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2017 Jan

Q & A: Hearing Problems

Most children hear and listen to sounds from birth. They learn to talk by imitating the sounds around them and the voices of their parents and caregivers. But that’s not true for all children. In fact, about two or three out of every 1,000 children in the United States are born deaf or hard-of-hearing. More lose their hearing later during childhood.

Many of these children may need to learn speech and language differently, so it’s important to detect deafness or hearing loss as early as possible. For this reason, universal newborn hearing screening programs currently operate in all U.S. states and most of the territories. As a result, more than 95 percent of babies have their hearing screened soon after they are born.

When will my baby’s hearing be screened?
Your baby’s hearing should be screened before he or she leaves the hospital or birthing center. If you and your baby are already home and you haven’t been told the results of the screening, ask your doctor. If the results indicate your baby may have hearing loss, it’s important to make an appointment with an audiologist to perform a more thorough hearing test before your baby is three months old.

Why is it important to have my baby’s hearing screened early?
The most important time for a child to learn language is in the first three years of life. In fact, children begin learning speech and language in the first six months of life. Research suggests that children with hearing loss who get help early develop better language skills than those who don’t. The earlier you know about a child’s hearing loss, the sooner you can make sure your child benefits from strategies that will help him or her learn to communicate successfully.

How can I recognize if my child develops hearing loss later in childhood?
Even though the screening tests are designed to detect hearing loss as early as possible, some children may not develop hearing loss until later in childhood. In those instances, parents, caregivers, or grandparents are often the first to notice. This means that, even if your baby has passed the hearing screening, you should still continue to look for signs that your baby is hearing well.

For example, during the first year, notice whether your baby reacts to loud noises, imitates sounds, and begins to respond to his or her name. When your child is age two, ask yourself whether he or she makes playful sounds with his or her voice, imitates simple words, and enjoys games like peek-a-boo and pat-a-cake. Is he or she using two-word sentences to talk about and ask for things? When your child is age three, notice whether he or she begins to understand “not now” and “no more” and follows simple directions. If for any reason you think your child is not hearing well, talk to your doctor.

If my child has hearing loss, can hearing be improved?
A variety of assistive devices and strategies are helpful for children who are hard-of-hearing. Some examples of these devices are listed here. An audiologist can help you determine whether these or other devices will help your child.

• Hearing aids are devices that make sounds louder. They are worn in or behind the ear and come in several different shapes and sizes. Hearing aids can be used for varying degrees of hearing loss from mild to severe. An audiologist will fit a hearing aid that will work best for your child’s degree of loss. Hearing aids can be expensive, so you’ll want to find out whether they have a warranty or trial period. You’ll also want to talk with your insurance provider to understand what, and how much, it will pay for.

• Cochlear implants are small electronic devices that help provide a sense of sound to people who are profoundly deaf or hard-of-hearing. They consist of a microphone worn just behind the ear, which picks up sound from the environment; a speech processor, which selects and arranges the sounds; a transmitter and receiver/stimulator, which receive signals from the speech processor and convert them into electric impulses; and an implanted electrode array, which collects the impulses from the stimulator and sends them to the auditory nerve.

• As children get older, many other devices are available to help their hearing. Some devices help children hear better in a classroom. Others make talking on the phone or watching television easier. For example, induction loop systems and FM systems can help eliminate or reduce distracting noises and make it easier to hear individual voices in a crowded room or group setting. Others, such as personal amplifiers, are better for conversation.

How can I help my child communicate?
There are a variety of ways to help children with hearing loss express themselves and interact with others. The option you choose will depend on what you think is best for your child. Find out as much as you can about the choices, and ask your doctor to refer you to experts if you want to know more.

• Auditory-oral and auditory-verbal options combine natural hearing ability and hearing devices such as hearing aids and cochlear implants with other strategies to help children develop speech and language skills. Auditory-oral options use visual cues such as lip reading and sign language, while auditory-verbal options work to strengthen listening skills.

 • American Sign Language (ASL) is a language used by some children who are deaf and their families. ASL consists of hand signs, body movements, and facial expressions.

 • Cued speech is a system that uses hand shapes along with natural mouth movements to represent speech sounds. Watching the mouth movements and the hand shapes can help some children learn to speech-read English.

 • Signed English is a system that uses signs to represent words or phrases in English. Signed English is designed to enhance the use of both spoken and written English.           

Will my child have a tough time in school?
Just like other children, children who are deaf or hard-of-hearing can develop strong academic, social, and emotional skills and succeed in school. You can do a lot to make sure this happens. Find out how your school system helps children with hearing loss.

With your input, your child’s school will develop an Individualized Education Program for your child. Explore programs outside of school that may help you and your child, and talk with other parents who have already dealt with these issues. Remember, the Individuals with Disabilities Education Act ensures that children with hearing loss receive free, appropriate, early intervention services from birth throughout the school years.

For more information, visit www.nidcd.nih.gov.

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