Former Miss America Receives Cochlear Implant Heather Whitestone McCallum didn’t mind not hearing her name being called when she won the title of Miss America in 1995, but when it came to her family, it was another story. She couldn’t accept missing out on what her children said. When the winner of the 1995 Miss America ... Features
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Features  |   November 01, 2002
Former Miss America Receives Cochlear Implant
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Hearing Aids, Cochlear Implants & Assistive Technology / Features
Features   |   November 01, 2002
Former Miss America Receives Cochlear Implant
The ASHA Leader, November 2002, Vol. 7, 1-18. doi:10.1044/leader.FTR3.07202002.1
The ASHA Leader, November 2002, Vol. 7, 1-18. doi:10.1044/leader.FTR3.07202002.1
Heather Whitestone McCallum didn’t mind not hearing her name being called when she won the title of Miss America in 1995, but when it came to her family, it was another story. She couldn’t accept missing out on what her children said.
When the winner of the 1995 Miss America pageant was announced, McCallum—then Whitestone—turned to a fellow finalist for a visual cue, knowing that the winner almost always cries. When she saw that the finalist was dry-eyed, she stepped forward, becoming the first woman with a disability to win the crown.
During her reign, McCallum—who lost her hearing when she was 18 months old—spoke at the ASHA Convention and described the Miss America role as a platform from which she could make a difference and serve as a role model for others. In an emotional speech, McCallum emphasized that “people who are deaf and hard of hearing should have the freedom to choose whatever communication option will help them build the self-esteem to be successful.” For McCallum, learning to speak was a key factor in her success, but she noted that for others, it might be American Sign Language or total communication.
She also was honored with the Annie Glenn Award at the 19th Annual Communication Awards, a project of the National Council on Communicative Disorders sponsored by ASHA and the National Association for Hearing and Speech Action.
McCallum had long been aware of cochlear implants, but felt that she didn’t need one. Despite a profound hearing loss, she was able to talk on the phone with her family and, using a hearing aid and FM system, was able to converse at noisy media receptions. But six years later, after marrying John McCallum, former aide to Newt Gingrich and now executive director of the TAG Foundation, and starting a family, the limitations of using hearing aids and speechreading became more apparent. When her sons, John and James, now 2 years and 13 months, respectively, became toddlers, she couldn’t understand their speech. They spoke while looking down, walking away, or from behind her back.
But the turning point came when McCallum realized that visual cues are not always enough. Last fall, John Jr. fell and scraped his head on the patio. McCallum never heard his cries, although her husband responded. “He cried and I was not there to comfort him. That made me want to have an implant. I wanted the option to hear more,” she said. “My boys have taught me a lot about my deafness—I have been missing far more sounds than I realized.”
McCallum received a cochlear implant on Aug. 7 at Johns Hopkins Hospital in Baltimore, MD, where the surgery was performed by otolaryngologist John Niparko. Six weeks later, audiologist Jennifer Yeagle activated the device. She noted that, for all cochlear implant patients, learning to use the implant takes time, motivation, patience, and audiologic rehabilitation.
“Heather’s motivation for a cochlear implant was generated by her strong desire to better communicate with her children as they grow,” Yeagle said. “Her determination will allow her to work through the frustrations and be patient while learning to hear with the implant. She has already proven that she embraces difficult challenges.”
In the weeks following the activation, McCallum, who had not heard anything out of her right ear for 28 years, was able to hear the sound of water, the whoosh of hairspray, the rolling wheels of her sons’ bicycles, the zipper on her purse, and strains of music from the violin and piano.
She plans to seek audiologic rehabilitation services. “There will be new sounds that I did not hear with the hearing aid that I am not familiar with,” she said. “Aural rehabilitation will help me better understand the sounds I’m hearing.”
Meanwhile, voices, while still fuzzy, are gradually becoming clearer. After a week of using the implant, McCallum was able to hear the sound of her sons’ voices at the breakfast table.
Audiologic Rehabilitation: Making Sense of Sound

by Loretta M. Nunez and Jennifer Yeagle

While cochlear implants give adults greater access to sound, aural rehabilitation or audiologic rehabilitation is critical in building auditory skill development, maximizing successful use of the device, and providing information and support counseling.

For Heather Whitestone McCallum, audiologic rehabilitation will begin with a consultation one month after activation. At this time, an inventory is taken of the environmental and speech sounds heard by the individual. The patient and family member complete questionnaires, such as the Self-Assessment of Communication and Significant Other Assessment of Communication, which are designed to identify difficult communication situations and elicit their feelings about current communication function.

A variety of closed-set and open-set auditory speech perception activities are presented to assess communication function and determine the need for audiologic rehabilitation, and the Client Oriented Scale of Communication Inventory (COSI) is used to identify individualized, functional communication goals. Counseling also is provided on the use of the cochlear implant, auxiliary equipment, realistic expectations, factors that influence speech understanding, and communication management strategies. Support counseling is provided as needed.

Individual Goals

The degree to which audiologic rehabilitation is needed varies, depending on the patient’s hearing loss history and communication skills. Services are provided on a short-term basis, consisting of 10 hour-long sessions, or on a long-term basis, with an average of 20–30 sessions. In some cases, an audiologic rehabilitation consult is all that is needed.

For post-lingually deafened adults, audiologic rehabilitation is designed to optimize the communication benefit provided by the implant and improve the communication relationships affected by deafness. Treatment is usually short-term and focuses on open-set auditory speech perception, managing difficult communication situations using assistive technology and communication strategies, telephone instruction, and support counseling. Independent practice is emphasized by listening to audio books, television, and radio, and using the telephone with a variety of speakers.

Audiologic rehabilitation for prelingually deafened adults may be limited to awareness of speech and environmental sounds and closed-set pattern or word recognition.

For McCallum and others with perilingual or prelingual deafness who have used hearing aids consistently and demonstrate oral language proficiency, audiologic rehabilitation initially focuses on closed-set speech perception and then progresses to open-set speech perception for words and sentences. Enhancement of auditory perception of manner, voice, and place of production of English phonemes also is beneficial, and integration of these newly acquired auditory skills with speechreading is encouraged.

Telephone communication focuses on using closed-set questions initiated by the cochlear implant recipient, such as yes/no questions or those featuring a choice of two responses. In some cases, open-set speech understanding over the telephone is achieved with familiar speakers when limited to familiar topics of conversation. However, this population may prefer technology options available today, such as e-mail, text pagers, text telephones, or telecommunications relay services, including voice carryover or CapTel, an enhanced voice carryover service that is currently on trial in several states.

Those with long-term hearing losses tend to have a longer and more difficult time adjusting to the sound provided by the implant. Expectations for performance vary depending on the length of deafness. However, although anything is possible, other factors also play a role in learning to use the implant. Supportive counseling to maintain realistic expectations and accept hearing limitations with the implant is critical.

Loretta M. Nunez is coordinator of cochlear implant rehabilitation at Johns Hopkins Hospital in Baltimore, MD. Contact her by phone at 301-896-3164 or by e-mail at loretta@thelisteningcenter.com.

Jennifer Yeagle is a cochlear implant audiologist at Johns Hopkins Hospital. Contact her by e-mail at jennifer@thelisteningcenter.com.

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November 2002
Volume 7, Issue 20