Hearing Loss in Children: A Neurological & Developmental Emergency
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ﾠﾠﾠﾠﾠ Professionals who are providing direct services to children with hearing loss should strive to maintain developmental synchrony whenever possible. That is, if a child with hearing loss is to take advantage of these natural stages of neurological and linguistic development, our goal should be to assist the child in acquiring communication outcomes at the same rate and at the same age when typical hearing children would acquire them. For this to happen, newborn screening must occur before the child leaves the hospital or birthing center and a referral to a pediatric audiologist must be immediate. Once the diagnosis is confirmed and amplification (i.e., digital hearing aids) is fitted, prompt implementation of appropriate family-centered early intervention services must occur. ﾠﾠﾠﾠﾠﾠﾠ If the child's parents have chosen a spoken language outcome, intensive and concentrated efforts must focus on building those auditory connections within the brain. Because these areas of the brain haven't been stimulated consistently prior to receiving amplification, the child's first responses may be minimal. However, through consistent exposure to auditory input and planned reinforcement of listening and spoken language, those neural connections will quickly form. The child will begin to respond. If the child has full access to the speech spectrum (i.e., low, mid, and high frequency sounds), he will start to gain greater environmental awareness and begin to form speech sounds, combine those sounds through babbling, and produce first words. By managing the hearing loss, providing intense and consistent intervention, and having high expectations for listening, most children with hearing loss can regain developmental synchrony and progress through these natural stages in the acquisition of spoken language. For children with severe and profound sensorineural hearing loss, cochlear implantation may be necessary, but parents should have the same expectations for developmental synchrony. ﾠﾠﾠﾠﾠﾠﾠ Unfortunately, there is too much variation in the services that are provided to infants and toddlers with hearing loss. Parents are told "to wait until the child reaches the age of 18 months before working on speech development." In other situations, parents are told that "spoken language is not realistic unless the child has a cochlear implant, which most likely won't work anyway." Of course, these so called "recommendations" are simply false and more accurately reflect the professionals' poor training and deep-seeded personal bias. ﾠﾠﾠﾠﾠﾠﾠ Parents must be diligent and obtain the services that support the outcomes they desire for their children with hearing loss. Professionals must recognize that when an infant is diagnosed with a hearing loss, the child is facing a neurological and developmental emergency. If the parents have expressed having a spoken language outcome, then waiting to stimulate those auditory centers is simply unacceptable. As Carol Flexer, Ph.D., a noted pediatric audiologist, professor, and researcher, has stated, "we hear with our brains, the ears are just a way in." If we support this statement, then time cannot be wasted. Neurologically, these children are at risk, and they deserve our focused efforts to obtain developmental synchrony. Their brains can't wait.
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Feb 3, 2010 at 10:46 AM I am a mom of a 7 year old who just received her first pair of hearing aids. I myself have been wearing them for 11 years. Sarah is in the first grade and struggling academically. I did not learn of her moderate loss until last year. Being that it is something that runs in the family I had them tested since birth. I recognized when she was 4 that there may be an issue but it wasnt until last year that we learned of the degree of loss. The reason is unknown. The ENT did exploratory surgery and found no physical reason for it to be so. She has had a tough school experience thus far and now that she has the tools to hear I am seeing a need to teach her how to listen. Her handicap is not easily seen by others as she appears to speak and communicate well. However I am seeing gaps widening and it is becoming increasingly more puzzling to me and her teachers. I have so many questions and need to learn how to help her. My first mistake was thinking that because I am hard of hearing, that I would understand this completely. I was very wrong. My second mistake was trusting her Dr, her audiologist, the deaf and hard of hearing teacher, as well as school staff to point Sarah and I in the right direction. Time is of great importance. Sarah cannot wait any longer. Can you suggest someone for me? A book perhaps? Someone I can talk to to ask these questions too? Thanks for your time.
Feb 5, 2010 at 7:12 AM Staci:
Thank you for your comment and for sharing your and your daughter's story. It certainly sounds as if you need to convene the IEP team and ensure that Sarah is getting all of the necessary support services to be successful. Some of these services/accomodations could be: a personal FM unit for her in the classroom, preferential seating, preteaching/tutoring for upcoming lessons, additional speech-language services, and additional resource support from a teacher of the deaf. There's a ton of information available. You can start with the AG Bell Association for the Deaf & Hard of Hearing at www.agbell.org, and they may have a local chapter in your state. A book that I can recommend is Your Child's Hearing Loss: A Guide for Parents, 2nd Edition, which is published by Plural Publishing (www.pluralpublishing.com). Please let me know if you need additional assistance. I'm happy to help!
Apr 20, 2010 at 12:20 PM Hearing loss in new born is too difficult to diagnose at the starting.Normally parents check for it when there will be problem in speech of child.If hearing loss is diagnose at the early stage then the child would not have speech problem.Thanks for all the nice information.
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