When to Have Your Child's Hearing Tested

Back when I was in graduate school, I worked for an Audiologist and conducted more than my fair share of hearing screenings.  Not only did I really enjoy it, but I learned an awful lot about hearing loss.  Did you know that hearing loss is one of the most common birth disorders in the United States?  According to the National Institute on Deafness and Other Communication Disorders, 1 in 1000 infants is born totally deaf and an additional 1-6 per 1,000 are born with less severe, but significant, hearing loss.  

Why is this important?

In the first 3 years of life, a child's auditory pathways and language cortex are developing at a rapid pace.  This neurological development happens in response to auditory (or visual) language. For families that are part of the deaf culture, parents begin signing from day one, so the baby is learning visual (sign) language.

But, it is estimated that 96% of children with hearing loss are actually born to hearing parents. So, it follows to reason that these children are at much greater risk for delays in speech and language skills, especially if their hearing loss goes undetected.  For example, even a child with a mild hearing loss may not hear "quiet" speech sounds such as /s/, /sh/, /f/, /t/ and /k/ and therefore would not include them in their speech. This can also affect their understanding and usage of vocabulary and grammar....  

Think about how often these "quiet" sounds pop up in this sentence...
"Seven cats sat on the fence shaking their tails".  
That's a lot of information missed if you aren't hearing those sounds. 

Newborn Hearing Screenings 

Thankfully, most babies born in hospitals in the U.S. are screened for hearing loss at birth using one of two tests:

1. Otoacoustic Emissions (OAE) is conducted by placing a sponge earphone/microphone in the infant's ear canal. The response (echo) of the outer hair cells of the cochlea (nerve pathways from the inner ear to the brain) is then measured by the microphone.
2. ​​Auditory Brainstem Response (ABR) is a more complex test that requires earphones be placed on the ears and electrodes placed on the infant's head and ears. The sound is emitted through the earphones while the electrodes measure how the baby's brain responds.

Both tests are painless, relatively quick, and can even be done while the baby is resting.

Can babies pass a newborn hearing screening and still have hearing loss or develop hearing loss later?

Yes!  It's important to remember that no screening is perfect and babies with mild hearing loss may even pass newborn hearing screenings. So, being aware of the signs of hearing loss as your child grows is crucial.  It's also possible that hearing loss may develop later on in a child's life for a variety of reasons, including chronic ear infections (acute otitis media), excessive earwax, congenital malformations, or a genetic hearing loss.

Here are some signs of hearing loss to watch for in children:

• Not being startled by sudden, loud noises
• Delays in speech or language
• Difficulty paying attention and behaving
• Difficulty with academic performance
• Lack of response to soft-level sounds or spoken language 
• Frequent use of "what?" or "huh?"
• Intently watching the faces of speakers
• Difficulty understanding speech when there is background noise
• Sitting close to the TV when the volume is loud enough for others
• Difficulty figuring out where a sound is coming from

If your child exhibits any of these symptoms, ask your pediatrician about a hearing screening.  They can often be done quickly at your pediatrician's office, once a child enters school, or by an Audiologist by request or referral.

Early detection is crucial.  Very often, depending on the type of loss (which is a post for another day), hearing loss can actually be corrected. But, even with a permanent hearing loss, research indicates that children who begin services early may be able to develop language (spoken and/or signed) on a par with their hearing peers.  So, don't delay if you suspect your child may have hearing loss!

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