Article By Emily Williams | Published In OTMJ on February 5th, 2020
According to the National Institute on Deafness and Other Communication Disorders, roughly one in 1,000 children are born deaf.
“In Alabama, that’s going to be about 30 to 40 kids, because there are about 30,000 to 40,000 live births a year,” said Dr. Audie Woolley, chief of pediatric otolaryngology at Children’s of Alabama.
Many of those babies end up at the Children’s Pediatric Cochlear Implant Program, started by Woolley in 1995. Since then, the program has completed more than 700 implant procedures.
In addition, Woolley serves as the co-founder and director of the Woolley Institute for Speech-Language Education, a preschool that provides educational and therapy programs to children with hearing disabilities.
A Vestavia Hills resident, Woolley will be honored for his impact on the local community and the state with the Leadership Vestavia Hills’ Distinguished Citizen Award at the Community Awards Luncheon on Feb. 25.
He will be honored alongside Citizens of the Year Gina and John Henley.
“It’s a great privilege to be honored the same year as the Henley’s,” he said. “I have known this family for many years, having taken care of their nephew who has a cochlear implant.”
When Woolley and his wife first moved to Birmingham, the couple thought they would be in the city for maybe four or five years.
“We’re not from Alabama,” he said. “(My wife and I) are from Texas, and we thought we’d go back but stayed because of the hospital and living in Vestavia – where the community was so supportive of everything we were doing.”
Drawn to Surgery
Woolley grew up in Cisco, Texas, a small town of about 4,000 people.
“We had one doctor in the whole county, and he delivered my brother and sister,” Woolley said. “He was a very close friend of the family, and I so admired him and his dedication throughout my early education.”
While in high school, Woolley would spend summers observing surgeries and clinical work. This is when he realized he wanted to be a surgeon. knowing he wanted to become not just a doctor, but a surgeon. At first, he fancied neurosurgery but was drawn into the field of otolaryngology while in medical school at the University of Texas Health Science Center.
“It was just so broad – you could be a sinus surgeon, head-neck cancer surgeon, do cleft palates, perform major complicated ear surgery or manage complicated airway problems. It was also a rewarding field, because most of your patients are really healthy, and most of them do very well postoperatively,” he said.
At the time Woolley started his residency at Washington University, the cochlear implant was still a relatively new device. It had passed clinical trials in adults, and by the time he started his fellowship at St. Louis Children’s Hospital, it was FDA approved for children.
“I would see children come into the hospital who were deaf, and they would leave with their hearing,” he said. “I just thought, nothing could be more rewarding than that.”
While the surgeries gave his patients their hearing, it is the therapy afterward that gives a patient their ability to listen.
While in St. Louis, Woolley would see patients through their surgery, and then the child would typically need to move on to attend one of the city’s two major schools for the deaf: St. Joseph Institute for the Deaf and Central Institute for the Deaf.
“Children were flying from all over the world to get their cochlear implants at Washington University, and then they would stay at those boarding schools for four to six years, until they were ready to go back to their homes,” he said. “We had entire families move up there. I remember families from Birmingham moving to St. Louis just so their hearing-impaired child could go to CID.”
All of the knowledge Woolley gleaned from his time in Missouri found its way to Alabama when he was recruited to join Children’s of Alabama.
The late Dr. Jim Dearth, who was serving as CEO at the time, along with Brian Wiatrak, chief of otolaryngology, were committed to having a cochlear implant program.
“Before Jim became CEO of the hospital, he was a cancer physician at Children’s, very well known, and specialized in leukemia,” Woolley said. “He had a number of children who had survived their cancer but had been deafened by the chemotherapy. So, he saw the need firsthand and was very passionate about it.”
Use of the Program Rose
Children’s first cochlear implant program consisted of two people: Woolley and Nancy Gregg, an auditory verbal therapist.
“We did four or five surgeries that first year, and then the word got out that Children’s of Alabama had a cochlear implant program,” Woolley said. “We immediately jumped to averaging about 25 to 30 implants a year.”
When the program started in 1995, the procedure was still foreign to many people, he said. Many people within the hearing-impaired community were against cochlear implants, feeling that the medical community was forcing the ability to hear on deaf patients. Yet, the statistics regarding those who are deaf were daunting.
A study published in 2015 by Dr. Susan Emmett and Dr. Howard Francis of John Hopkins University School of Medicine focused on a group of adults ages 20-69 over the course of 1999-2002. It was found that – regardless of age, sex and race – individuals with significant hearing loss were associated with low educational attainment, such as not completing high school. It also was found that hearing loss is clearly associated with low income and unemployment or underemployment.
“Once the implant technology proved to be great and kids started being able to go to college, then the whole world changed their view of it,” he said. “Now we see deaf parents who can’t talk bring their deaf baby to us for implants, because they see the advantage that they missed out on.”
One of Woolley’s former patients was able to graduate from high school with a full scholarship to Washington and Lee University and is now a producer for a television news network.
Were things as they were twenty years ago, Woolley suggested she may only be communicating with sign language and most likely would not be employed in the way she is today.
Focus on the Therapy
Woolley had always wanted to start a school in Alabama modeled after the schools for the hearing impaired in St. Louis, as a way to help patients further harness their potential.
“I could see that, really, the work was the therapy, and the more therapy they could get the more successful the children became with using their device and improving their speech,” he said. “The surgeries were obviously necessary, but the real mission was to get the kids using their new ears – being able to mainstream back into a public-school system as soon as possible.”
Therapy was conducted only in-house at Children’s until Woolley was approached by Dr. Robbie Baldwin, a private ENT and founder of the Alabama Ear Institute, to help set up a school providing auditory-verbal therapy for preschool-aged children with hearing loss.
The two teamed up and co-founded the Alabama School for Hearing in 2009, first located in Canterbury United Methodist School and serving 10 students in its first year.
Woolley took on the role of chairman of the school in 2018, electing a new board of 14 people who hired a superintendent – Nancy Gregg, who helped Woolley start Children’s program.
One of the board’s first actions was to rename the school Wise, including Woolley’s name.
“I was humbled, nervous and reluctant to let them do that, as I did not feel I deserved such an honor,” he said. “But it has really helped with fundraising, networking and has thrust me into a leadership role for the school.
The school is now located at Shades Valley Presbyterian Church and is free of charge for the kids who attend.
Its overall mission is to get kids with hearing impairments used to their devices and ready to attend school.
“If you put an implant on a child and they just disappear, they’re not going to really learn to use it,” he said.
The majority of his patients are implanted about the age of 1, having already missed 12 months of hearing; or fit with hearing aides as young as 3 months old. They then undergo therapy and rehabilitation either in-house at Children’s, or through attendance at WISE. That includes meeting with an audiologist regularly to adjust the implant or hearing aides, and working with speech and language pathologists.
“We have to teach them how to listen,” he said. “That’s one thing that we take for granted. We’re born with it, but if you have never heard, then you have to be taught how to use your ears.”
Kids go to WISE for about four hours a day, Monday through Friday, and parents are given homework to continue the process at home.
Parents aren’t opposed to traveling long distances so their child can attend the school. One family travels to WISE from Montgomery every day, and Woolley said that student is progressing very well and will be ready for mainstream school in just a few years.
Moving forward, Woolley and the WISE team envision opening satellite schools, beginning with the state’s other major cities – for example Huntsville, Mobile and Tuscaloosa.
“Our goal is to have multiple schools like this spread across Alabama, providing an opportunity for every child who needs these services,” Woolley said.