June 20, 2017
Hearing Deficiencies or a Loss Can Impede Your Child
Hearing deficiencies or a hearing loss can slow down or derail your child’s learning, social development, and emotional health. The key to effective treatment is discovering hearing loss at its earliest stage. Fortunately, hearing screenings are provided at several childhood milestones, and if deficiencies are discovered, there are treatments and assistive devices available to keep your child from missing a beat.
Directed by state law in Pennsylvania, newborns receive an initial hearing screening. After that, your child’s pediatrician will look for signs of hearing loss, beginning with the first well baby check-up. He or she will determine if your baby startles to sudden loud noises, like clapping, and confirm that your baby is cooing or babbling.
At three months, the pediatrician will confirm that your baby is turning toward the person speaking, and also that the baby smiles when someone speaks to him or her. By six months, babies should make a variety of sounds, respond to “no,” and notice new sounds around them.
Between nine months to a year, the pediatrician will ask if your child responds to “come here” and “do you want more?” By this time, your child may say up to 10 words, though they may not be clear; your child is imitating sounds and using their voice to get attention. During the year between one to two, your child’s pediatrician will ask multiple questions, such as: Does your child respond to two-part requests, like “put down the cookie, and come over here”? Other questions include: Can your child can say 10–15 words? Can your child repeat your requests and ask one-to-two word questions? And, is your child putting together two words, as in, “more cookie?”
If you ever suspect that your child cannot hear or is experiencing a hearing issue between these milestone check-ups, you should not hesitate to ask for a professional evaluation. Parents are often the first to discover a hearing loss in their child.
Typically, school-administered hearing screenings for children occur prior to kindergarten and then again in grades 1, 3, 5, 7, and 11. A child who shows a hearing deficiency may be referred to an audiologist for additional follow-up or treatment. An audiologist is a health care professional trained to evaluate, diagnose, treat, and manage hearing loss, tinnitus, and balance disorders in individuals of all ages, from newborns to the elderly.
At the beginning of your child’s appointment with an audiologist, you will provide his or her medical history, including whether family members have hearing loss, or any events, such as the possible puncture of the ear drum or an ear infection. Next, the audiologist will use a lighted tool, called an otoscope, to look inside the middle ear for any conditions, such as fluid, that may require a referral to an Ear, Nose, and Throat (ENT) specialist.
Hearing tests are performed by an audiologist in a sound-treated environment that looks like a music recording studio. The tests match the skills of the patient. For example, an infant will sit on a parent’s lap while the audiologist projects sound into the sound suite from two speakers while watching for the infant’s response to both sound and lack of sound coming from either side of the room.
For children ages two-and-a-half to five, the hearing test resembles a play session, where the child is asked to respond to simple commands, such as, “point to the ball” and “put the block in the bucket when you hear the bird,” to assess hearing and response. Older children wear headphones and are asked to respond to sounds by raising a corresponding hand to the ear in which they hear certain tones.
The audiologist records the speech frequencies that the child can hear, from the lowest tones to the highest, on a graph called an audiogram. This graph is used to determine what type of treatment would help improve your child’s hearing. Many times, the issues are medically related and treated by your child’s pediatrician and/or potentially referred to an ENT specialist, for the possible use of ear tubes.
Kimberly S. Dzikowski , MS, CCC-A, specializes in audiology at UPMC Susquehanna.