Almost nothing tips you off that Karlee Trebesch was born profoundly deaf 11 years ago.
She listens intently to the conversation going on around her, offering up her own witty, thoughtful commentary. She loves listening to music; Carrie Underwood is currently her favorite.
She is a bright, attentive student at Paxson Elementary School, where she's near the top of her fifth-grade class.
And yet when Karlee was 2 days old, an audiologist sat her parents, Loren and Stephanie, down and delivered frightening news: "It looks like your daughter has a moderately severe to severe hearing loss," Ruth Fugleberg told them.
Karlee's hearing loss was discovered by a newborn hearing screening program that had just been developed at Missoula's Community Medical Center.
That early discovery is part of the reason that Karlee is so well-spoken. Historically, kids with profound hearing losses often haven't been diagnosed until an average age of 2 1/2. In that time - a period when language and speech develop most quickly - a hearing-impaired child can fall drastically behind.
But not Karlee. She had hearing aids as a baby, then had a cochlear implant in 2004.
That implant radically changed Karlee's already rich life.
"She was already doing so well with hearing aids, sign language, reading lips," said her mother, Stephanie Dunaway. "But that brought her a whole new world of sound."
The implant involves surgery to position electrodes wound through the ear's cochlea. An implanted receiver draws information from an external transmitter and microphone, which sit right behind the ear and stay in place with a magnet.
In the years since Karlee's first implant, doctors have started to use bilateral implants, which gives patients a better and fuller range of sound.
Karlee's parents thought a second implant might further enrich their daughter's hearing experience, but they wanted her to make the decision.
"She's only 11, but she's pretty grown up and responsible, and we felt like this needed to be something she wanted to do," Stephanie said. "We really did put it in her hands."
Karlee dove into the research with the zeal of an experienced reporter.
She read articles, searched the Internet and eventually met another girl in Spokane who'd gotten bilateral implants.
"She was really good to talk to about what all was involved," Karlee said recently. "She told me everything that happened and said she was really glad she'd done it. Now we're really good friends."
Karlee got the second implant in late January, with Dr. Peter Von Doersten reprising his role as surgeon from 2004.
"It's a long night in the hospital, but it's only one," Karlee said.
For a month, she was on restricted activity, ensuring that the new implant wouldn't be jostled. That was tough on Karlee, a dedicated soccer player and snowboarder.
"I really missed that, but now I'm back to doing everything," she said.
Karlee has noticed both major and subtle shifts in her hearing since getting the new implant.
The most notable change is being able to tell where sounds are coming from. Those who hear mostly in one ear often have trouble localizing sound.
"For me, it's way better when I'm in a room with a lot of noise," Karlee said. "I can tell where people are better now. It also filters things out better so I can hear more of what people are saying to me instead of having it mixed with all these other sounds."
Karlee has always had a sign language interpreter, but she said she finds herself paying more and closer attention to her teacher now.
"I'd say I'm probably watching my teacher more than my interpreter," she said. "It's a lot fuller sound I hear."
Even better, Loren Trebesch said his daughter's hearing will only improve as she adapts to the second implant.
"There's sort of a learning curve, where everything adapts to the new implant," he said. "It's sort of like the body is learning how to use it. So things should get better and better for her."
That said, even Karlee is quick to admit there are times when it's advantageous to just tune things out.
Like, say, a 15-year-old brother whom she loves dearly but can sometimes get too much of.
"Oh definitely, it's nice to be able to just check out," she said. "It's a cool superpower to have."
Reporter Michael Moore can be reached at 523-5252 or at firstname.lastname@example.org.