Hearing Loss and Early Intervention
Hearing Loss in Children
Hearing loss can affect a child’s ability to develop speech, language, and social skills. The earlier children with hearing loss start getting services, the more likely they are to reach their full potential. If you think that a child might have hearing loss, ask the child’s doctor for a hearing screening as soon as possible. Don’t wait!
What is Hearing Loss?
Signs and Symptoms
The signs and symptoms of hearing loss are different for each child. If you think that your child might have hearing loss, ask the child’s doctor for a hearing screening as soon as possible. Don’t wait!
Even if a child has passed a hearing screening before, it is important to look out for the following signs.
Signs in Babies
- Does not startle at loud noises.
- Does not turn to the source of a sound after 6 months of age.
- Does not say single words, such as “dada” or “mama” by 1 year of age.
- Turns head when he or she sees you but not if you only call out his or her name. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss.
- Seems to hear some sounds but not others.
Signs in Children
- Speech is delayed.
- Speech is not clear.
- Does not follow directions. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss.
- Often says, “Huh?”
- Turns the TV volume up too high.
Babies and children should reach milestones in how they play, learn, communicate and act. A delay in any of these milestones could be a sign of hearing loss or other developmental problem. Visit our web page to see milestones that children should reach from 2 months to 5 years of age.
Screening and Diagnosis
Hearing screening can tell if a child might have hearing loss. Hearing screening is easy and is not painful. In fact, babies are often asleep while being screened. It takes a very short time — usually only a few minutes.
All babies should have a hearing screening no later than 1 month of age. Most babies have their hearing screened while still in the hospital. If a baby does not pass a hearing screening, it’s very important to get a full hearing test as soon as possible, but no later than 3 months of age.
Children should have their hearing tested before they enter school or any time there is a concern about the child’s hearing. Children who do not pass the hearing screening need to get a full hearing test as soon as possible.
Many people who are deaf or hard-of-hearing have some hearing. The amount of hearing a deaf or hard-of-hearing person has is called “residual hearing”. Technology does not “cure” hearing loss, but may help a child with hearing loss to make the most of their residual hearing. For those parents who choose to have their child use technology, there are many options, including:
- Hearing aids
- Cochlear or brainstem implants
- Bone-anchored hearing aids
- Other assistive devices
Hearing aids make sounds louder. They can be worn by people of any age, including infants. Babies with hearing loss may understand sounds better using hearing aids. This may give them the chance to learn speech skills at a young age.
There are many styles of hearing aids. They can help many types of hearing losses. A young child is usually fitted with behind-the-ear style hearing aids because they are better suited to growing ears.
Cochlear And Auditory Brainstem Implants
A cochlear implant may help many children with severe to profound hearing loss — even very young children. It gives that child a way to hear when a hearing aid is not enough. Unlike a hearing aid, cochlear implants do not make sounds louder. A cochlear implant sends sound signals directly to the hearing nerve.
Persons with severe to profound hearing loss due to an absent or very small hearing nerve or severely abnormal inner ear (cochlea), may not benefit from a hearing aid or cochlear implant. Instead an auditory brainstem implant may provide some hearing. An auditory brainstem implant directly stimulates the hearing pathways in the brainstem, bypassing the inner ear and hearing nerve.
Both cochlear and brainstem implants have two main parts — the parts that are placed inside the inner ear, the cochlea, or base of the brain, the brainstem ear during surgery, and the parts that are worn outside the ear after surgery. The parts outside the ear send sounds to the parts inside the ear.
Bone-Anchored Hearing Aids
This type of hearing aid can be considered when a child has either a conductive, mixed or unilateral hearing loss and is specifically suitable for children who cannot otherwise wear ‘in the ear’ or ‘behind the ear’ hearing aids.
Other Assistive Devices
Besides hearing aids, there are other devices that help people with hearing loss. Following are some examples of other assistive devices:
- FM System
An FM system is a kind of device that helps people with hearing loss hear in background noise. FM stands for frequency modulation. It is the same type of signal used for radios. FM systems send sound from a microphone used by someone speaking to a person wearing the receiver. This system is sometimes used with hearing aids. An extra piece is attached to the hearing aid that works with the FM system.
Many television programs, videos, and DVDs are captioned. Television sets made after 1993 are made to show the captioning. You don’t have to buy anything special. Captions show the conversation spoken in soundtrack of a program on the bottom of the television screen.
- Other devices
There are many other devices available for children with hearing loss. Some of these include:
- Text messaging
- Telephone amplifiers
- Flashing and vibrating alarms
- Audio loop systems
- Infrared listening devices
- Portable sound amplifiers
- TTY (Text Telephone or teletypewriter)
Medical And Surgical
Medications or surgery may also help make the most of a person’s hearing. This is especially true for a conductive hearing loss, or one that involves a part of the outer or middle ear that is not working in the usual way.
One type of conductive hearing loss can be caused by a chronic ear infection. A chronic ear infection is a build-up of fluid behind the eardrum in the middle ear space. Most ear infections are managed with medication or careful monitoring. Infections that don’t go away with medication can be treated with a simple surgery that involves putting a tiny tube into the eardrum to drain the fluid out.
Another type of conductive hearing loss is caused by either the outer and or middle ear not forming correctly while the baby was growing in the mother’s womb. Both the outer and middle ear need to work together in order for sound to be sent correctly to the inner ear. If any of these parts did not form correctly, there might be a hearing loss in that ear. This problem may be improved and perhaps even corrected with surgery. An ear, nose, and throat doctor (otolaryngologist) is the health care professional who usually takes care of this problem.
Placing a cochlear implant, auditory brainstem implant, or bone-anchored hearing aid will also require a surgery.
Without extra help, children with hearing loss have problems learning language. These children can then be at risk for other delays. Families who have children with hearing loss often need to change their communication habits or learn special skills (such as sign language) to help their children learn language. These skills can be used together with hearing aids, cochlear or auditory brainstem implants, and other devices that help children hear.