Four out of every 1,000 newborns are born with some degree of hearing loss.

Hearing is a critical part of a child�s social, emotional, and cognitive development. Even the presence of a mild hearing loss can affect a child�s speech and language development.

• All newborns must have a hearing screening before being discharged from the hospital to detect hearing loss at birth. Those who have or are planning on giving birth at home or a birthing center should make it their priority to have their child screened within the first three weeks of life.
• Through early detection, it is possible to treat a child�s hearing problems so that they can develop the same as their peers. The Arth speech and hearing clinic recommends that your child�s hearing gets screened early and evaluated regularly to empower and better your child�s life.

• Premature birth
• Complications during birth
• Infections at birth such as cytomegalovirus (CMV), Rubella, and herpes simplex
• Placement on mechanical ventilation system after birth
• Admission to the neonatal intensive care unit (NICU)
• Congenital diaphragmatic hernia or needing ECMO therapy
• Repeated courses of IV antibiotics or diuretics
• Diagnosis of a syndrome such as Down, Usher, Alport or Treacher Collins
• Family history of permanent childhood hearing loss
• Exposure to loud sounds or noises

Hearing loss is the most common birth defect in children, affecting approximately three in 1,000 births. Early Hearing Loss Detection, Diagnosis, and Intervention Program helps to diagnose, track, and treat children before their critical communication growth years.

At Arth Speech & Hearing Clinic we are associated with different hospitals in different cities and organizations in rural and urban areas to track infants who need hearing screenings along with follow-up diagnostic services.

Hearing loss, when left undetected, can negatively impact academic achievements, social and emotional development, along with speech and language acquisition. Through early detection and intervention, a child won�t be left behind.

We have compiled a list of common risk factors for hearing loss. Please contact your physician or one of our clinics if you have any concerns about your child.

• A congenital infection
• Bacterial meningitis
• Chronic middle ear problems
• Conditions/Syndromes associated with hearing loss
• Craniofacial anomalies
• Exposure to ototoxic medications
• An extended stay in NICU � more than 48 hours
• Family history of hearing loss
• Parent or caregiver concern about hearing, speech, language, or development
• Infections during pregnancy such as CMV, herpes, German measles, syphilis and toxoplasmosis
• Low birth weight � less than 1500 grams
• Mechanical ventilation for more than 5 days
• Neurologic diseases such as Hunter syndrome, Freidrich�s ataxia, Charco-Marie-Tooth syndrome
• Problems at birth including jaundice or breathing problems
• Severe hyperbilirubinemia requiring exchange transfusions
• Trauma to the head

Hearing loss can affect those of all ages, including children. Diagnosing and treating hearing loss in the pediatric population requires different instruments than those used on adults. Children may also experience different disorders.

To test the hearing of newborns and infants, subjective tests must be used, as newborns are unable to articulate what they can and cannot hear. Auditory Brainstem Response (ABR) provides information on how a child�s cochlea and the neural pathway are functioning. Electrode stickers are placed on and around their head to measure their brainwave activity in response to sounds.

Otoacoustic Emissions (OAEs) are the barely audible sounds given off by the hairs lining the cochlea. A small earphone is placed into the ear and a sound is played to elicit the release of OAEs. If no OAES are detected, this could mean there is a blockage in the ear canal, fluid in the middle ear, or damage to the hair cells within the cochlea.

For slightly older children, depending on their age, they are either taught to turn their head toward an animated toy or video (visual response) or drop a block in a bucket (conditioned play) when they hear a sound. These versions of pure-tone testing will discern single-sided hearing loss unless headphones are worn.

Two types of speech testing are common. First, is speech detection which is finding the softest word a child can hear? The second is speech recognition which the child repeats back to the word to the tester or the child points to the word on a page. This test may be performed in different environments with different levels of background noise.

Infections of the middle ear are the most common cause of hearing loss in children. An infection is caused by a buildup of fluid within the middle ear. Eustachian tubes are small tubes that connect the middle ear with the back of the throat. In children, these tubes are much smaller and sit horizontally, which means they are more likely to get blocked. These tubes are responsible for regulating pressure and fluid within the middle ear.

A common solution to long-standing middle ear infections is ear tubes. A simple surgery by an Ear Nose and Throat specialist creates a hole in the child�s eardrum, and a small tube is placed within the hole to keep it open. This hole helps to prevent fluid from building up, preventing future ear infections. After a few months, these tubes usually fall out on their own.

Children all learn and develop differently, so it can be difficult to determine whether a baby�s communication abilities are progressing at a normal, healthy rate. Despite huge variations in the process of early childhood development, infants typically follow some universal patterns of speech and hearing growth. Using these patterns, pediatricians can evaluate a child�s development through a set of guidelines called speech-language milestones.

These communication guidelines aren�t just useful for doctors; they�re a helpful tool for parents as well. A basic understanding of speech-language milestones will allow you to assess whether your child�s language development is normal or irregular. Irregular communication development doesn�t always indicate an auditory impairment; however, any child who shows signs of slow development should get a hearing assessment as soon as possible.

Some of the most important speech-language milestones for infants and toddlers are listed below. Normally developing children should be able to perform the tasks described by the end of the milestone�s specified age range.

Speech Milestones

• Age 0-1 year. Infants begin producing basic sounds, like babbling, early in their first year. By their first birthday, they string different multi-tonal sounds together and repeat familiar sounds like mama, dada, or baba.
• Age 1-2 years. Within a year, a child�s language production should transform from incoherent babbling to recognizable speech. By age two, most children can produce about 50 words and can form basic two- or three-word phrases.
• Age 2-3 years. During this year, a child�s vocabulary rapidly expands to hundreds of words. By age three, a toddler should be producing basic sentences of at least two or three words. Toddlers with normal hearing will begin engaging in communication with their parents, teachers, and peers.
• Age 3-4 years. By four, a child�s speech should be grammatically complicated and understandable, even to strangers. Children of this age ask questions, use pronouns and tell stories that are a few sentences long.

• Age 0-1 year. Infants should respond to loud, familiar, or surprising sounds (e.g. music, bangs or thuds, dog barking, their name, whistling, etc.) through actions like movement, eye contact, and speech.
• Age 1-2 years. During this year, children gain an understanding of the names of familiar objects as well as basic commands. By 24 months, children can typically understand and perform commands with two parts (e.g. touch your ear and wiggle your toes).
• Age 2-3 years. During this year, children develop the skill to differentiate between words like �over� and �under.� They also can follow more complicated commands and identify some numbers and colors. Unresponsiveness is common for this age; however, children with normal hearing should still react to loud sounds and give some response when their name is spoken.
• Age 3-4 years. At this age, children recognize and respond when their name is called from another room and display a solid understanding of basic language. Your child should also be able to hear TV, movies, games, and music at the same volume as adults with normal hearing.

If your child is behind on any of these language development benchmarks, it�s imperative to check for hearing impairment right away. Untreated hearing loss can result in major developmental, behavioral, and communication setbacks for young children.

Our pediatric audiologists will take the time to understand your concerns, assess your child�s hearing and develop the best treatment plan for your child�s needs.

It offers a variety of child-friendly hearing products that employ the latest technologies designed to improve the quality of your child�s hearing no matter their age. Just some of the steps our Audiologists will take in fitting a pediatric hearing aid are:

The pediatric hearing loss management process

• Discussing and planning for your child�s specific hearing needs
• Taking an earmold impression
• Ordering and fitting the hearing aids
• Caring for, cleaning, and repairing the hearing aids as needed
• Staying involved and reevaluating your child�s changing hearing needs