleeping loft in our cabin when he slipped and fell several feet to the floor, smack on his face. I had been very worried, but all evening there had been no change except the spectacular bruise developing across the bridge of his nose. Now he was hysterical.

  There had probably been internal swelling in the night, and the rest of his hearing was finally gone. I thought I’d been prepared for that, but his reaction threw me. Until that point, when Alex took off his processor—the external part of his cochlear implant—and his hearing aid to go to bed or get in the bathtub, we had still been able to communicate in a limited way. I had to get close and yell into his left ear. But he could hear me. Once he had cracked the code of language with the help of the implant, it had gotten easier. Probably by combining speechreading and what he knew of language, he managed well enough for me to help him with his bath.

  I had assumed that when he lost the remaining hearing, it would be this limited conversation we would miss. He hadn’t told me and I hadn’t realized—presumably he hadn’t realized either—that for him, hearing his own voice was the all-important distinction between his profoundly deaf right ear and his hard-of-hearing left ear. The hearing in his left ear hadn’t been enough to kick the spoken language motor into gear on its own, and he couldn’t possibly have heard himself very well, but something was not at all the same as nothing.

  I ran for my purse. The night before, after the fall, we’d all gone out to dinner. Perhaps shaken up by the accident, or just worn out from playing all day at the farm, Alex had become sleepy early and crawled into my lap at the restaurant. He handed me his processor and hearing aid and I put them in my bag. They were still there in the morning when he woke up. I pulled them out and put his processor on. He could hear me again. He could hear himself again. I rocked him in my lap and tried to soothe him. He began to calm down, but we were both shaken. Mark was up in the fields doing the early-morning farm chores; to get him, I would have had to leave Alex, and I wasn’t going to do that. Besides, I knew there was nothing he could do. Jake and Matthew, who’d been awoken by Alex’s screams, were hovering in the background, unsure what was going on. “What’s the matter, Mommy? What’s the matter?” they asked anxiously. I tried to explain. They crowded onto my lap and added to our hug.

  It was December 30. We were more than two hundred miles from New York City, and several feet of snow lay on the ground. It was only seven in the morning. Dr. Parisier’s office wasn’t open yet. With three anxious children to keep calm, I pulled out the Dog Bingo game they loved and we played a few rounds. I felt surreally as if I were at the eye of the hurricane, waiting for the wind and rain to whip up again.

  When Mark came near enough—to the closest corral to feed the goats—I ran out to explain what had happened.

  At nine, I called Dr. Parisier’s office.

  “How long will it take you to get here?” his receptionist, Eva, asked.

  “About four and a half hours. It depends on traffic.”

  She put me on hold briefly, then returned to the line.

  “He was supposed to leave at twelve for the holiday, but he’ll wait. Come as fast as you can.”

  I had Alex dressed and in the car in minutes. We’d decided that I would take him into the city alone and the others would stay at the farm. It seemed quicker and more efficient.

  Everyone stood waving in the driveway.

  “Hey, buddy,” I said as I pulled into the road. “It’s not every day we get to go somewhere just you and me. And, wow, you get to pick the movie you want to watch! No arguing with your brothers.” Like comfort food, he picked Elmo Visits the Firehouse, which the bigger boys thought was entirely beneath them by that point.

  The sun was glaring off the snow, and I had to keep reminding myself to slow down on the slippery, winding roads.

  It was close to two in the afternoon when we reached Dr. Parisier’s office, but he was waiting. The hearing test showed a nearly flat line at the bottom of the chart. Alex couldn’t hear anything softer than ninety decibels—a train whistle or a jackhammer. The audiogram of his left ear now looked like his right. “Profound hearing loss in both ears,” wrote the audiologist.

  The vestibular aqueduct that sat above Alex’s inner ear had ruptured. Because he had hit his face rather than the side of his head, it had taken longer for the swelling to do its damage, but the damage was done.

  Dr. Parisier prescribed an intense course of steroids, which, if taken quickly enough after the trauma, might stop the inflammation before too much harm had been done. We’d been warned that this was the course of action we’d have to take. That was why I’d driven pell-mell through the frozen countryside to get back to the city.

  “How often does it work?” I asked.

  Parisier hesitated. “I’ve seen it work,” he replied.

  Our chances are not good, I thought.

  Back home in Brooklyn, Alex and I went from one pharmacy to another in search of the prescribed steroid. It was dark, getting toward closing time, and no one seemed to have it.

  “What’s it for?” asked one pharmacist. “Allergies?”

  How to answer that?

  “My son hit his head. If he doesn’t get this medicine today, he could lose what remains of hi
s hearing.” I tried to quiet the panic I could hear in my voice. Alex was holding tight to my hand.

  “Sorry. I could get it by Monday, after the holiday.”

  Up the street, the same answer.

  “What’s it for? Croup?”

  After a few minutes of looking on the shelves, no luck. Sensing the desperation on my side of the counter, the pharmacist dug out the phone book so I could call other pharmacies. I called four. No luck. I was beginning to be unable to speak a coherent sentence.

  There was a metal chair pushed up against a rack of Ace bandages in the far aisle, where customers sat while waiting for prescriptions to be filled. I collapsed into it and began sobbing. The people in the store were glancing toward me and then looking uncomfortably away. I was embarrassed and horrified that I was so completely losing it in front of Alex.

  And he was equally horrified. “Mommy, don’t cry. Mommy, don’t cry. We’ll find it.” He clambered onto my lap and put his arms around my neck. He started crying, too. I knew better, oh so much better. I am utterly and completely blowing it, I thought. There we sat in the pharmacy’s dinky metal chair, mother and son, clinging to each other and weeping.

  A voice interrupted. “I found it.”

  I looked up. The pharmacist, a young Hispanic woman with long dark hair, was holding up a box triumphantly. “It was hidden away.”

  I didn’t know what to say. “You have it? You have it!”

  Alex exclaimed through his tears, “She has it!”

  It had been hidden on a back shelf. We had it. We blew our noses, wiped our eyes, paid for the steroids, and walked back through the dark streets—it was now night—to the empty house.

  Alex and I had never spent the night in the house alone. I promised him he could sleep in my room. But first, he had to take the medicine.

  It tasted awful. I tried to make him just gulp it down. I made it into a milk shake but diluted it too much, so now he had to drink an enormous glass of bitter shake. He took tiny sips. I bribed. I cajoled. I begged. I threatened. I held his nose. I added syrup and anything else I could think of. I lost it again.

  “I’m sorry I fell, Mommy,” Alex said in a small voice.

  Oh god. We sat on the floor and hugged.

  “I wish Dr. Parisier could just make it better,” he said.

  “I do, too.”

  Again, I was blowing it. I remembered the mantra of Deaf culture: “There’s nothing wrong with Alex.” Clearly, I was not sending that message. As far down the path toward profound deafness as we already were, I was surprised by how desperately I was clinging to what hearing remained. I really, really wanted him to take the medicine. Although I’d given the cochlear implant most of the credit for his transformative progress, I understood by now how much help he was getting from his left ear and how useful it would be for learning to read, which he had yet to do. I had also been rattled by Alex’s hysteria. I wished he was old enough to tell me more about how he was experiencing the world.

  Four hours later, he had downed three-quarters of it. Enough.

  When we went to bed, Alex insisted on keeping his processor on his head (and still does).

  The next day, New Year’s Eve, we drove back to the farm in a blizzard. It took us nearly eight hours to get back. It was four below zero, but Mark was waiting in the driveway.

  For the next ten days, Alex did battle with the milk shakes. I let Mark take over making the concoctions. He bribed, cajoled, threatened, and did vaudeville acts. Alex took the medicine.

  And it worked.

  On the ninth day, back in Brooklyn, we were putting the boys to bed. Mark was doing an unscientific hearing test, one that traditionally made the boys laugh. Standing behind Alex’s left ear, with no cochlear implant on the other side, Mark said loudly, “Scooby-Dooby-Doo.” And Alex said, “Scooby-Dooby-Doo.” Then he turned around and looked at Mark in surprise.

  “Daddy, I heard you.”

  “You heard me?!”

  “I heard you!”

  “Hamburger.”

  “Hamburger.”

  “Banana, banana, banana.”

  “Banana, banana, banana.”

  “He heard him!” we all shouted. Mark threw Alex up on his shoulders and we all did a victory dance. But quickly, we lifted him down. Gently.

  22

  THE READING BRAIN

  Ask an average four-year-old to tell you the difference between “cat” and “hat,” and he will probably tell you that one is an animal you pet and the other is something you put on your head. Ask the same question when he’s five, and you might hear that “cat” starts with a “k” sound and “hat” with a breathy “hu” sound. Something profound has occurred. Once a child understands that there’s a relationship between the spoken words “cat” and “hat” that has nothing to do with their meanings and everything to do with how they sound, he is launched on the challenging obstacle course of learning to read. All along the way, he must master successive, compounding skills until he soars to the finish line ready to read fluently, or is left behind mired in the mud.

  That first hurdle, phonological awareness, requires recognizing that spoken words are made of parts. For those who’ve completed the obstacle course, that no longer seems like such a big deal. Good adult readers know it so intuitively and act on it so gracefully that we often don’t remember what a leap the idea required. We don’t go to school to learn to talk, because spoken language, for the hearing, comes naturally. That doesn’t mean it’s easy, just that it’s mostly unconscious. “Our brains know that there are separate phonemes and syllables within words,” says Ken Pugh, a cognitive psychologist at Haskins Laboratories in New Haven, Connecticut. We don’t need to be aware of that fact to acquire speech. “We’re wired to talk and listen and chew gum at the same time if you will.” Reading, on the other hand, as Steven Pinker has put it, “is an optional accessory that must be painstakingly bolted on.” It is also a relatively recent cultural invention that requires a child to actively consider and come to some understanding about how language works. That process begins with phonological awareness.

  I had to make the leap all over again when Alex started to learn to read. Until then, I hadn’t had to think much about the way that spoken language underpins written language or that the term “phonological awareness” refers to speech rather than print. It is the ability to hear that “big” has one syllable and “bigger” has two, that “big” and “ball” begin with the same sound, that “big” and “pig” rhyme, or finally, at the most sophisticated level, that “big” consists of three sounds: “b-i-g.” In my ignorance, I was apparently not alone. “People hear this term all the time, parents in particular, but they still don’t quite understand,” says Haskins scientist Stephen Frost. “Many educators as well don’t get it.”

  Haskins Laboratories, a nonprofit research institute affiliated with Yale and the University of Connecticut, studies the science of the spoken and written word. It might be considered a church of phonological awareness. Certainly, no group of researchers has done more to further the mission of understanding the connections between spoken language and reading—or in the case of people with reading disabilities or hearing loss, the misconnections. They have shown not only how important phonology is for typically developing children but also that it is the leading cause of reading problems. Their work has such obvious implications outside of the laboratory that Haskins scientists spend a good amount of time spreading the word. Donald Shankweiler, the pioneering reading researcher from whom I borrowed the lines about the cat and the hat and the four-year-old and the five-year-old, likes to tell his colleagues stories of talking to rooms full of educators and suddenly seeing them begin to nod their heads when they have seen the light.

  Shankweiler himself saw the light at Haskins in the late 1960s and early 1970s. When he and his longtime collaborator Isabelle Liberman began to test explanations for reading problems, there was a pretty strongly held view that reading was visual and that readi
ng disability was probably visual as well. “Reversals of letters and words were still considered to be the hallmark of dyslexia,” wrote Shankweiler. Treatments included eye exercises and motor patterning. Shankweiler and Liberman approached the subject differently. “Because writing transcribes language, it seemed natural to ask how reading builds on the foundations of the child’s development of primary language,” wrote Shankweiler. It was especially natural at Haskins, which, under the direction of Isabelle’s husband, Alvin Liberman, already specialized in speech science and was a breeding ground for new ideas. Al Liberman regularly walked the halls asking, “Made any discoveries today?”

  In order to read an alphabetic language like English or Spanish, children need to master the alphabetic principle that letters correspond to speech sounds or phonemes. That much was clear. A phoneme is the smallest unit of a word that has a distinct sound and, depending on dialect, there are about forty in English, such as the “c” in “cat” or the “sh” at the end of “push.” The ancient Greeks are credited with being the first phoneticians and “doggedly perfecting the correspondence between letters and all known sounds,” wrote Maryanne Wolf, director of the Center for Reading and Language Research at Tufts University and author of Proust and the Squid: The Story and Science of the Reading Brain. The discovery that “the entire speech stream of oral language could be analyzed and systematically segmented into individual sounds,” she goes on to note, “is not an obvious perception for anyone, in any era… . [Yet] the great breakthrough by the inventors of the Greek alphabet … happens unconsciously in the life of every child who learns to read.”

  At Haskins, the Libermans, Shankweiler, and another scientist named Ignatius Mattingly began to debate how it was that children arrived at the alphabetic principle, since the alphabet did not actually directly correspond to the sounds of speech. They came up with the idea of phonological awareness as a preliminary step. No one had really thought to look for such a thing before. In their earliest studies, they found that many preschool children have made a start on phonology—they are aware of syllables—but very few can separate out a phoneme. In the decades of research that followed at Haskins and elsewhere, it has been clearly established among other things that preschool oral language skills are predictive of fourth-grade comprehension skills, that how the brain reacts to speech sounds on the first day of school has big implications for what that child has to do to learn, and that more specifically, the location of a kindergartner’s brain response to sound is correlated with how many words she will read per minute in second and fourth grades. Furthermore, says Usha Goswami, the Cambridge researcher who discussed Dr. Seuss with me, “There’s now twenty to thirty years of research across many different languages which shows that individual differences in brains that are good at reading and brains that struggle to read are really related to sound structure.”