2021: A Century of Serving Northeast Ohio!
I couldn’t be prouder to lead an organization with a legacy and mission that have stood the test of time. Looking back, there is so much about our story that inspires me. This will be the first in a series of reflections to bring you along on the century-long journey of Cleveland Hearing and Speech Center (CHSC). As you read along, I hope you will share in my sense of awe and wonder as we embark on our second century of serving Northeast Ohio.
1921: Pandemic, Poverty & Civil Rights
I struggle to think about the inception of our legacy without the context of what was going on in the world in 1921. It was a momentous period in world history and the history of our country. Certainly, rolling off of a world war and global pandemic situates our beginning in the context of a broader story. World War I accelerated innovation and technology, including unprecedented advances in medical care. The Spanish Flu of 1918-19 infected one in three and killed one in 10 worldwide. Like the COVID-19 pandemic today, the impact was felt greatest among those who were poorest. Illiteracy meant little access to information because newspapers were the primary means of communication. This illness was particularly lethal in those who were 20-40 years old, sparing the young and very old. My own husband’s grandmother, at 7 years of age, was responsible for walking over a mile each way to the store to get the groceries for her family because her parents and grandparents were too ill. Then, too, was the passing of the 19th Amendment of the U.S. Constitution in 1920, after nearly a century of fighting for women’s right to vote that began before the Civil War.
A Woman’s Intrepid Leap
Within this context, the Cleveland Association for the Hard of Hearing (CAHH) was founded in 1921 by Mrs. Helen Newell Garfield. The first daughter-in-law of President James A. Garfield, Mrs. Garfield experienced hearing loss herself at the age of 52, in 1918. A fierce advocate for the education of children with hearing loss, her lipreading school fulfilled a critical and unmet need in our region that helped these children learn critical communication skills.
Mrs. Garfield understood the impact of hearing loss on communication, including missing access to information and, for children, missing out on education and the opportunity to become literate. While the war brought women out of the home and into the workplace, I cannot imagine the bold courage of Mrs. Garfield at this time. Her social connections likely aided her success in establishing the foundational resources to begin serving this noble mission. But it was she alone who took the intrepid leap to serve our community through the founding of the agency that would, one day, become Cleveland Hearing and Speech Center.
Born 100 Years Too Early
100 years ago, hearing loss imposed incredible limitations on many individuals. Mrs. Garfield’s work and vision were about removing the barriers to achievement that were faced by children who had hearing loss.
Mr. Daniel D. Dauby was one such child. Born in 1910 to N.L. and Bessie Dauby, a locally prominent family who co-owned The May Company department stores, Danny suffered a birth injury and began his life without hearing and a compromised respiratory system. His sister, Lucille, would become the mother of local Cleveland business owner and philanthropist, Robert Gries. When Mr. Gries reflects on his Uncle Danny’s life, he can’t help but talk about how different his life might have been had he been born a century later. Despite every advantage, including being educated at Clarke School for the Deaf in Massachusetts, Danny was not able to live independently, work, or have a spouse. Mr. Gries laments, “There were so many constraints at that time. He was born 100 years too early.”
Hearing Care Then
It is important to note that early hearing loss in infants and children was often not identified until much later in childhood and services were not available for children and families to learn how to communicate with each other. Literacy and academic achievement in children were limited by the lack of language development.
In addition, hearing aid technology was quite different from what it is today, meaning that even children with mild or moderate hearing loss were not able to develop language or speech typically.
You may be familiar with the ear-trumpets that became distributed and manufactured as early as 1800. These devices were bulky and not terribly effective in amplifying sounds. At the time when Mrs. Garfield lost her hearing, electronic hearing aids were beginning to be manufactured by the Siemens company. The technology was developed from the technology used for telephones and included a carbon transmitter. These units were quite bulky and heavy and have been described as being the size of a “large cigar box.”
By 1920, the carbon transmitter was replaced with the vacuum tube, which significantly improved the portability of these sound amplifying devices. Mind you, the idea of portability was relative—vacuum tube hearing aids weighed more than even the heftiest of laptop computers today, at 7 pounds!
It wasn’t just the size and weight that limited the usefulness of these devices, however. The amplification tended to distort the sounds important for speech understanding. As any hearing aid user today can tell you, louder is not necessarily better for addressing the complexity of hearing loss! Clearly, this early hearing aid technology was infeasible for most people with hearing loss, especially children.
Hearing Care Now
Looking back at the earliest days of our agency, it is astonishing to reflect on how far our society has progressed with removing barriers for children and adults with hearing loss. Crucially, federal legislation passed in 2000 established programs and funding in every state to screen hearing in newborn infants before they are discharged from the hospital, to confirm hearing loss with full diagnostic testing in infancy, and to provide early intervention in children from birth to age three, including medical services, family support and training, and child-focused early intervention that ensure.
These requirements are mandated by the Early Hearing Detection Act, passed by Congress first in 2000 and reauthorized in 2010 and 2017 until 2022. This legislation has changed the trajectory for an entire generation of children, literally opening the world of language and communication to thousands. Prior to the passing of this legislation in 1999, fewer than 10% of children were screened for hearing loss in infancy and 47% of children were not diagnosed with hearing loss until their 3rd birthday or later. This meant that children missed what we refer to as the “critical period” for language development, in the first 1000 days of life.
The Importance of Early Intervention
During the first three years, children’s brains are primed for the complex processes required to learn and produce language. Missing this period limits the ability to achieve in language acquisition which, in turn, limits a child’s ability to learn to read and achieve academically and vocationally.
We are incredibly proud to be part of the early intervention efforts in Northeast Ohio, providing training and support to hundreds of families in Cuyahoga and the five surrounding counties! For many families, our early interventionists become part of the family, supporting them through crucial decisions, teaching them how to connect with their infant and stimulate language, and connecting the family to critical resources to ensure their child can achieve to their full potential. This important pivot in our society is a real testament to the importance of legislative advocacy for our agency. CHSC leadership played a pivotal role in the passing of supporting legislation in the State of Ohio that requires that all infants’ hearing is screened in the earliest days of life.
Improvements in Technology
It likely goes without saying that advances in hearing aid technology in the past century go far beyond what Mrs. Garfield could have ever imagined. Digital hearing aids, microchips, and microprocessors were introduced in the 1980s and these advances in technology were combined to create the hearing aids that are common today. Barely visible and light enough to be indetectable by the users, hearing aids today can provide users customized programing to be used in different listening settings, they can self-adjust based on ambient noise, and they can connect to all of the digital devices that are ubiquitous in society so that users can answer calls or listen to music directly through their hearing aids.
Despite these advances, the technology is still far from perfect and many people with hearing loss still struggle with hearing or understanding in a variety of listening settings. Crucially, however, advances in hearing aid technology have enabled countless children to acquire language and achieve their potential in academic and work settings. Cochlear implants have also made great strides in advancing what is possible for children with hearing loss.
Our Next 100 Years
Despite the amazing advancements in technology, we still have a long way to go to achieve the vision that Mrs. Garfield established and that we still live by today: “A community where every person can communicate effectively.” The cost of hearing aids is a barrier for many children and families, for instance. Our agency is able to provide hearing aid technology to children and adults with financial constraints through our Audiology Patient Assistance program. In addition, we work tirelessly to advocate to our state legislators to advance legislation requiring private insurance to cover the cost of hearing aids for children. This barrier must be removed to achieve our vision. Similarly, hearing aid costs are not covered by Medicare, meaning that aging adults who are most vulnerable to hearing loss have ongoing barriers to access to this care. I hope that by our 200th anniversary (...honestly, our 110th), we look back and see that these barriers were removed. Until then, Cleveland Hearing and Speech Center will be here for everyone in our community.