1. Hearing Loss in Children up to age 1 By Amy Williams CD 315

2. Warning Signs : Lack of Normal Developmental Milestones ( Gordon-Langbein, n.d )  “Hearing loss is invisible, and signs of a hearing loss are subtle in young children” (Gordon-Langbein, n.d.).  Parents need to watch for developmental milestones in their children – if they are not occurring, the children need a hearing evaluation.

3. Normal Milestones (Gordon-Langbein, n.d.)  Birth to 4 months Startle at loud sounds Wake due to noise Crying calms when mom talks Recognize mom’s voice Turn head to sound  4 to 8 months Turn head to sounds outside range of vision Show response and enjoyment to noisy toys Babble as a response to conversation

4. Normal Milestones (Gordon-Langbein, n.d.)  8 to 12 months Change intonation when vocalizing Turn directly to noise Respond to their name Enjoy and respond to music

5. Suspicions (Gordon-Langbein, n.d.)  Make an appointment with your child’s pediatrician  Attend appointment – discuss worries, answer questions relative to suspicions  Pediatrician will refer you to an ENT or Audiologist for further evaluation if needed

6. Audiological Evaluation (Alexander Graham Bell Association for the Deaf and Hard of Hearing, n.d.)  Computerized Testing –Requires no response from child –Not uncomfortable or painful –Automated Brain Stem Response (ABR) – measures brainstem response to sounds through electrodes taped to child’s head –Otoacoustic Emissions (OAE)– Uses a small probe tip (gently and painlessly inserted into the ear canal) to assess the function of the inner ear.  Behavioral Testing –Used when a child is old enough to respond to sounds or play games –Measures the sounds a child hears –Measures how well a child understands words –Can indicate if there is fluid in the middle ear

7. Types of Hearing Loss (Martin & Clark, 2000)  Sensorineural –Permanent –Problem with cochlea or auditory nerve  Conductive –Problem with outer or middle ear –Not permanent – surgical or medical treatment  Mixed –Combination of Sensorineural and Conductive

8. Degree of Hearing Loss (Alexander Graham Bell Association for the Deaf and Hard of Hearing, n.d.)  Mild 15 – 40 dB –Can’t hear whispers at close range  Moderate 40 – 60 dB –Can’t hear normal speech at close range  Severe 60 – 90 dB –Can’t hear speech – only loud noises  Profound – over 90 dB –Can’t hear speech - only very loud noises

9. Emotional Impact (Martin & Clark, 2000)  Parental Reaction –Denial –Anger –Guilt –Confusion –Anxiety  Solution –Support –Information

10. Treatment Options (Alexander Graham Bell Association for the Deaf and Hard of Hearing, n.d.)  Amplification/Hearing Aids  Style –Behind the Ear (BTE) –In the Ear (ITE) –In the Canal (ITC)  Circuitry –Analog/Conventional –Analog/Programmable –Digital/Programmable  Considerations –Price –Children’s growth –Troubleshooting information –Cleaning and maintaining equipment

11. Treatment Options (cont.)  Cochlear Implants –Surgical procedure –Child must be 18 months or older –For a severe to profound loss –Parental involvement is important

12. Communication Options ( Alexander Graham Bell Association for the Deaf and Hard of Hearing, n.d.)  Auditory/Oral  Auditory/Verbal  Cued Speech  Total Communication  Sign Language –American Sign Language –Pidgin Sign Language –Signed Exact English

13. Final Considerations  Importance of parental support and involvement  Early identification and intervention

14. Resources  Alexander Graham Bell Association for the Deaf and Hard of Hearing. (n.d.). So Your Child Has a Hearing Loss: Next Steps for Parents. Retrieved October 12, 2002 from http://www.agbell.org/information/brochure s_parent_so.cfm

15. Resources (Cont.)  Gordon-Langbein, A. (n.d.). Facts About Hearing Loss in Children. Retrieved October 12, 2002, from http://agbell.org/information/brochures_faq.cfm http://agbell.org/information/brochures_faq.cfm http://agbell.org/information/brochures_faq.cfm  Martin, F.N., & Clark, J.G. (2000). Introduction to Audiology. Needham Heights, MA: Allyn & Bacon.