A Doctor's Insights on Infant Hearing Loss

By Susie McGee

Dr. K. Todd Houston was kind enough to share information about the "Hear From the Start, Talk for a Lifetime" campaign with LoveToKnow and give our readers some very interesting and helpful information on infant hearing loss. Dr. K. Todd Houston serves as the executive director & CEO of the Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell). During his four-year tenure in this position, Dr. Houston has positioned AG Bell as a network, resource and advocate for members of the hearing-loss community, their families and the professionals who serve them.

As a speech-language pathologist and a Certified Auditory/Verbal Therapist®, Dr. Houston has cared for children with hearing loss in a wide variety of clinical and community settings, specifically focusing on their spoken language development. Dr. Houston is also an adjunct faculty member at University of Queensland in Australia, and he continues to lecture both nationally and internationally, presenting scientific papers and keynote addresses on a variety of topics related to childhood hearing loss.

In addition to his professional endeavors, Dr. Houston serves on various notable hearing and speech advisory boards, including the Council on the Education of the Deaf, the National Advisory Group at the National Technical Institute for the Deaf, the Board of Hearing International and the Join Together Advisory Board.

What is Hear From the Start, Talk for a Lifetime?

This campaign is designed to help parents get the information they need. The campaign raises awareness of the benefits of early diagnosis and intervention for children who are deaf or hard of hearing, including the ability to use spoken language to communicate. The Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell) will develop parent and professional educational materials, drive advocacy efforts at national and grassroots levels, broadly disseminate the latest research and engage media through public service announcements and other efforts to spread information on hearing loss and the options for addressing it.

At the same time, AG Bell will offer continuing education programs and training to hearing-health and education professionals and provide certification to professionals through the AG Bell Academy for Listening and Spoken Language®. The goal: to ensure that spoken language - and the vast opportunities it offers - becomes a well-known option for children with hearing loss.

By launching this campaign, we're opening the door to life-changing possibilities for children who are deaf or hard of hearing, technologies such as cochlear implants, digital hearing aids and other interventions can help children with hearing loss learn to listen and talk. Now it's time to make people aware of the lasting difference these resources can make.

What Are the Results of a Recent Survey of New and Expectant Mothers?

A recent survey of new and expectant mothers shows a severe lack of awareness about the opportunities for children with hearing loss to learn to listen and talk. This is a concern, given that most babies learn language by hearing it long before they can talk.

In addition, early diagnosis of hearing loss is critical to a child's successful speech and language development. The survey points to the need for significant parent education - and the need for healthcare professionals to actively discuss the issue with them.

Survey highlights include:

Hearing Loss is not "Top of Mind"

The majority of new and expectant moms (55 percent) are not concerned about the possibility of their child experiencing hearing loss - yet it is the No. 1 birth defect in America.

When it comes to their baby's health, only 1 percent of mothers ranked hearing loss as their top concern - even though hearing loss is more common than conditions such as Down syndrome.

Most Moms Unclear About Screening and Intervention Options

More than half (58 percent) of new and expectant mothers who knew about newborn health screenings were unaware that testing for hearing loss is typically part of those screenings.

One-third (33 percent) of the survey respondents admitted they didn't know that early intervention is critical for addressing childhood hearing loss. Yet experts recommend beginning family-centered early intervention programs before a baby is 6 months old to take advantage of the critical time window for learning language.

Only 2 percent of new and expectant mothers volunteered cochlear implant surgery and only 5 percent suggested hearing aids as options for children with hearing loss.

Yet almost all moms (98 percent) said they would be inclined to explore spoken language if their child experienced hearing loss.

What Are the Signs of Hearing Loss in Infants?

Most children with hearing loss can learn to listen and talk - but early intervention is key to take advantage of the critical time window for learning language. Follow-up testing and intervention should begin right away if parents, healthcare providers or educators notice that a baby fails to reach the following milestones:

Birth to Three Months

Do the baby's eyes move in the direction of loud sounds?
Is the baby awakened by loud sounds?

Three Months to Six Months

Does the baby react to a parent's voice?
Has the baby begun to repeat sounds?

Six Months to Ten Months

Does the baby look toward the speaker when his/her name is called?
Does the baby understand common phrases, such as "bye-bye"?

Ten Months to Fifteen Months

Can the baby put sounds together that closely resemble speech?
Does the baby experiment with his or her own voice?

Fifteen Months to Eighteen Months

Is the baby beginning to communicate using single words or two- to three-word sentences?
Is the baby able to follow simple directions?

Eighteen months to Twenty-four months

Does the baby enjoy being read to?
Does the baby understand yes or no questions such as "are you tired?"

How Can Catching Hearing Loss Early Benefit a Child?

Hearing loss affects 12,000 children born in the United States each year - 33 babies a day - making it the most common birth defect. Because most babies learn language by hearing it long before they can talk, a baby's first months and years are critical for learning language and communication skills. For children with hearing loss, early screening, diagnosis and intervention can make a considerable difference.

Causes

More than 95 percent of children who are deaf or hard of hearing have at least one hearing parent. Hearing loss can be caused by a number of factors, including genetic traits, premature birth and infections during pregnancy, as well as meningitis and head injuries.

Screening

A simple test known as universal newborn hearing screening, which is required in most states, can identify most newborns at risk of hearing loss. Infants typically are screened in the hospital or birthing center the day they are born. If they are not screened at birth, all infants should be screened before they are 1 month old, according to national guidelines.

Babies who fail the newborn hearing screening or who do not reach developmental hearing milestones should be evaluated promptly by an audiologist and diagnosed before they are three months old. And even if a baby passes the newborn screening, ongoing monitoring is important, as hearing loss can develop after birth in up to 30 percent of children.

Warning Signs

Because hearing loss can develop throughout childhood and deafness is an invisible handicap, parents need to watch for warning signs. They can use simple tests such as:

Do the baby's eyes move in the direction of loud sounds? (newborn)
Does the baby react to a parent's voice? (3 months to 6 months)
Does the baby look toward the speaker when his/her name is called? (6 months to 10 months)
Can the baby put sounds together that closely resemble speech? (10 months to 15 months)

Interventions

The sooner a child is diagnosed with hearing loss, the better. Experts recommend beginning family-centered early intervention programs (including listening and speech training) before a baby is 6 months old to take advantage of the critical time window for learning language. Historically, the majority of children with hearing loss communicated through sign language, alone or in combination with the spoken word. Now, advances in technologies are providing a greater range of communication options - even for young children. Babies can be fitted with hearing aids before they are 3 months old, and cochlear implants can help children as young as 1 year old.

What Can Parents Do?

Most babies learn language by hearing it long before they can talk, so a baby's first months are critical for learning language and communication skills. That's why it's important to know the signs of hearing loss to help you identify a problem as early as possible. With early intervention, most children who are deaf or hard of hearing can learn to listen and talk as well as other children.

Before Your Baby Turns One Month Old

Make sure your baby is screened for hearing loss in the hospital or birthing center at birth. In many states, newborn hearing screening is automatic. But if your baby was not screened at birth, call the hospital or a hearing-health professional to request a screening before your baby is 1 month old.

Before Your Baby Turns Three Months Old

Schedule a follow-up evaluation with an audiologist if your baby "fails" the newborn hearing screening. Intervention is possible even this early. For example, babies can begin to develop language and communication skills with the help of a hearing aid before they are 3 months old.

Before Your Baby Turns Six Months Old

Enroll in a family-centered early intervention program as soon as possible if your baby is diagnosed with hearing loss. Babies with hearing loss who are enrolled in early intervention programs by the time they are 6 months old can take full advantage of the critical time window for learning language. Find out whether your baby would benefit from other technologies, such as cochlear implant surgery.

Ongoing

Ongoing monitoring is important even if your child passes the newborn hearing screening or a follow-up test. Hearing loss can develop after birth in up to 30 percent of children - and it is an invisible handicap.