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Detecting hearing loss early



Hearing is the key to your child's healthy development


A child’s laughter is one of the most beautiful sounds in the world, and the child himself should be able to hear that wondrous noise. But hearing loss remains the most common birth defect among newborns.

According to Mary Gallert, AuD, of Hearing Healthcare Associates in Warwick, about 12,000 children are born with hearing loss every year in the United States. Although that’s less than 1 percent of the average 4 million births in this country each year, it’s still a formidable number.

For parents, detecting hearing loss or difficulties in an infant or young child can be a mystery. Knowing the warning signs to look out for and detecting a hearing problem early are the best things you can do for your child to ensure a healthy life.

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What causes hearing loss?
The majority of American children are screened for hearing at birth. Dr. Gallert says 39 states have mandated newborn hearing screening programs. An additional 5 states have voluntary programs. If you’ve delivered a baby in New York State you know that your newborn was given a hearing screening prior to discharge from the hospital.

This objective computerized test is brief and easy to administer – the baby is given either an Auditory Brainstem Response (ABR) screening or an Evoked Otoacoustic Emission (OAE) screening, or a combination of both. “These are non-invasive and involve placing electrodes on the skin, and tiny earphones or a probe in the ears,” says Dr. Gallert. “The purpose of a screening is to determine if additional diagnostic testing is indicated. Should a baby fail the newborn hearing screening, the managing pediatrician will check the baby’s ears to see if any debris is present, and determine if any middle ear pathology or physical anomaly is present.”

Parents are alerted that a follow-up with an audiologist should occur a few weeks later.

Being told that your new baby failed a hearing test can be pretty frightening. Lots of questions arise: why can’t my baby hear properly, and what difficulties will my child face down the road because of this?

About half of the cases of congenital [present at birth] infant hearing loss are caused by genetic factors. A baby can also be affected by the mother’s health while in nutero such as intrauterine infection, maternal diabetes and maternal toxemia.

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“While hearing loss is often present at birth, it can, unfortunately, occur at any age,” adds Gallert. So, a child may pass the hearing test at birth, only to develop a problem later due to any number of issues, such as disease (cytomegalovirus, meningitis or mumps), ototoxic medications (such as aspirin and some chemotherapy drugs), or noise exposure.

“Central Auditory Processing (CAP) disorders can either be acquired [e.g. head trauma] or in most cases occur as a result of how the central nervous system and brain are organized and developing,” says Kathie Stein, AuD, an audiologist in Warwick. “This problem affects children at every age and in different ways because there is individuality of brain organization and conditions that affect this organization.”

An ear infection can also lead to serious hearing problems if left undiagnosed or untreated.

“Many children are prone to various forms of middle ear infection,” explains Dr. Gallert. “This is due to their anatomy and their immature immune systems. When fluid, with or without infection, is present in the middle ear space – the area behind the eardrum – it can result in temporary hearing loss. Over time, even mild hearing loss can negatively impact speech and language development, and possibly auditory processing.”

Signs that your child may not be able to hear
Because hearing loss can occur at any time in childhood, often with no warning, how would parents know if their infant or toddler was at risk? “Hearing loss is silent, invisible and not easy to detect unless professional diagnostic testing is obtained,” Dr. Stein says. “Children will rarely tell a parent they have a hearing problem.”

However, there are some warning signs parents might be able to recognize, including:

  • poor attention
  • poor balance
  • difficult behavior
  • an unusually loud voice for a youngster
  • changes in his or her speech patterns
  • difficulty with academic achievement or decline in performance
  • need for repetition of statements

Does your child seem to have a language delay? It could indicate a hearing problem. “Children should be using single words by 15 months and simple two-word sentences by age 2,” says Dr. Gallert.

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Even in infancy, your child should react to loud noises and familiar voices. If your child does not show this reactive response, you should reach out to your family pediatrician. Also, some children are at higher risk for hearing problems due to prematurity, low birth weight, serious infection, jaundice, treatment with certain antibiotics, craniofacial abnormalities, certain medical conditions, and family history of hearing loss.

How to help your child live with hearing loss
Your child has been diagnosed with a hearing problem. What’s next? Dr. Stein advises parents to be involved in the rehabilitative process. Learn all you can to understand the problem and its treatment, which will increase your comfort level.

“The audiologist is highly trained to provide this education and can provide the family with helpful resources, connect them with their local early intervention program if the child is under age 3, or facilitate what is needed in their school educational program,” she says. “Parents need to know that hearing is a primary channel for brain development and learning which requires proper stimulation. Hearing needs to be protected and parents need to be aware that early identification is critical for their child’s development.”

Be aware of your child’s behavior. Protect your child’s hearing by reducing high levels of noise, especially with headphones or ear buds. If your child complains of any ear pain, with or without a fever, or you think you may have noticed some of those early warning signs, see your pediatrician. Then, follow through on your doctor’s recommendations for an audiologist or ear/nose/throat specialist if there may be a problem.

If you suspect your child has difficulty hearing, there are local resources that can help.