Hearing Loss in Newborns and Babies

Free hearing testing for new borns before they leave hospital is common practice. Without such testing , the average age of detection is approximately 12-14 months of age.

When hearing loss is detected late, language development can be delayed. Children are more likely to perform poorly and be held back or even drop out of school. Children with hearing problems identified early and who receive treatment as a result are more likely to function at the level of their peers by the time they enter school.

What happens if a newborn does not pass the first screening?

Many newborns do not pass the hearing test the first time. Don't panic.  This is often due to a blockage of the hearing canal., left over fluid in the ear, or moving or crying while the test is being administered. If your newborn fails the first hearing test, arrange for a second appointment. within 3 months. Around 1-3 in every 1,000 healthy babies and 2-4 of every 100 babies born in intensive care can suffer from hearing loss. Hearing loss is also more common in premature babies.

If there is a problem you want to catch it early. Babies start developing communication skills during the first few months of their lives, and need the stimulation of their brain hearing centres to develop their speech and language skills. Hearing loss can delay the development of speech and language skills. See the Universal Newborn Hearing Screening Protocol: Algorithm.

Hearing development

0-6 months : React to loud sounds. Baby should turn head towards sound and after 3 months begin to seek out the sound. At this stage the baby should also start to respond to their name and smile when parents are speaking.

6-12 months : Baby should be able to seek out the sound source and respond to both soft and loud noises. Babbling begins, usually in response to being spoken to.

12-18 months :  Babbling starts to vaguely starts sounding like speech. Child can follow simple instructions and repeat around 20 words.

What To Do

• If your child failed their first screening or you suspect they may be suffering from hearing loss, get them to an audiologist for testing
• If there is a problem, identify the type of hearing loss and plan appropriate coping and development strategies both for you as a parent and for your baby

Hearing Loss in Toddlers

Hearing is a key part of normal development, including playing, learning and social skills.  Toddlers learn through imitation of the sounds they hear. Undetected hearing loss makes them miss much of the sound stimulation going on around them. This can result in delayed speech and language development, social development and learning difficulties.

Toddler hearing loss risk factors to watch for:

• Parental, caregiver and/or health care provider has concerns regarding hearing, speech, language, and/or developmental delay
• Family history of hearing loss
• Characteristics are present associated with known sensorineural and/or conductive hearing loss
• Child has or has had medical conditions or infections associated with sensorineural hearing loss isuch as bacterial meningitis or mumps
• Child demands the television or radio be turned up excessively loud
• Head trauma
• Child responds incorrectly to simple questions, or does not reply at all when called (Sometimes they do just ignore you)
• Watch their friends closely when doing activities to see what to do next
• Child complains ongoing of ear ache,noises in the ear or pain in the ear

Toddler hearing testing

Toddler testing involves the cooperation and involvement of the child and the following techniques:

Visual reinforcement audiometry (VRA) is the method of choice for children between 6 months and 2 years of age. The child is trained to look toward a sound source. When the child gives a correct response, e.g., looking to a source of sound when it is presented, the child is "rewarded" through a visual reinforcement such as a toy that moves or a flashing light.

Conditioned play audiometry (CPA) can be used as the child matures. It is widely used between 2 and 3 years of age. The child is trained to perform an activity each time a sound is heard. The activity may be putting a block in a box, placing pegs in a hole, putting a ring on a cone, etc. The child is taught to wait, listen, and respond.

With both of these methods, sounds of different frequencies are presented at a sound level that children with normal hearing can hear.

Alternative procedures, such as otoacoustic emissions (OAEs) or auditory brain stem response (ABR) may be used if the child is unable to be conditioned.

Preschoolers

The goal of screening for hearing loss in preschoolers (ages 3-5 years) is to identify children most likely to have hearing loss that may interfere with communication, development, health, or future school performance. In addition, because hearing loss in this age range is so often associated with middle ear disease, it is also recommended that children in this age group be screened for outer and middle ear disorders.

School age (6-18 years)

School-age children should be screened for hearing loss as needed, requested, mandated, or when conditions place them at risk for hearing disability. Screening for hearing loss identifies the school-age children most likely to have hearing impairment that may interfere with development, communication, health, and education. School age children with even minimal hearing loss are at risk for academic and communication difficulties.

Periodic screenings are recommended because of the increased potential for hearing loss due to overexposure to high levels of noise and the importance of identifying children at risk for hearing impairment that may affect their future educational, vocational, or social opportunities.

Hearing and Balance in Children

Balance, or one’s sense of equilibrium, is controlled through the vestibular system that is also contained in the inner ear. The vestibular organs share the temporal bone space with the cochlea. These organs also share the same fluid that is in the cochlea.

Balance and equilibrium help us stay erect when standing, know where we are in relation to gravity, and help us walk, run, and move without falling. The functioning of the vestibular system depends on information from many systems, hearing as well as vision and muscle feedback. Play is an important part of every childs development, from the playground through to sports. Balance impairment can affect these activities and even put the child in danger.

Key indicators that something might be wrong:

• Child keeps falling over (Don't confuse this with clumsiness as a result of normal development)
• Child seems to never walk in a straight line, but rather into or along walls
• Child battles to run in a straight line

What To Do

• If you recognize a risk factor or behavior which may indicate hearing loss at any level in your child
• If you newborn has failed their first hearing screen
• Find your nearest audiologist and book in for a hearing test immediately. The audiologist will test to see if there is hearing loss and then discuss the diagnosis and strategies for dealing with the hearing loss with you. Delay and you could be delaying your child's normal development.