How can hearing loss affect my child?
Hearing loss can affect more than your child’s ears! Undiagnosed hearing loss can have negative impacts on speech and language development as well as social skills. Our sense of hearing helps us develop vocabulary at a normal pattern and rate, and delays of this development can adversely affect academic achievement and work environments. Hearing loss in only one ear can cause difficulty hearing in background noise and locating sounds. Additionally, hearing loss affects speech, as children are not able to access common sounds in everyday language. Subsequently, components of speech may be missing or mispronounced. Generally, earlier identification and treatment of hearing loss reduces these developmental delays.
What are the signs of hearing loss in children?
There are multiple signs and symptoms of hearing loss in children, particularly in response to sound, sentence structure, and speech. Children with unidentified hearing loss use shortened sentences with simpler structures, which may extend to a lack of understanding and writing complex sentences. Additionally, these children exhibit characteristic speech which may be difficult to understand. This is due to their hearing loss, which creates a "barrier" between hearing common, more quiet sounds of speech - such as "s", "sh", "f", "t", and "k."
Younger children with unidentified hearing loss may show the following signs of hearing loss:
- Not startling to louder sounds
- Not turning his/her head towards sounds after 6 months of age
- Not verbalizing speech by the age of 1 year
- Appears to hear some sounds but not others
- Asks for repetition or responds incorrectly to questions
- Overly responsive to visual stimuli versus auditory stimuli
- Appears to talk loudly
If your child exhibits any of these symptoms or reports difficulty hearing, please schedule a full comprehensive evaluation to rule out hearing loss.
What happens during a hearing loss consultation for my child?
Extensive case history
A full comprehensive case history is essential to create a complete picture of your child’s hearing health and history. At times, hearing loss in children is associated with an underlying disorder or diagnosis. The audiologist may ask questions regarding your child’s birth, speech patterns, reactions to sound, and any additional information regarding health history which may become pertinent for management of symptoms.
An otoscopic evaluation allows the audiologist to see the entire ear canal and eardrum. Otoscopy reveals abnormal growths, size differences, and shapes of ear canals. In some cases, it can also identify the presence of fluid behind the eardrum.
Tympanometry is used to confirm the eardrum is moving normally, and is free of damage. During this test, a small amount of pressure is applied to the eardrum and a "picture" is taken of this movement. This test can confirm the presence of fluid behind the eardrum and holes, if present. Both conditions can cause hearing loss in children.
Pure tone and Speech Testing
This testing may vary depending on your child’s age. In smaller children, responses to soft sounds are measured by observing their actions, such as widening eyes, turning of the head, or other non-verbal cues. These actions are then reinforced with a positive response for encouragement. As your child ages, conventional approaches such as hand-raising or pressing a button may be used to confirm hearing thresholds. Age-appropriate speech materials are used to determine how well your child understands speech at a comfortable level.
Distortion Product Otoacoustic Emission (DPOAE) testing
This testing allows the Audiologist to determine the presence or absence of a hearing loss without your child having to respond. A small probe is put into your child’s ear and soft tones are played. The ear’s response to these soft sounds is measured and recorded for the Audiologist to interpret. This testing requires a quiet, still environment for accurate results.
What about Hearing Aids or Cochlear Implant?
The Audiologist will review all testing completed at the initial appointment and recommend hearing aids or a cochlear implant for further evaluation if necessary. Both hearing aids and cochlear implants are programmed appropriately for a child’s hearing loss and give access to speech sounds that their hearing loss would otherwise prevent them from hearing. Intervention and management of hearing loss do not stop at the fitting appointment of these devices, however. Depending on your specific communication goals for your child, additional intervention from outside professionals may be necessary for success and integration into a fully hearing world.
Modes of Communication
Yes, there are different ways to communicate! Below are some of the most common approaches to communication for children who are Deaf or Hard of Hearing. At Hearing Doctors of the Heartland, we recognize the importance of making an informed decision about your child’s path to communication after the detection and diagnosis of hearing loss, depending on the child’s abilities and long-term goals for communication.
With the use of Manual Communication, the child learns and communicates through sign language (American Sign Language in the United States). This acts as the main way to communicate and learn to interact with peers. It is ideal that parents and those in close proximity of the child be fluent in signed language. Sign Language is a deep component of Deaf Culture. Deaf Culture believes that deafness or profound hearing loss is not a disability, but rather something that defines a group of people and is a way of life. Sign language is thus believed to be a language that is acquired from birth and is used to communicate.
In Auditory Verbal, children are taught to use their hearing alone to listen and speak in daily life. The use of lip-reading cues are usually discouraged in this type of communication and children are taught to rely only on auditory information. Children use their residual hearing as well as assistance with a hearing aid or cochlear implant. Subsequently, the goal is for the child to reach normal milestones in listening and communication development, just as with their peers without hearing loss.
Two particular components are necessary for the success in this model of communication:
- The parent or guardian is the primary teacher and extremely involved in the therapy process, having high demands.
- Children are mainstreamed into regular preschools and classrooms from the start of school to give access to normal patterns of speech, language, and social behavior.
The goal of this approach is to give children the same opportunities and an equal start in life as children who have normal hearing.
The Auditory Oral approach not only aims to develop listening skills, but also lip reading and speech reading in order to develop verbal communication in children. Children are not only taught to listen with their residual hearing, but also taught to focus on watching movements of the mouth, face, and body in order to understand what is being said. With this modality, children are placed in classes focusing on verbal communication until they are ready to join a mainstream classroom.
Cued speech uses a system of learned hand cues in combination with verbal speech to help a child understand spoken words. With hand cues, children are able to differentiate between sounds that look the same visually. In order to use cued speech fully, parents need to be taught and fluent in it in order to be successful.
Total communication uses a combination of gestures, speech reading, sign language, and verbal speech to develop full communication skills. To participate fully, it is necessary for parents to be fluent in sign language. The emphasis and balance of each component to communicate effectively depends on the child and individual.
How can an Audiologist help?
If your child has been diagnosed with a hearing loss, it is a natural reaction to be concerned, anxious, and overwhelmed. At Hearing Doctors of the Heartland, our trained audiologists will guide you through the process of diagnosing and managing your child’s hearing loss. Using our extensive knowledge of auditory development, we ensure our patients and their families understand all available options for communication, while our ties to the community provide appropriate referrals for services outside our scope of practice.
Multi-disciplinary effort for the management of hearing loss.
Communication is a multidisciplinary approach, and assistance from professionals outside of Audiologists may be warranted for the complete and well-rounded management of any communication disorders that are present.
These may include but are not limited to:
- Speech-Language Pathologists
- Educational Audiologists
- Ear, Nose, and Throat Specialists
- Deaf Education Specialists
Effective communication between specialists is pertinent to ensure that a child is developing speech and language at an age-appropriate rate.