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Vital Signs with Dr. Sanjay Gupta
New Technologies in Hearing Aids Examined; Interview with NFL Player Derrick Coleman. Aired 2:30-3p ET
Aired September 12, 2015 - 14:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[14:30:23] DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: It's the most common sensory disorder affecting 360 million people worldwide. Today we're talking about hearing loss and sound. This is "Vital Signs." I'm Dr. Sanjay Gupta.
Our ears are made up of three main parts, the outer ear, the middle ear, and the inner ear. The smallest bones in your body are actually located in your middle ear. They're called ossicles, and they transmit sounds to the cochlea in your inner ear. It's this fragile, complicated system. And while some people are born profoundly deaf, hearing loss for many people happens over time from reasons like disease, age, or damage to the auditory system.
But deafness doesn't stop people like Derrick Coleman. He is a Super Bowl champion breaking down the sound barrier.
Saturday morning on a military base outside Tacoma, Washington, 450 kids, dozens of coaches and three professional football players from the NFL have all gathered for a camp. Derrick Coleman is a fullback for the Seattle Seahawks. He also holds a unique place in the NFL record books that has nothing to do with touchdowns scored or yards gained. Derrick is the third deaf player in NFL history and the first to play offense in the league.
DERRICK COLEMAN, SEATTLE SEAHAWKS: On the field, field of 10, normal people range seven, eight, nine. Without my hearing aids, I'm one, two.
GUPTA: One out of every two cases of hearing losses in babies is due to genetic causes. Derrick's parents both have normal hear but they are each missing a hearing gene. It resulted in a decline in Derrick's hearing. By the time he was three years old he was almost deaf.
COLEMAN: It's just who I am. Honestly, some people just say I'm born with it because I don't ever remember not having it.
GUPTA: He might not remember being able to hear, but Derrick remembers getting bulky hearing aids in elementary school. He remembers the bullies, the kids calling him "four ears." And he remembers the first time he ever played football in middle school where he finally found the place he belonged.
COLEMAN: Football, basically, it gave me a sense of understanding as well, and it made me understand the world a lot better. And in between these white lines, you know, that's all that mattered. If you have a disability, are you letting that disability affect your performance? Are you making a future for it? Football was the first thing where I don't want to make excuses for this. I don't want to do that. I just want to play.
GUPTA: But football for Derrick almost never happened. His parents worried the tough hits in football could do further damage both to his ears and to his hearing aids. An MRI showed the structure in the ears would withstand the hits, but there was one more critical obstacle Derrick needed to figure out, communicating on the field. So he perfected lip-reading even behind face masks and mouth guards.
COLEMAN: The biggest challenge and the only challenge really that I faced was making sure the quarterback knows that I'm there.
GUPTA: After a childhood spent trying to fit in, Derrick was suddenly standing out for all the right reasons. He played college football at UCLA and graduated after four years with a degree in political science and 11 touchdowns his senior season. He had caught the attention of the NFL, first with the Minnesota Vikings, and then with Coach Pete Carroll and the Seattle Seahawks. On September 8th, 2013, he played his first regular season game as a professional football player.
[14:35:09] COLEMAN: And I end up getting three catches for 30 yards, which is kind of crazy. I didn't even think I was going to touch the ball at all.
GUPTA: Derrick's success was making local headlines as the Seahawks marched toward the Super Bowl in 2013. But it was an unexpected opportunity that would change everything.
COLEMAN: They told me it couldn't be done, that I was a loss cause.
GUPTA: This Duracell battery commercial first aired in January, 2014, right before a Seahawks playoff game. It became a viral sensation.
COLEMAN: That commercial basically let me know that, one, I'm not alone. It's the whole world. You know, it's not just because we are hearing impaired, but because it's everything, everybody has problems. I want to build a community where everybody is picking each other up. You know, that's why I made the No Excuse Foundation. There's no excuse for letting your brother fall down.
GUPTA: "No excuses," two words Derrick has lived by his entire life. He's just written a book by the same title, and it is the message he's hoping to convey to the kids at his camp in Washington.
COLEMAN: Good job.
GUPTA: Out of the 450 plus kids signed up, 85 of them have special needs. But they aren't singled out, and that's by design.
COLEMAN: You got to blend in. Like I said, we all have problems. But you know, they got to learn how to interact with society. And, believe it or not, there's somebody out there in society that wants it to happen. GUPTA: Not seeing the difference between the deaf and the hearing,
it's the same idea that inspired a researcher to change what we have known about language and the brain for more than 100 years.
GUPTA: Our senses help us perceive the world around us. A certain smell or sound can trigger some of our deepest memories. When it comes to hearing, the entire auditory system relies on tiny little hairs in your ears.
[14:40:03] They pick up the vibrations from your eardrums and convert them to nerve impulses. That's the message your brain receives, interpreting the impulses as sound. For more than 100 years it was believed that brain tissue in this region was intended to process sound and sound only. That was until Dr. Laura-Ann Petitto began her work, focusing not on sound and speech but on language. And what she found was revolutionary.
At first glance it might not look like much, but what this baby is doing is changing the way we think of language and the brain. This little boy is babbling in sign language.
DR. LAURA-ANN PETITTO, SCIENCE DIRECTOR, VL2 AND BL2 LABS: I think we all agree there's something extraordinary and magical about human language.
GUPTA: Dr. Laura-Ann Petitto is a cognitive neuroscientist. She's dedicated her life's work to understanding language. It all started with the chimpanzee named Nim.
PETITTO: They said that the reason that makes us different is that we talk and animals can't talk. Well, I thought that was so strange, because if you see me working with the chimpanzee there's something that's very striking. I wasn't trying to teach him how to talk English. I was trying to teach him American sign language. And so that really was beginning of my question, how is it that we are different?
GUPTA: Pettito has spent four decades asking and answering questions about speech and language. Today she runs the Brain and Language Lab at a Gallaudet University in Washington, D.C. Founded an 1864, Gallaudet is the world's only university specifically for deaf and hard of hearing students. It's a unique setting perfectly matched for her unique research. In her lab Petitto and her graduate students work with a special machine Petitto helped design. It's called the FNRS (ph), a faster, quieter, and more portable version of an MRI machine. If Petitto was going to study the brains of infants she needed a way to look at them.
PETITTO: And this is quite an extraordinary new microscope into the brain. It also allows the baby to engage in more naturalistic behaviors. They can look, they can turn their head, they can move their hands. And this was very exciting.
GUPTA: Remember that baby babbling in sign language? Well, Petitto found that babies exposed to sign language hit the same developmental milestones as babies exposed to speech. For example, the first word and first sign both come around 12 months. That meant something was happening in the brain, unique to language, not speech. Whether through signing or speaking, the brain simply wanted the patterns of language. But for more than 100 years, it was universally accepted that a certain part of the brain, the superior temporal gyrus, was intended specifically to process sound.
PETITTO: We gave profoundly deaf people, while they were inside a brain scanner, phonetic units be in signs. These were bits and pieces of signs that had no meaning. They're like if I said to you ba-ta-ga- ta, just streams of phonetic units. And there what we found is that profoundly deaf people exposed to sign language were having extraordinary activity in just that tissue that had been thought to be the exclusive bastion for the processing of sound. It raised questions about how is it possible, why didn't that tissue in a deaf person become atrophied? And our conclusions were that there was a mistake, that science had misunderstood the function of this tissue.
GUPTA: The research also showed early exposure to a visual language like American Sign Language did not undermine a baby's ability to learn spoken language. In fact, Petitto says, it's just the opposite.
PETITTO: Early exposure to sign language is by far the most healthy thing we can do for the human brain because the brain, the research shows us that the brain doesn't care about modality. It doesn't care if you give it the hands or the tongue.
GUPTA: No matter how it's expressed, communication is really what language is all about. A little boy and his family were fully prepared for a life spent communicating through sign language. But a clinical trial is offering a second chance for deaf children like Caiden.
DANIELLE MORAN, CAIDEN'S MOTHER: Wow, you're fast.
[14:48:14] GUPTA: For many who are deaf, cochlear implants have been a big breakthrough for the past 30 years. Unlike a traditional hearing aid, which amplifies sound, cochlear implants have both external and internal components that work together to help perceive sound. It provides direct stimulation to the auditory nerve in the inner ear.
People who are profoundly deaf and can't be helped by hearing aids can often be helped by cochlear implants. But there is another group who can't be helped by either one. And that's why a clinical trial in California is providing some much-needed hope, bypassing the ear all together and going straight to the source.
MORAN: Run, run, run, run, run.
GUPTA: Meet Caiden Moran. He's five-year-old, and like most kids his age is incredibly curious about the world around him. Being profoundly deaf hasn't slowed him down one bit. MORAN: When Caiden was born, before we left the hospital he did the
newborn hearing screening. And he had failed, so we came back a week later, did the test again. He failed again.
GUPTA: Tommy and Danielle Moran are Caiden's parents. Tommy is in the United States Navy based in Hawaii. At the time doctors confirmed baby Caiden was deaf, Tommy was deployed.
TOMMY MORAN, CAIDEN'S FATHER: I was sad. In fact, Danielle said I didn't know anybody who was deaf, I didn't know sign language, I didn't know how to be a good dad and raise a deaf child.
GUPTA: Their youngest son Brett is two and he has normal hearing like his parents. But Caiden was born without cochleas, the part of the ear that converts sound to nerve impulses and then sends them to the brain. With no cochleas, a cochlear implant would be no help.
[14:50:04] So from the start, Tommy and Danielle learned sign language. They figured it would be the only way Caiden would ever communicate. Then Danielle heard of another option.
DANIELLE MORAN: It was random. I just talking to a friend and she was like, I think that they're doing ABIs in the U.S. now.
DR. MARK KRIEGER, CHILDREN'S HOSPITAL, LOS ANGELES: So ABI stands for auditory brain stem implant. The main use for this is for kids born without nerves to the ears. So I like calling it a bionic ear.
GUPTA: Dr. Mark Krieger is a pediatric neurosurgeon at children's hospital in Los Angeles. In conjunction with USC's Tech School of Medicine, a clinical trial was started in 2014 to perform auditory brain stem implants on young children.
Here's how it works. Similar to a cochlear implant, it has external and internal parts. A microphone and transmitter on the head converts sounds from the outside world into electrical signals. Those signals are transmitted to the internal receiver made of electrodes implanted on the brain stem. The auditory neurons are stimulated directly in the brain, bypassing the inner ear completely.
KRIEGER: By putting this electrode directly into the hearing centers of the brain it actually is taking stuff and using the brain the way it's designed to work. And the brain itself in a very young child is able to grow and develop around this implant.
GUPTA: Caiden was chosen as the fourth patient for the trial. In January of 2015 he underwent brain surgery to implant the device. Dr. Krieger was one of three surgeons performing Caiden's operation. Dr. Eric Wilkinson was another.
Dr. ERIC WILKINSON: I'm just going to take a look at the implant. His scar is actually really nicely healing up.
GUPTA: Dr. Wilkinson is one of the lead investigators on this ABI trial. Children's Hospital of Los Angeles and the University of Southern California aren't the first to be performing auditory brain stem implants. In fact surgeons in Italy have been doing this procedure for more than 10 years. But this trial is the only FDA approved one in the United States funded by the national institutes of health.
UNIDENTIFIED MALE: Do you want that? Do you want that?
GUPTA: They are also focusing on one particular age group.
KRIEGER: Good job, buddy.
We know from cochlear implant studies that the earlier the auditory system in the brain can be stimulated, the better the children will do. In our study we actually have the ages of two through give, so we feel that that's a balance between finding a safe age to do it but also doing it at a young enough age that the child will actually benefit from the device.
GUPTA: Caiden just made the age cutoff, turning five one month after his surgery. The operation was a success, but the work is only just beginning. Caiden has spent his entire young life with absolutely zero auditory input. It will take years of work to train his brain to understand and interpret sounds.
This video is from March, 2015. That's when Caiden's device was activated. And this is what happened when he heard his grandfather for the first time.
UNIDENTIFIED MALE: Hi.
UNIDENTIFIED FEMALE: Say hi, grandpa.
UNIDENTIFIED MALE: Hi.
GUPTA: An incredible moment and a promising start. Caiden now goes to therapy several times a week to work on his speech and his hearing.
MARGARET WINTER, USC CARUSO FAMILY CENTER: And I'm going to raise up his upper level of stimulation just a little bit on some of these electrodes.
When we first saw him, after he received the implant for initial stimulation, we were amazed and delighted at how well he responded. Not all children know what that sound is to begin with and don't always respond to it immediately, but he did.
GUPTA: Margaret Winter is an audiologist with the USC Caruso Family Center in Los Angeles. She and co-worker Jamie Glader have been working with Caiden and the ABI patients since day one. The Moran family is at the clinic today for the three-month follow-up.
Through a series of tests that are disguised as games, Margaret and Jamie monitor frequencies and volumes to see what Caiden can hear through his implant. For example, Caiden knows he can't add another leg to the table he's building until he hears a sound. UNIDENTIFIED FEMALE: Wow. You're fast.
WINTER: Imagine a newborn baby doesn't come into the world with the ability to understand what sound is or that it should be meaningful. And so over time with all of the things that we do with babies, we're going to be doing it with children who have hearing aids or cochlear implant or ABIs.
[14:55:03] UNIDENTIFIED FEMALE: Birthday cake.
GUPTA: For now Caiden still relies primarily on sign language, but he's already repeating certain sounds, and he's becoming increasingly vocal.
UNIDENTIFIED FEMALE: Listen. Baby. Baby.
GUPTA: Keep in mind, he's only been able to hear any sound at all for three months.
UNIDENTIFIED FEMALE: Here's a loud one, all right.
TOMMY MORAN: If he can just hear noises like a car coming when he's a kid playing, have him hearing something like that save his life, I would be happy with that.
I'm proud because of such a young boy that he is, the things that he has to deal with and overcome that I didn't have to, and I think it's going to build a lot of character in him. I already see that in him. So I'm proud of him for just sticking to it.
GUPTA: Hearing is a gift, along with our other senses, an incredible function of our bodies. That doesn't mean deafness is a curse. Just ask Super Bowl champion Derrick Coleman, or the Ph.D. students in Dr. Petitto's lab, whose research is changing how we understand learning, language, and development. Like Dr. Petitto says, people might discriminate between spoken language and sign language, but the brain does not. It's hard to argue with that.
For "Vital Signs," I'm Dr. Sanjay Gupta.