I attended a workshop yesterday on hearing loss in very young children.  Many of you know that, by day, I work as an Early Childhood Interventionist with children ages birth to three many of whom have speech and language delays.  Hearing evaluations are done routinely on these children to

• Each year, 24,000 children are born with hearing loss in the United States.
• In a normal newborn population, the incidence of hearing loss is 2 in 1000 births.
• Most of these children are born to parents who have normal hearing
• Not all states require that hospitals screen babies at birth for possible hearing loss. (Source:  Opening Doors:  Technology and Communication Options for Children with Hearing Loss, United States Department of Education)

• The outer ear which is comprised of the pinna, ear canal and eardrum.
• The middle ear which has the ossicles which are three tiny bones that vibrate when stimulated.  The middle ear is filled with air.  When a young child gets an ear infection, this area becomes filled with fluid which can be problematic.
• The inner ear where the cochlea (a snail shaped object) is filled with fluid and small hair cells which transmit nerve signals to the brain.

 (You can check out a diagram of the ear here   http://www.vestibular.org/images/ear_diagram_lg.gif)

• Conductive.  This type of hearing loss occurs as a result of problems in the outer and middle ear.  It is common for individuals experiencing conductive hearing loss to have difficulty hearing faint sounds or to experience a general reduction in sound level.  Conductive hearing loss can often times be treated medically or surgically.  Common causes include impacted earwax, fluid in the middle ear, a malformation in the outer or middle ear and let’s not forget about foreign objects.  For my son, it was a piece of wadded up paper.  For my niece, it was a pretzel.  That’s right...a pretzel.
• Sensorineural.  This type of hearing loss occurs when there is a problem in the inner ear or the auditory nerve to the brain.  This type of hearing loss is permanent and cannot be medically or surgically corrected.
• Mixed.  Mixed hearing loss involves a combination of conductive and sensorineural hearing problems. 

 A word about otitis media.  Otitis media is the medical term for an inflammation of the inner ear.  The American Speech Language Hearing Association has a wonderful site with comprehensive information on otitis media and the impact it can have on your child’s hearing.  I strongly encourage you to check out this link: www.asha.org/public/hearing/disorders/causes.htm#otitis.

Back to our discussion of hearing loss, there can be a number of causes.  These causes are broken down into to separate categories: 

• Congenital hearing loss is the result of heredity or factors in utero or at the time of birth.  This includes infections like rubella or herpes simplex virus; prematurity, maternal diabetes, toxemia during pregnancy, lack of oxygen, and complications with the Rh factor in blood.
• Acquired hearing loss occurs after birth.  Causes include ear infections, meningitis, measles, encephalitis, chicken pox, influenza, mumps, head injury and noise exposure.

 The following are some red flags to watch for that may be indicative of a hearing loss:

• A family history of hearing loss
• Lack of responsiveness to sounds/voices
• Limited babbling/vocal play
• Cannot be calmed by sound alone
• Delayed speech/language development
• Language development with poor articulation
• Inattentiveness
• Wanting the television or radio louder
• Misunderstanding directions

 There are a number of things that you can do as a parent to make sure your child does not have a hearing loss such as:

• Be sure to have your baby screened after birth
• If your baby fails the initial screening, be sure to get him or her re-screened within three months.
• Know the warning signs for hearing loss.
• Have your child’s hearing screened on a regular basis.
• If you have concerns about your child’s hearing or language development, discuss them with your doctor right away.

I’ll be honest with you, I hadn’t given much thought to my kids hearing when they were infants.  Lucky for me, the hospital and our physician completed hearing screenings and everything was fine.  But as I listened to the speakers discuss the incidence of hearing loss, I wished I would have known more about it when my kids were younger.  I’m hoping that there are other parents out there who will find this important topic as interesting and helpful as I did.

 I used a number of sources in this article including my notes from the wonderful presentation given by Lori Van Riper, Anita Vereb, and Angelique Boerst of the Sound Support Program at the University of Michigan.  Thank you ladies for increasing my awareness on the subject!  Other sources include:

• www.vestibular.org
• www.asha.org
• www.hearingloss.org