When an audiologist suggested they could teach her son, Micah, to speak, the Cary woman thought, "She's crazy.

"I saw her do the audiogram, so I knew he couldn't hear anything," Keim said.

Nearly nine years later, Micah, now 10, is reading at grade level, can tell his mother about his dreams and nightmares, and holds his own among his five siblings. He played in his first piano recital a few months ago.

Keim credits Micah's achievements to UNC's CASTLE program in Durham. "The CASTLE program has been like the guiding force in making Micah who he is today," said Keim.

CASTLE, a UNC Chapel Hill Department of Otolaryngology program, stands for Center for Acquisition of Spoken language Through Listening Enrichment. It provides parent training, classes and auditory and verbal therapy sessions for babies to pre-schoolers learning to listen and talk despite hearing loss.

In recent years, more children have started receiving cochlear implants, a surgically embedded device designed to produce hearing sensations. But medical professional in many communities have not worked with the technology.

The dream of speech language pathologist and audiologist Carolyn Brown, CASTLE opened in 2001 to help children use technology to speak and listen, and bridge a training gap for educators of the deaf in the state.

Up to three out of every 1,000 children in the United States are born deaf or hard of hearing, according to the National Association of the Deaf.

Historically, such children learned to communicate using sign language. Now more parents are choosing the spoken-language approach as hearing loss is being identified earlier and technology has improved, CASTLE director Hannah Eskridge said.

In 1995 about 60 percent of families with deaf children chose sign language. In 2005, 85 percent chose spoken language, according to the National Resource Center for Early Hearing Detection and Intervention.

Filling the void

Few university deaf-education programs provide training on teaching deaf children to speak, Eskridge said.

CASTLE has trained professionals in half of North Carolina's 100 counties through onsite visits or internships at CASTLE programs in Durham and Wilmington, Eskridge said. It receives more than half its $1 million budget from the state. The rest is covered by private donations, she said.

When Keim learned about Micah's hearing deficit, she was overwhelmed by the prospect of raising a child she couldn't communicate with, listen to or home school along with her other children.

"I just have always said to people, 'Children learn to walk, children learn to talk, and parents never think [about it],'" Keim said. "If someone took the bones outside of your child's legs, and said, 'Here, teach them to walk,' you'd be like, 'I can't. I can't do it.' "

Micah started with hearing aids at 15 months. Keim attended speech therapy once a week until Micah was 3, to learn how to teach her son how to talk. "It consumes your life, because you are always working on a deficit," Keim said, comparing her son to a runner in a marathon who is always trying to catch up with peers who can hear.

But in Micah's marathon, CASTLE was on the sidelines, coaching him, repeating hard words and sounds, and providing tools to help him make up time, Keim said.

At 3, CASTLE professionals realized Micah couldn't hear "f" or "s" sounds with his hearing aids. He eventually received cochlear implants in both ears.

The improvements were immediate. He was zipping through new word lists, and coming up with some words on his own, Keim said.

Micah completed the CASTLE program at 6, but he returns once a week to read to the pre-school classes.

Keim once overheard a parent of a CASTLE student say that Micah "isn't really deaf."

"Oh no, honey," Keim responded. "He is deaf as your kid is."