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Modern technology has enabled audiologists to test the hearing of
newborn infants and children with great accuracy. Unfortunately, many
parents and medical professionals are still unaware of these tests. A
hearing problem is usually suspected when the child does not meet
appropriate language development milestones. Parents are often told by
pediatricians to “wait and see” as there is a wide span of time that is
considered normal development. Without early testing, most children with
hearing loss are not diagnosed until after its initial onset, usually
between the ages of 2 and 3. This late diagnosis results in significant
speech, language and cognitive delays.
If you think your baby or child might not be hearing noises or speech,
it is imperative that you act quickly. Refer to the extensive checklist,
“Determining if Your Child Has a Hearing Loss,” at
http://www.hearingexchange.com/articles/determine.htm. Other warning
signs of hearing loss in babies are listed below. Schedule a hearing
test if your…
• baby does not startle or jump to loud sounds
• baby does not stop sucking or crying when there is a new sound
• three month old baby does not coo at times or make eye contact when
talked to
• nine month old does not turn toward you when called from behind or
make babbling sounds, such as "baba"
• one year old does not babble using a variety of consonant sounds (g,
m, n, b, d)
• eighteen month old does not use single words to express his or her
wants
• two year old does not repeat words or phrases and does not use short
phrases when talking
• child has had many ear infections
• child uses gestures to communicate
If you checked any of the items on the list or any of these warning
signs apply to your child, contact your pediatrician. Inquire about
having your child tested with one or more of the following screenings or
tests. You may need to consult a pediatric otologist, neurotologist or
otolaryngologist. When a behavioral hearing test is recommended, every
effort should be made to find an audiologist with significant experience
testing young children. Often, schools for deaf and hard of hearing
children have audiologists on staff.
Below are the different types of screenings and tests for babies and
children.
Otoacoustic Emissions (OAE)
Otoacoustic emissions are sounds produced by the normally functioning
inner ear. The OAE is typically used as a preliminary screening test.
The procedure involves placing a small probe in the outer ear canal with
the patient sitting still and quietly. A computer analyzes the emissions
or lack thereof. This test does not require the child’s active
participation and usually takes about 15 minutes.
Auditory Brainstem Response (ABR) or Brainstem Auditory Evoked Response
(BAER)
This test consists of sounds that are presented to a child’s ears
through earphones. Small electrodes are taped to the child’s head and a
computer analyzes responses. The infant or child must be completely
still and is often sedated for this test unless asleep. Testing usually
takes less than one hour. This is an expensive and highly specialized
test requiring an experienced professional.
Behavioral Tests
Behavioral hearing tests are used with children who are able to respond
to sounds either by turning their head or by playing a game. For young
children there are usually two evaluators, an audiologist outside the
sound booth monitoring the testing and another one inside who plays
games with the child. Sometimes a parent is allowed inside the booth as
well. Testing usually takes less than one hour.
Behavioral tests offer three important types of information. They
measure the degree of hearing loss. They also assist in locating the
source of the problem. These tests can also indicate how the hearing
loss will affect the child’s ability to communicate.
Types of Behavioral Testing
There are three types of behavioral tests:
• Threshold testing measures the quietest tones or speech that a child
is able to hear.
• Word Recognition testing measures the child’s ability to understand
speech at comfortable loudness levels.
• Middle Ear testing searches for the presence of fluid or other middle
ear dysfunction. The results are presented in a diagram called a
tympanogram.
Infants with hearing loss can be fitted with hearing aids as early as
four weeks of age. Children with severe and profound hearing losses may
be eligible to receive a cochlear implant device as young as 11-12
months of age. With timely amplification and appropriate intervention,
the likelihood of more normal speech and language development is
significantly improved.
Children may need to be tested more than once, sometimes by different
professionals. Obtaining an accurate diagnosis of hearing loss and
appropriate fitting of amplification is not an easy task. It is a
crucial time requiring knowledge, persistence and diligence. Swift
intervention and diagnosis will help stem further delays of speech,
language and cognitive development.
For further information visit these resources:
http://www.boystownhospital.org/home.asp – Center for Hearing
Loss in Children at Boystown National Research Hospital
http://www.infanthearing.org
– National Center for Hearing Assessment & Management (NCHAM)
http://www.asha.org/public/hearing/
– American
Speech-Language-Hearing Association (ASHA)
http://www.cdc.gov/ncbddd/ehdi/parent_home.htm – Early Hearing Intervention &
Detection Program (EHDI)
http://www.oticonus.com/OtiKids/index.html – Oticon’s OtiKids web
site
http://www.oae-ilo.co.uk –
Otoacoustic Emissions Information Web Site
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Paula Rosenthal, J.D. is married and has three children. She,
her husband and daughter are all hearing impaired. Her son
has normal hearing. A law school graduate, Paula is the
publisher of
http://www.HearingExchange.com, an online community for
people with hearing loss, parents of deaf and hard of
hearing children and professionals. She is also a writer and
speaker on hearing loss and related issues. To contact her,
send an email to
info@hearingexchange.com. |
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© 2001-2007 Paula Rosenthal and Taylor Rose, Inc. All rights reserved. For
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