Communication is one of the very first skills we learn in order to navigate the world. As infants, we are quick to begin communicating our needs and respond to those around us. However, babies who are born with hearing disorders and children who lose their sense of hearing face a very different communication landscape—one that now involves technology and strategies to help them to communicate with the wider world.
May is Better Hearing and Speech Month, sponsored by the American Speech-Language-Hearing Association. It draws attention to the many challenges faced by those who have speech and hearing disorders, whether present from birth or developed over time.
“One of the most common causes of hearing loss in young children is otitis media, which is a buildup of fluid behind the eardrum. Recurrent otitis media can cause a temporary hearing loss due to the fluid buildup, but hearing usually returns to normal when the fluid is resolved,” says Gina Cato, chief speech-language pathologist at the Center for Hearing & Speech, a nonprofit organization providing audiology and speech therapy services to children and adults.
“Congenital hearing loss is hearing loss that is present at birth, and approximately 50 percent of these cases have been attributed to genetic factors,” Cato says. “In addition to heredity, congenital hearing loss can be caused by viruses contracted by the mother during pregnancy, by a premature birth and from lack of oxygen. Hearing loss that is acquired during childhood can be caused by meningitis, measles, mumps, head trauma and noise exposure.”
Parents are often tipped off to a baby’s hearing loss when they notice that the infant does not startle to loud noises or stops babbling, although even deaf babies babble in the first few months of life, explains Richard Hogan, of Ear Care and Skull Base Surgery Audiology Services. Speech delays or speech that is not clear are early signs of hearing loss in children. In some cases, children who seem to be ignoring instructions or not paying attention are actually having trouble hearing conversation.
Early detection is key to developing strategies around medical interventions and speech therapies that allow children with hearing loss to fully experience and participate in activities and school. “Prior to 2002, when the universal newborn hearing screening law took effect, the average age of identification of hearing loss in a child was 3 years,” Hogan says. “After the law took effect, the average age of identification dropped to 3 months of age. Because of this program and education of health care providers, we are able to identify, diagnose and begin rehabilitation in time that a child now has a significantly better opportunity to have a successful educational career.”
Missouri law states that ‘every newborn delivered on or after Jan. 1, 2002, in an ambulatory surgical center or hospital must be screened for hearing loss prior to discharge unless the parents object on religious grounds.’ Health insurance policies and Medicaid are required to cover newborn hearing screenings and additional diagnostic exams.
Hearing aids and cochlear implants allow children to grow up in the hearing world. “Unlike a hearing aid, which amplifies incoming sound, a cochlear implant provides direct electrical stimulation to the auditory (hearing) nerve in the inner ear,” Cato says. “Early intervention programs play a large part in speech and language learning for very young children who have cochlear implants. As a result, profoundly deaf children with cochlear implants are mainstreaming earlier and spending less time in specialized classes and schools for the hearing impaired.”
Any indication that a child is not hearing or speaking at a developmentally appropriate level should be assessed by a physician or audiologist. “Fortunately, most children with speech, language, and hearing problems can be helped,” Cato notes. “Even if the problem cannot be eliminated, we can teach the child strategies to help them cope with their communication disorder or provide them with the appropriate technology. We hope to help the child listen to and express their wants, needs and ideas through improved speech and language skills.”