Should my child have a hearing evaluation?
If your newborn did not pass a newborn hearing screening in either one or both ears, it is recommended that your baby receive one follow up re-screening by 1 month of age. If your newborn did not pass a second hearing screening after hospital discharge, it is then recommended that your baby receive a diagnostic evaluation prior to 3 months of age. Also, parents are often good judges of their children’s hearing status. If you suspect hearing loss or if your child has any of the risk factors listed below, then hearing testing is strongly recommended. In addition, if your child exhibits a speech and language delay, then hearing testing is also highly recommended.
Risk factors which increase the chances of a child having hearing loss:
- Family history of childhood hearing loss
- > 48 hour Neonatal Intensive Care Unit (NICU) hospitalization at birth
- Treatment with potentially ototoxic medications (usually IV antibiotics given due to infection)
- Hyperbilirubinemia (requiring exchange transfusion)
- Abnormalities of the ear, head, or neck, which are present at birth
- Bacterial meningitis
- Congenital infections such as rubella, herpes, toxoplasmosis, cytomegalovirus (CMV), which are present at birth
- Syndromes such as Down, Usher, Turner
- Head trauma
- Neurodegenerative disorders
If you have any doubt about your child’s status for the above factors, please contact your pediatrician.
Is my child old enough to have a hearing test?
Yes! No child is too young to have a hearing test. Even a newborn can undergo hearing testing. Hearing levels of children are evaluated using either “behavioral” test methods or “physiologic” test methods. Behavioral test methods require the child to respond in some manner to different sounds. Physiologic test methods rely on technology to evaluate different parts of the hearing system without a behavioral response from the child. However, physiologic measures do require that the child be quiet and still or even asleep during testing. Often, a combination of behavioral and physiologic techniques is used.
FACT 1: Every day, 33 babies (12,000 each year) are born in the U.S. with permanent hearing loss. With 3 of every 1,000 babies having a hearing loss, it is the most frequently occurring birth defect.
FACT 2: In a 1998 report to Congress and the President, the Commission on Education of the Deaf estimated that in the U.S., the average age that children with congenital hearing loss were identified was 2½ to 3 years of age, with many children not being identified until 5 or 6 years of age.
FACT 3: If children with hearing loss are not identified early, it is difficult, if not impossible, for many of them to acquire the fundamental language, social and cognitive skills that provide the foundation for later schooling and success in society.
FACT 4: The National Institutes of Health, American Academy of Pediatrics, American Academy of Audiology, the Joint Committee on Infant Hearing and the Healthy People 2000 Report have all recommended that children with congenital hearing loss be identified before 6 months of age.
FACT 5: In 1993, a Consensus Panel convened by the National Institutes of Health concluded “that all infants should be screened for hearing impairment. . . this will be accomplished most efficiently by screening prior to discharge. Infants who fail. . . should have a comprehensive hearing evaluation no later than 6 months of age.”
FACT 6: The cost per child identified with congenital hearing loss is about 1/10 the cost per child identified with PKU, hyperthyroidism or sickle cell anemia in metabolic disorder screening programs.
FACT 7: More than 95% of all babies should be screened for hearing loss in the birth hospital, and comprehensive family-centered services should be available for identified children and families.
FACT 8: When early identification and intervention occurs, children with hearing loss make dramatic progress, are more successful in school and become more productive members of society.
FACT 9: Research has compared children with hearing loss who receive early intervention and amplification before age 6 months versus after 6 months of age. By the time they enter first grade, children identified earlier are 1-2 years ahead of their later-identified peers in language, cognitive and social skills.
FACT 10: Infants with hearing loss can be fit with amplification as young as 4 weeks of age. With appropriate family-centered intervention, normal language, cognitive and social development for such infants is likely.
FACT 11: If it remains undetected, even mild hearing loss or hearing loss in only one ear has substantial detrimental consequences. For example, research shows that children with hearing loss in one ear are 4-10 times as likely to be held back at least one grade compared to a matched group of children with normal hearing.
FACT 12: Research shows that by the time a child with hearing loss graduates from high school, as much as $421,000 per child can be saved in special education costs if the child is identified early and given appropriate early intervention. These savings in special education costs will pay for universal newborn hearing screening, detection and intervention many times over.
CAN YOUR BABY HEAR?
Most parents anxiously await their baby’s first word, and how exciting it is to hear “Mama” or “Dada” for the first time! Your child’s development of speech and language skills is dependent upon normal hearing. Children learn to talk by imitating what they hear. Most experts agree that the human brain comes “pre-programmed” to develop speech during the first three years of life. This is a critical time for your baby to hear well. Below is an outline of normal hearing and speech development from birth to age three.
Please follow this as a basic guide.
Check to see that your baby can do most of the things listed. If not, there may be a hearing problem. If you think there may be a problem, don’t wait. Your baby’s hearing can be tested at any age!
- Startles or jumps when there is a sudden sound.
- Stirs, wakes or cries when someone talks or makes a noise.
- Recognizes your voice and quiets when you speak.
- Turns eyes toward interesting sounds.
- Appears to listen.
- Turns head to search for source of a voice.
- Awakes easily to sounds.
- Anticipates feeding by hearing familiar sounds (rattling of bottles, pots and pans, etc.).
- Enjoys rattles and noise-making toys.
- Reacts to music by cooing.
- Responds to own name.
- Turns head toward soft sounds.
- Looks to correct person when words “mommy” or “daddy” are said.
- Understands “no” and “bye-bye.”
- Begins to imitate speech sounds (babbles).
- Says first words such as “Da-Da,” “Ma-Ma,” or “bye-bye.”
- Knows names of favorite toys and can point to them when asked.
- Likes rhymes and jingles.
- Can follow simple directions (“put the block in the box”).
- Recognizes body parts when named (hair, mouth, nose, etc.).
- Asks for wants by naming “milk,” “cookie,” etc.
- Speaks 10-20 words.
- Begins combining words such as “go bye-bye car” and “juice all gone”.
- Refers to self by name.
- Enjoys being read to.
- Shows interest in the sounds of radio and television.
- At 24 months, speaks about 270 words with a very fast daily rate of increase in vocabulary.
- Child wants to communicate and tell experiences.
- Is frustrated if adults don’t understand.
- By age 3, vocabulary equals about 1000 words, 80% of which are intelligible even to strangers. It is common for some sounds to be mispronounced (i.e., “l,” “r” and “th”).